guillain-barré syndrome and preceding infection with campylobacter, influenza and epstein-barr virus in the general practice research database格林-巴利综合征和前感染弯曲杆菌、流感和巴尔病毒一般实践研究数据库.pdfVIP

´ Guillain-Barre Syndrome and Preceding Infection with Campylobacter, Influenza and Epstein-Barr Virus in the General Practice Research Database 1,2 3 4 4 4 1 Clarence C. Tam *, Sarah J. O’Brien , Irene Petersen , Amir Islam , Andrew Hayward , Laura C. Rodrigues 1 Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom, 2 Environmental and Enteric Diseases Department, Health Protection Agency Centre for Infections, London, United Kingdom, 3 Division of Medicine and Neuroscience, School of Medicine, University of Manchester, Salford, United Kingdom, 4 Department of Primary Care and Population Sciences, University College, London, London, United Kingdom Background. A number of infectious agents have previously been suggested as risk factors for the development of Guillain- ´ Barre syndrome (GBS), but robust epidemiologic evidence for these associations is lacking. Methods and Findings. We conducted a nested case-control study using data from the United Kingdom General Practice Research Database between 1991 and 2001. Controls were matched to cases on general practice clinic, sex, year of birth and date of outcome diagnosis in their matched case. We found positive associations between GBS and infection with Campylobacter, Epstein-Barr virus and influenza-like illness in the previous two months, as well as evidence of a protective effect of influenza vaccination. After correction for under-ascertainment of Campylobacter infection, the excess risk of GBS following Campylobacter enteritis was 60-fold and 20% of GBS cases were attributable to this