000056140 001__ 56140 000056140 005__ 20200221144312.0 000056140 0247_ $$2doi$$a10.1186/s12883-016-0598-z 000056140 0248_ $$2sideral$$a95198 000056140 037__ $$aART-2016-95198 000056140 041__ $$aeng 000056140 100__ $$aAlcalde-Cabero, E. 000056140 245__ $$aGuillain-Barré syndrome following the 2009 pandemic monovalent and seasonal trivalent influenza vaccination campaigns in Spain from 2009 to 2011: Outcomes from active surveillance by a neurologist network, and records from a country-wide hospital discharge database 000056140 260__ $$c2016 000056140 5060_ $$aAccess copy available to the general public$$fUnrestricted 000056140 5203_ $$aBackground: Studies have shown a slight excess risk in Guillain-Barré syndrome (GBS) incidence associated with A(H1N1)pdm09 vaccination campaign and seasonal trivalent influenza vaccine immunisations in 2009-2010. We aimed to assess the incidence of GBS as a potential adverse effect of A(H1N1)pdm09 vaccination. Methods: A neurologist-led network, active at the neurology departments of ten general hospitals serving an adult population of 4.68 million, conducted GBS surveillance in Spain in 2009-2011. The network, established in 1996, carried out a retrospective and a prospective study to estimate monthly alarm thresholds in GBS incidence and tested them in 1998-1999 in a pilot study. Such incidence thresholds additionally to observation of GBS cases with immunisation antecedent in the 42 days prior to clinical onset were taken as alarm signals for 2009-2011, since November 2009 onwards. For purpose of surveillance, in 2009 we updated both the available centres and the populations served by the network. We also did a retrospective countrywide review of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis from January 2009 to December 2011. Results: Among 141 confirmed of 148 notified cases of GBS or Miller-Fisher syndrome, Brighton 1-2 criteria in 96 %, not a single patient was identified with clinical onset during the 42-day time interval following A(H1N1)pdm09 vaccination. In contrast, seven cases were seen during a similar period after seasonal campaigns. Monthly incidence figures did not, however, exceed the upper 95 % CI limit of expected incidence. A retrospective countrywide review of the registry of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis did not suggest higher admission rates in critical months across the period December 2009-February 2010. Conclusions: Despite limited power and underlying reporting bias in 2010-2011, an increase in GBS incidence over background GBS, associated with A(H1N1)pdm09 monovalent or trivalent influenza immunisations, appears unlikely. 000056140 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/ 000056140 590__ $$a2.006$$b2016 000056140 591__ $$aCLINICAL NEUROLOGY$$b124 / 194 = 0.639$$c2016$$dQ3$$eT2 000056140 592__ $$a1.093$$b2016 000056140 593__ $$aMedicine (miscellaneous)$$c2016$$dQ1 000056140 593__ $$aNeurology (clinical)$$c2016$$dQ2 000056140 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000056140 700__ $$aAlmazán-Isla, J. 000056140 700__ $$aGarcía López, F.J. 000056140 700__ $$0(orcid)0000-0002-9788-2083$$aAra-Callizo, J. 000056140 700__ $$aAvellanal, F. 000056140 700__ $$aCasasnovas, C. 000056140 700__ $$aCemillán, C. 000056140 700__ $$aCuadrado, J.I. 000056140 700__ $$aDuarte, J. 000056140 700__ $$aFernández-Pérez, M.D. 000056140 700__ $$aFernándezÓscar 000056140 700__ $$aMerino, J.A.G. 000056140 700__ $$aMontero, R.G. 000056140 700__ $$aMontero, D. 000056140 700__ $$aPardo, J. 000056140 700__ $$aRodríguez-Rivera, F.J. 000056140 700__ $$aRuiz-Tovar, M. 000056140 700__ $$aDe Pedro-Cuesta, J. 000056140 773__ $$g16, 1 (2016), [13 pp]$$pBMC neurol.$$tBMC Neurology$$x1471-2377 000056140 8564_ $$s572290$$uhttps://zaguan.unizar.es/record/56140/files/texto_completo.pdf$$yVersión publicada 000056140 8564_ $$s80290$$uhttps://zaguan.unizar.es/record/56140/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000056140 909CO $$ooai:zaguan.unizar.es:56140$$particulos$$pdriver 000056140 951__ $$a2020-02-21-13:37:53 000056140 980__ $$aARTICLE