Esteghamati Abdoulreza, Gouya Mohammad Mehdi, Keshtkar Abbas Ali, Mahoney Frank
Center of Disease Control and Prevention, Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran.
Vaccine. 2008 Sep 15;26(39):5058-61. doi: 10.1016/j.vaccine.2008.07.014. Epub 2008 Jul 26.
Case reports and epidemiologic studies have reported a relation between different vaccines including measles, rubella, mumps and Guillain-Barre syndrome (GBS). In this study we investigated relation between receiving measles and/or rubella vaccines and occurrence of GBS after national immunization campaign in 2003 in Iran.
We used the national surveillance system for acute flaccid paralysis from the beginning of 2002 to the end of 2004 and studied the incidence of GBS disease among 5-14-year-old children. The 3-year time span of the study was divided into fifteen 10 weeks intervals and the number of reported and confirmed GBS case reports in each time period was analyzed supposing their distribution was according to Poisson distribution.
From 2002 through 2004 there were 370 patients confirmed GBS case reports among persons 5-14 years of age. The annual incidence in this age group remained relatively constant over the 3-year period and ranged from 0.65 per 100,000 population in 2004 to 0.76 in 2003. The estimated average annual incidence of GBS in persons <15 years of age was 1/100,000 (CI 95%: 0.88-1.13), and 0.7/100,000 in persons 5-14 years of age (CI 95%: 0.58-0.83). No obvious seasonal pattern in GBS occurrence was observed. The mean number of GBS patients during each 10 week study interval was 23.8. Twenty-five patients with GBS were reported in the time period which coincided with national immunization campaign. The probability of occurring >or=25 cases of GBS in that time period according to Poison distribution with expected case numbers of 23-8 is equal to 0.43 (p=0.43).
The yearly incidence rate of GBS in this study was similar to other studies. According to our results, there was no increase in GBS Incidence in the 4 weeks national Immunization campaign and 6 weeks after it in comparison to other 10 weeks periods before or after this time period.
病例报告和流行病学研究报告了包括麻疹、风疹、腮腺炎疫苗在内的不同疫苗与吉兰 - 巴雷综合征（GBS）之间的关系。在本研究中，我们调查了2003年伊朗全国免疫活动后接种麻疹和/或风疹疫苗与GBS发生之间的关系。
我们使用了2002年初至2004年底的全国急性弛缓性麻痹监测系统，研究了5 - 14岁儿童中GBS疾病的发病率。研究的3年时间跨度分为15个10周的时间段，并假设报告和确诊的GBS病例分布符合泊松分布，分析每个时间段内的病例数。
2002年至2004年期间，5 - 14岁人群中有370例确诊为GBS的病例报告。该年龄组的年发病率在3年期间保持相对稳定，范围从2004年的每10万人0.65例到2003年的0.76例。估计<15岁人群中GBS的年平均发病率为1/10万（95%置信区间：0.88 - 1.13），5 - 14岁人群中为0.7/10万（95%置信区间：0.58 - 0.83）。未观察到GBS发生的明显季节性模式。每个10周研究时间段内GBS患者的平均数量为23.8例。在与全国免疫活动同期的时间段内报告了25例GBS患者。根据泊松分布，预期病例数为23.8时，该时间段内发生≥25例GBS病例的概率等于0.43（p = 0.43）。
本研究中GBS的年发病率与其他研究相似。根据我们的结果，与该时间段之前或之后的其他10周时间段相比，在为期4周的全国免疫活动期间及其后6周内，GBS发病率没有增加。
