JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
study period both in orientation and magnitude. This is to be expected since infectionwith the genus Campylobacter has been identified as one of the main causative episodes of developing GBS. The data used in this study has several limitations worth noting. The LAHIDD database, represents approximately 80% of hospitalizations in the state. While the data is representative of Louisiana’s hospitalizations, case counts most likely are underestimates of the true number of cases in Louisiana. Secondly, it is nearly impossible to draw any concrete conclusion regarding the reason for increases in GBS cases using concurrent diagnoses data from LAHIDD or IDRIS campylobacteriosis due to the variance in amount of time between an etiologic event such as an episode of bronchitis and the development of GBS signs and symptoms.
Starting in 2015, the ICD10 codes (G61.0) will be used.
REFERENCES
1. Zantner AE, JohannC, Strubel A, et al. Seroprevalence of campylobacteriosis and relevant post-infectious sequelae. Eur J Clin Microbiol Infect Dis 2014; 6:1019-1027. 2. Ho TW, Mishu B, Gao CY, et al. Guillain-Barre syndrome in northern China. Relationship to Campylobacter jejuni infection and anti-glycolipid antibodies. Brain 1995; 118:597-605. 3. Ravi V, Taly AB, Shankar SK, et al. Association of Japanese encephalitis virus infection with Guillain-Barré syndrome in endemic areas of south India. Acta Neurol Scand 1994;90:67-72 4. Cao-Lormeau VM, Blake A, Mons S, et al. Guillain-Barré syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. 5. Lancet 2016;387:1531-1539 CDC Q&A re GBS https://www.cdc.gov/ h1n1flu/vaccination/gbd_qa.htm 2009 6. Yoshikawa H. Epidemiology of Guillain Barré Syndrome (in Japanese). Brain & Nerve 2015 (11): 1305-1311 7. Sipilä JOT, Soilu-Hännimen M, Ruuskanen JO, Kytö V. Epidemiology of Guillain Barré Syndrome in Finland 2004-2014. J Peripher Nerv Syst 2017 (22)4: 440-445 8. McGrogan A, Madle GC, Seaman HE, de Vries CS. The epidemiology of Guillain Barré Syndrome, a systematic literature review. Neuroepidemiology 2009. 32: 150-163 Benjamin Munley, MPH, Sean Simonson, MPH, and Raoult Ratard, MD are affiliated with the Infectious Disease Epidemiology Section of the Louisiana Office of Public Health.
Going Forward
The Louisiana Sanitary Code (LAC 51:II.105) requires that certain diseases or conditions of public health importance be reported to the Office of Public Health (OPH). Depending on the severity and risk to public health, each condition is categorized in a certain Class which determines how quickly it must be reported. The OPH Infectious Disease Epidemiology (ID Epi) Section is in the process of making GBS a reportable condition in the State of Louisiana. This will allow ID Epi to more accurately track the disease, identify any geographic or population trends occurring, and make associations between GBS and other conditions or infections. All cases of Zika Viral infections are investigated thoroughly and any GBS occurring as a complication would be documented. In the state of Louisiana, a case of GBS syndrome is defined as an illness characterized by clinical symptoms beginning with progressive ascending weakness (usually beginning peripherally in the limbs), impairment of position and vibration sense, reduced or absent tendon reflexes, and an elevated CSF protein with abnormal EMG results (indicating motor neuron involvement). For surveillance and reporting purposes, a confirmed case is defined as a clinically compatible physician- diagnosed case of GBS. Upon receipt of a report of GBS, ID Epi will conduct a case investigation in order to elicit more information about each case. These investigations will collect standard information; such as symptom onset, patient demographics, symptom listings, and hospitalization status. Unique to GBS, these investigations will also collect information related to antecedent diagnoses or symptoms (such as gastrointestinal illnesses or viral infections), any available CSF lab work results, and any recent travel (in order to investigate potential linkage to flaviviruses). This data will help ID Epi to better characterize any trends related to GBS in Louisiana.
To assess the completeness of reporting of GBS, the section will continue monitoring the LAHIDD database for GBS diagnosis.
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