Viral infection and GBS

Q: Which of the following viruses is mostly associated with Guillain Barré Syndrome (GBS)? - select one

A) Campylobacter jejuni 

B) Cytomegalovirus 

C) Influenza A and B 

D) HIV

E) Ζikа virus 

Answer: A

According to the International Guillain Barré Syndrome Outcome Study, about three-fourths of patients have a triggering event a month before GBЅ. Although upper respiratory tract infection seems higher than gastroenteritis, Campylobacter jejuni gastroenteritis is the most common precipitant of GΒS, identified in almost one out of every four cases. Moreover, it is not necessary to have any diarrheal symptoms. Only 70 percent of C. jejuni-positive patients reported diarrheal illness three months prior.

The risk for developing GBЅ after acquiring a symptomatic episode of C. jejuni is 100-fold within 2 months than the general population.

Different strains of GBS have different effects, like strain O-19 in Japan and strain O-41 in South Αfriса have a higher risk. Many other viruses, including COVID-19 (as well as choices B, C, and D), are reported, but no strong association has been found yet.

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References:

1. Rees JH, Soudain SE, Gregson NA, Hughes RA. Campylobacter jejuni infection and Guillain-Barré syndrome. N Engl J Med 1995; 333:1374.

2. Leonhard SE, van der Eijk AA, Andersen H, et al. An International Perspective on Preceding Infections in Guillain-Barré Syndrome: The IGOS-1000 Cohort. Neurology 2022; 99:e1299.

3. Doets AY, Verboon C, van den Berg B, et al. Regional variation of Guillain-Barré syndrome. Brain 2018; 141:2866.

4. McCarthy N, Giesecke J. Incidence of Guillain-Barré syndrome following infection with Campylobacter jejuni. Am J Epidemiol 2001; 153:610.