Guillain Barre syndrome has been described as “one of the best examples of a post infectious immune disease” (Ref. 1). It is also the most common form of neuromuscular paralysis in developed countries, and the only autoimmune disease to be strongly linked to a vaccination.
Autoimmune diseases in general are not well understood. In many cases, they appear to be triggered by ordinary infections. The immune system reacts to kill the invading microbe, and then continues to run in high gear. One hypothesis is that the invader stimulates the adaptive immune system to misidentify some part of the body's own cells as part of the infection. Guillian Barre syndrome is linked to infections with:
1. Campylobacter jejuni, a bacteria that causes diarrhea,
2. Cytomegalovirus, which is a silent infection with no symptoms in 50% to 70% of Americans. It can cause disease in babies and in people with weakened immune systems.
3. Epstein Barr virus, a common virus that causes mononucleosis
4. Upper respiratory illnesses from a variety of pathogens.
There has been concern that if infections can trigger autoimmune disease, then maybe vaccinations can too. The 1976-77 swine flu vaccine in the United States was linked to an increase in cases of Guillain Barre syndrome which started within 5 weeks after the vaccine. The risk was estimated at one case of Guillain Barre syndrome per 100,000 vaccines. For flu vaccines since that time, the risk is estimated at one case per million vaccinations. The National Vaccine Injury program provides legal expenses and possible compensation for individuals who experience adverse effects following vaccination.
The symptoms of Guillain Barre syndrome include weakness or paralysis of the arms and legs, which may progress to full quadriplegia, and respiratory difficulty. In severe cases, positive pressure ventilation may be required. Recovery usually starts within 2 – 4 weeks of the first symptoms, but many patients need months of rehabilitation. The primary treatment is good intensive care with respiratory support when needed. Immunotherapies including plasma exchange and intravenous immunoglobulin have shown positive results. Steroids are generally not effective.
Guillian Barre syndrome affects mostly young people and may cause long term disability. However, approximately 80% are back on their feet within 6 months.
References:
1. Winer JB, “Guillain Barre syndrome”, J Clin Pathol: Mol Pathol 2001;54:381-385.
2. Khan F, “Rehabilitation in Guillian Barre syndrome”, Australian Family Physician 2004 Dec; 33(12): 1013-1017.
3. Vial T et al, “Autoimmune diseases and vaccinationations”, Eur J Dermatol 2004; 14: 86-90.
4. National Vaccine Injury Compensation Program:
https://www.empowher.com/news/herarticle/2009/11/03/national-vaccine-injury-compensation-program-part-1-who-qualifies
5. Cytomegalovirus information from the Centers for Disease Control:
http://www.cdc.gov/cmv/facts.htm
6. Epstein Barr virus information from the National Library of Medicine:
http://www.nlm.nih.gov/medlineplus/tutorials/epsteinbarrvirusmono/id299103.pdf
7. Campylobacter jejuni information from the FDA:
http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm070024.htm
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.