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Guillain-Barre Syndrome and H1N1 Flu Vaccine

  • Date: 2009/08/16 (Rev: 2018/03/16) Thomas C. Weiss - Disabled World
  • Synopsis : Article looks at the link between Guillain-Barre Syndrome and infections such as the influenza and swine flu (H1N1) vaccine.

Main Document

Guillain-Barre Syndrome is linked to infections such as the flu, yet it has also been suggested that a previous swine flu vaccine caused cases of Guillain-Barre syndrome in America in the 1976 pandemic when officials rushed a vaccine to citizens after an outbreak. Approximately forty-million people were given the vaccine; doctors reported an increase in Guillain-Barre syndrome, and twenty-five people died before the immunization program was ended.

Guillain-Barre (gee-YAH-buh-RAY) syndrome, also known as Guillain-Barre-Strohl syndrome or Landry's paralysis, is a rare disorder in which your body's immune system attacks your nerves.

Weakness and tingling in your extremities are usually the first symptoms.

The disease is usually triggered by an infection - which provokes immune-mediated nerve dysfunction.

Doctors are not absolutely certain whether or not the flu itself, or the vaccine was responsible for causing Guillain-Barre syndrome in those affected. The H1N1 vaccine being used in America is a different one that the one that was used thirty years ago, although doctors are being asked to report cases of Guillain-Barre syndrome. There is debate over the vaccine, with some doctors suggesting that it may even prevent the syndrome. In Britain, Guillain-Barre syndrome affects about one-thousand five-hundred people each year. A letter, sent by six-hundred neurologists on July 29th, expresses concern that the vaccine itself could cause serious complications, referring to the flu vaccine of 1976 in America.

During the 1976 flu vaccinations five-hundred people were diagnosed with Guillain-Barre syndrome. The vaccine was withdrawn after a period of only ten weeks because of the link with Guillain-Barre syndrome. The vaccine could have increased a person's risk of contracting Guillain-Barre syndrome by a factor of eight times. More people died from the vaccination than from the swine flu. The United States Government was forced to pay millions of dollars to people who were affected

There has already been some concern expressed that the new H1N1 vaccine has not been tested sufficiently. There is concern that the effects of the vaccine, particularly on children, remain unknown - even as the Fall flu season approaches in America. One senior British neurologist stated that he would not get the vaccine because of the risk of Guillain-Barre syndrome. Meanwhile, the focus of the vaccination program in America is to give the vaccine to everyone between the ages of six months and sixty-five years with an underlying health issue, as well as women who are pregnant and health care providers.

Defining Guillain-Barre Syndrome

Guillain-Barre syndrome is a disorder that attacks the body through the immune system and the person's peripheral nervous system. The first symptoms a person commonly experiences involve different degrees of tingling sensations and weakness in their legs. Many times, the sensations and weakness continue to spread to other areas of the person's body, such as their arms and upper body. The symptoms may increase in intensity, reaching the point where the person is unable to use their muscles and they become paralyzed, or nearly so. When a person reaches this point the disorder becomes life-threatening and a medical emergency.

Once Guillain-Barre syndrome becomes life-threatening, the person is many times placed on a respirator for breathing assistance. The majority of persons with Guillain-Barre syndrome do recover, even though some people do continue to have muscle weakness. The syndrome usually happens between a few days to weeks after someone has experienced symptoms of either a gastrointestinal or respiratory viral infection. On occasion, either a vaccination or surgery will trigger Guillain-Barre syndrome.

Medical science does not understand why Guillain-Barre syndrome affects some people but not others. What is known is that a person's immune system starts to attack itself causing an autoimmune disease. Persons who are affected commonly lose reflexes such as knee-jerks, and signals that travel along their nerves are slower. Doctors use a nerve conduction velocity test (NCV) to help them diagnose the syndrome. Persons with Guillain-Barre syndrome have cerebrospinal fluid that has more protein that usual, leading doctors to perform a spinal tap if needed to diagnose the syndrome.

Treatment

At this time there is no known cure for Guillain-Barre syndrome. Therapies may decrease the severity of the disorder while accelerating recovery. There are a variety of ways to treat the complications associated with the syndrome, such as plasmapheresis and high-dose immunoglobulin therapy. Plasmapheresis appears to reduce both the duration and severity of episodes of the disorder. High dose immunoglobulin therapy involves intravenous injections of proteins which, in small amounts, are used by the person's immune system to attack invading organisms. Research has found that administering high doses of immunoglobulins to persons with Guillain-Barre syndrome may decrease their immune system's attack on the nervous system. Most importantly, keeping the person's body functioning during recovery is a critical goal. Keeping a person's body functioning may involve the use of a heart monitor, respirator, or additional machines which assist in body function.

Prognosis

The reason that Guillain-Barre syndrome is particularly devastating is because it appears suddenly and is unexpected at onset. The majority of people reach the point of greatest weakness within their first two weeks after they first experience symptoms. By the third week of illness nearly ninety-percent of all persons affected by the syndrome are at their weakest. Recovering from Guillain-Barre syndrome may take anywhere from a few weeks to several years. Around thirty-percent of persons affected by this syndrome still experience residual weakness after three years. Approximately three-percent experience a relapse of muscle weakness and tingling sensations several years after their initial illness.

Quick Facts:

  • The exact cause of Guillain-Barre syndrome is unknown.
  • In 1976 there was a small increased risk of GBS following vaccination with an influenza vaccine made to protect against a swine flu virus.
  • The symptoms of Guillain-Barre syndrome usually develop two to four weeks after a minor infection, such as a cold, sore throat or gastroenteritis (an infection of the stomach and bowel).
  • 25% of people with Guillain-Barre syndrome develop weakness of the breathing muscles leading to respiratory failure, the inability to breathe adequately to maintain healthy levels of oxygen and/or carbon dioxide in the blood.
  • Anyone can develop GBS; however, it is more common among older adults. The incidence of GBS increases with age, and people older than 50 years are at greatest risk for developing GBS.
  • The background rate for GBS in the U.S. is about 80 to 160 cases of GBS each week, regardless of vaccination.
  • Guillain-Barre syndrome can lead to death as a result of a number of complications: severe infections, blood clots, and cardiac arrest likely due to autonomic neuropathy. Despite optimum care this occurs in about 5% of cases.

Statistics

  • Men are more likely to develop Guillain-Barre syndrome than women; the relative risk for men is 1.78 compared to women.
  • Children and young adults are less likely to be affected than the elderly: the risk increases by 20% for every decade of life.
  • In Western countries, the incidence (number of new episodes per year) has been estimated to be between 0.89 and 1.89 cases per 100,000 people.
  • In Europe and the United States, 60 to 80% of people with Guillain-Barre syndrome have the demyelinating subtype (AIDP), and AMAN affects only a small number (6-7%). In Asia and Central and South America, that proportion is significantly higher (30-65%).
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