Centers for Disease Control and Prevention, Atlanta, GA, USA.
Unidad de Vigilancia Epidemiologica, Hermosillo, Sonora, Mexico.
Epidemiol Infect. 2014 May;142(5):1089-99. doi: 10.1017/S0950268813001908. Epub 2013 Aug 7.
In June 2011, a cluster of suspected cases of Guillain-Barré syndrome (GBS), which can follow Campylobacter jejuni infection, was identified in San Luis Río Colorado (SLRC), Sonora, Mexico and Yuma County, Arizona, USA. An outbreak investigation identified 26 patients (18 from Sonora, eight from Arizona) with onset of GBS 4 May-21 July 2011, exceeding the expected number of cases (n = 1-2). Twenty-one (81%) patients reported antecedent diarrhoea, and 61% of 18 patients tested were seropositive for C. jejuni IgM antibodies. In a case-control study matched on age group, sex, ethnicity, and neighbourhood of residence, all Arizona GBS patients travelled to SLRC during the exposure period vs. 45% of matched controls (matched odds ratio 8·1, 95% confidence interval 1·5-∞). Exposure information and an environmental assessment suggested that GBS cases resulted from a large outbreak of C. jejuni infection from inadequately disinfected tap water in SLRC. Binational collaboration was essential in investigating this cross-border GBS outbreak, the first in mainland North America since 1976.
2011 年 6 月，在墨西哥索诺拉州圣路易斯里奥科罗拉多（SLRC）和美国亚利桑那州尤马县发现了一组疑似吉兰-巴雷综合征（GBS）病例，这种疾病可能与空肠弯曲菌感染有关。暴发调查确定了 26 名（18 名来自索诺拉州，8 名来自亚利桑那州）GBS 患者，发病时间为 2011 年 5 月 4 日至 7 月 21 日，超过了预期病例数（n=1-2）。21 名（81%）患者报告有腹泻前驱史，18 名患者中有 61%的血清抗空肠弯曲菌 IgM 抗体呈阳性。在一项按年龄组、性别、种族和居住地匹配的病例对照研究中，所有亚利桑那州 GBS 患者在暴露期间均前往 SLRC，而匹配对照者中这一比例为 45%（匹配比值比 8.1，95%置信区间 1.5-∞）。暴露信息和环境评估表明，GBS 病例是由于 SLRC 未充分消毒的自来水引起的空肠弯曲菌大规模感染暴发所致。此次跨边境 GBS 暴发的调查涉及美墨两国，是自 1976 年以来在北美大陆发生的首例此类暴发。
