Guillain-Barré syndrome after exposure to influenza virus

The Lancet Infectious Diseases

Volumn 10, Issue 9, 2010, Pages 643-651

  Lehmann, Helmar C ^a   Hartung, Hans Peter ^a   Kieseier, Bernd C ^a   Hughes, Richard AC ^b  

^a HEINRICH HEINE UNIVERSITY   (Germany)

^b UNIVERSITY COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

GANGLIOSIDE GD 1B; GANGLIOSIDE GQ 1B; INFLUENZA VACCINE; OSELTAMIVIR; VIRUS SIALIDASE; ZANAMIVIR;

DRUG SURVEILLANCE PROGRAM; ENZYME INHIBITION; FLU LIKE SYNDROME; GUILLAIN BARRE SYNDROME; HEALTH PROGRAM; HUMAN; INCIDENCE; INFLUENZA; INFLUENZA VACCINATION; INFLUENZA VIRUS A H1N1; NONHUMAN; PANDEMIC INFLUENZA; PRIORITY JOURNAL; REVIEW; UPPER RESPIRATORY TRACT INFECTION; CAMPYLOBACTERIOSIS; CLASSIFICATION; COMPLICATION; GENETIC VARIABILITY; GENETICS; GUILLAIN-BARRE SYNDROME; IMMUNOLOGY; ORTHOMYXOVIRUS; PATHOPHYSIOLOGY; RESPIRATORY TRACT INFECTION; SEASON;

CAMPYLOBACTER INFECTIONS; GENETIC VARIATION; GUILLAIN-BARRE SYNDROME; HUMANS; INFLUENZA A VIRUS, H1N1 SUBTYPE; INFLUENZA VACCINES; INFLUENZA, HUMAN; ORTHOMYXOVIRIDAE; RESPIRATORY TRACT INFECTIONS; SEASONS;

EID: 77955916539     PISSN: 14733099     EISSN: None     Source Type: Journal    
DOI: 10.1016/S1473-3099(10)70140-7     Document Type: Review

References (117)

1. Black S, Eskola J, Siegrist C, et al. Importance of background rates of disease in assessment of vaccine safety during mass immunisation with pandemic H1N1 influenza vaccines. Lancet 2009, 374:2115-2122.
2. Evans D, Cauchemez S, Hayden F " Prepandemic" immunization for novel influenza viruses, " swine flu" vaccine, Guillain-Barré syndrome, and the detection of rare severe adverse events. J Infect Dis 2009, 200:321-328.
3. Nicholson K, Wood J, Zambon M Influenza. Lancet 2003, 362:1733-1745.
4. Dawood F, Jain S, Finelli L, et al. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009, 360:2605-2615.
5. Schonberger L, Bregman D, Sullivan-Bolyai J, et al. Guillain-Barré syndrome following vaccination in the National Influenza Immunization Program, United States, 1976-1977. Am J Epidemiol 1979, 110:105-123.
6. Iskander J, Broder K Monitoring the safety of annual and pandemic influenza vaccines: lessons from the US experience. Expert Rev Vaccines 2008, 7:75-82.
7. Stowe J, Andrews N, Wise L, Miller E Investigation of the temporal association of Guillain-Barré syndrome with influenza vaccine and influenzalike illness using the United Kingdom General Practice Research Database. Am J Epidemiol 2009, 169:382-388.
8. Tam C, O'Brien S, Petersen I, Islam A, Hayward A, Rodrigues L Guillain-Barré syndrome and preceding infection with campylobacter, influenza and Epstein-Barr virus in the general practice research database. PLoS One 2007, 2:e344.
9. van Doorn PA, Ruts L, Jacobs BC Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol 2008, 7:939-950.
10. Hughes RA, Cornblath DR Guillain-Barré syndrome. Lancet 2005, 366:1653-1666.
11. Hartung HP, Willison HJ, Kieseier BC Acute immunoinflammatory neuropathy: update on Guillain-Barré syndrome. Curr Opin Neurol 2002, 15:571-577.
12. Ho TW, Mishu B, Li CY, et al. Guillain-Barré syndrome in northern China. Relationship to Campylobacter jejuni infection and anti-glycolipid antibodies. Brain 1995, 118:597-605.
13. Ramos-Alvarez M, Bessudo L, Sabin AB Paralytic syndromes associated with noninflammatory cytoplasmic or nuclear neuronopathy. Acute paralytic disease in Mexican children, neuropathologically distinguishable from Landry-Guillain-Barré syndrome. JAMA 1969, 207:1481-1492.
14. Yuki N Carbohydrate mimicry: a new paradigm of autoimmune diseases. Curr Opin Immunol 2005, 17:577-582.
15. Halstead SK, Humphreys PD, Goodfellow JA, Wagner ER, Smith RA, Willison HJ Complement inhibition abrogates nerve terminal injury in Miller Fisher syndrome. Ann Neurol 2005, 58:203-210.
16. Overell JR, Willison HJ Recent developments in Miller Fisher syndrome and related disorders. Curr Opin Neurol 2005, 18:562-566.
17. Willison HJ The immunobiology of Guillain-Barré syndromes. J Peripher Nerv Syst 2005, 10:94-112.
18. O'Leary CP, Veitch J, Durward WF, Thomas AM, Rees JH, Willison HJ Acute oropharyngeal palsy is associated with antibodies to GQ1b and GT1a gangliosides. J Neurol Neurosurg Psychiatry 1996, 61:649-651.
19. Rees JH, Thompson RD, Smeeton NC, Hughes RA Epidemiological study of Guillain-Barré syndrome in south east England. J Neurol Neurosurg Psychiatry 1998, 64:74-77.
20. Hughes RA, Rees JH Clinical and epidemiologic features of Guillain-Barré syndrome. J Infect Dis 1997, 176(suppl 2):S92-S98.
21. Govoni V, Granieri E Epidemiology of the Guillain-Barré syndrome. Curr Opin Neurol 2001, 14:605-613.
22. Cheng Q, Jiang GX, Fredrikson S, Link H, De Pedro-Cuesta J Incidence of Guillain-Barré syndrome in Sweden 1996. Eur J Neurol 2000, 7:11-16.
23. Sedano MJ, Calleja J, Canga E, Berciano J Guillain-Barré syndrome in Cantabria, Spain. An epidemiological and clinical study. Acta Neurol Scand 1994, 89:287-292.
24. Lehmann HC, Kohne A, zu Horste GM, Kieseier BC Incidence of Guillain-Barré syndrome in Germany. J Peripher Nerv Syst 2007, 12:285.
25. Rees JH, Soudain SE, Gregson NA, Hughes RA Campylobacter jejuni infection and Guillain-Barré syndrome. N Engl J Med 1995, 333:1374-1379.
26. Jacobs BC, Rothbarth PH, van der Meche FG, et al. The spectrum of antecedent infections in Guillain-Barré syndrome: a case-control study. Neurology 1998, 51:1110-1115.
27. Kieseier BC, Kiefer R, Gold R, Hemmer B, Willison HJ, Hartung HP Advances in understanding and treatment of immune-mediated disorders of the peripheral nervous system. Muscle Nerve 2004, 30:131-156.
28. zu Horste G Meyer, Hartung HP, Kieseier BC From bench to bedside-experimental rationale for immune-specific therapies in the inflamed peripheral nerve. Nat Clin Pract Neurol 2007, 3:198-211.
29. Yuki N Infectious origins of, and molecular mimicry in, Guillain-Barré and Fisher syndromes. Lancet Infect Dis 2001, 1:29-37.
30. Griffin JW, Li CY, Ho TW, et al. Guillain-Barré syndrome in northern China. The spectrum of neuropathological changes in clinically defined cases. Brain 1995, 118:577-595.
31. Asbury AK, Arnason BG, Adams RD The inflammatory lesion in idiopathic polyneuritis. Medicine 1969, 4:173-215.
32. Hall SM, Hughes RA, Atkinson PF, McColl I, Gale A Motor nerve biopsy in severe Guillain-Barré syndrome. Ann Neurol 1992, 31:441-444.
33. Massaro ME, Rodriguez EC, Pociecha J, et al. Nerve biopsy in children with severe Guillain-Barré syndrome and inexcitable motor nerves. Neurology 1998, 51:394-398.
34. Hafer-Macko C, Hsieh ST, Li CY, et al. Acute motor axonal neuropathy: an antibody-mediated attack on axolemma. Ann Neurol 1996, 40:635-644.
35. Hartung HP, Pollard JD, Harvey GK, Toyka KV Immunopathogenesis and treatment of the Guillain-Barré syndrome-Part I. Muscle Nerve 1995, 18:137-153.
36. Hughes RA, Hadden RD, Gregson NA, Smith KJ Pathogenesis of Guillain-Barré syndrome. J Neuroimmunol 1999, 100:74-97.
37. Ho TW, Willison HJ, Nachamkin I, et al. Anti-GD1a antibody is associated with axonal but not demyelinating forms of Guillain-Barré syndrome. Ann Neurol 1999, 45:168-173.
38. Yuki N, Yoshino H, Sato S, Miyatake T Acute axonal polyneuropathy associated with anti-GM1 antibodies following Campylobacter enteritis. Neurology 1990, 40:1900-1902.
39. Yuki N, Yoshino H, Sato S, Shinozawa K, Miyatake T Severe acute axonal form of Guillain-Barré syndrome associated with IgG anti-GD1a antibodies. Muscle Nerve 1992, 15:899-903.
40. Yuki N, Yamada M, Sato S, et al. Association of IgG anti-GD1a antibody with severe Guillain-Barré syndrome. Muscle Nerve 1993, 16:642-647.
41. Willison HJ, Veitch J, Paterson G, Kennedy PG Miller Fisher syndrome is associated with serum antibodies to GQ1b ganglioside. J Neurol Neurosurg Psychiatry 1993, 56:20406.
42. Lopez P, Villa A, Sica R, Nores G High affinity as a disease determinant factor in anti-GM(1) antibodies: comparative characterization of experimentally induced vs. disease-associated antibodies. J Neuroimmunol 2002, 128:69-76.
43. Lopez P, Zhang G, Bianchet M, Schnaar R, Sheikh K Structural requirements of anti-GD1a antibodies determine their target specificity. Brain 2008, 131:1926-1939.
44. Lehmann HC, Lopez PH, Zhang G, et al. Passive immunization with anti-ganglioside antibodies directly inhibits axon regeneration in an animal model. J Neurosci 2007, 27:27-34.
45. Sheikh KA, Zhang G, Gong Y, Schnaar RL, Griffin JW An anti-ganglioside antibody-secreting hybridoma induces neuropathy in mice. Ann Neurol 2004, 56:228-239.
46. Goodfellow JA, Bowes T, Sheikh K, et al. Overexpression of GD1a ganglioside sensitizes motor nerve terminals to anti-GD1a antibody-mediated injury in a model of acute motor axonal neuropathy. J Neurosci 2005, 25:1620-1668.
47. Susuki K, Rasband MN, Tohyama K, et al. Anti-GM1 antibodies cause complement-mediated disruption of sodium channel clusters in peripheral motor nerve fibers. J Neurosci 2007, 27:3956-3967.
48. Yuki N, Yamada M, Koga M, et al. Animal model of axonal Guillain-Barré syndrome induced by sensitization with GM1 ganglioside. Ann Neurol 2001, 49:712-720.
49. Yuki N, Susuki K, Koga M, et al. Carbohydrate mimicry between human ganglioside GM1 and Campylobacter jejuni lipooligosaccharide causes Guillain-Barré syndrome. Proc Natl Acad Sci USA 2004, 101:11404-11409.
50. Arasaki K, Kusunoki S, Kudo N, Kanazawa I Acute conduction block in vitro following exposure to antiganglioside sera. Muscle Nerve 1993, 16:587-593.
51. Arasaki K, Kusunoki S, Kudo N, Tamaki M The pattern of antiganglioside antibody reactivities producing myelinated nerve conduction block in vitro. J Neurol Sci 1998, 161:163-168.
52. Buchwald B, Weishaupt A, Toyka KV, Dudel J Immunoglobulin G from a patient with Miller-Fisher syndrome rapidly and reversibly depresses evoked quantal release at the neuromuscular junction of mice. Neurosci Lett 1995, 201:163-166.
53. Buchwald B, Toyka KV, Zielasek J, Weishaupt A, Schweiger S, Dudel J Neuromuscular blockade by IgG antibodies from patients with Guillain-Barré syndrome: a macro-patch-clamp study. Ann Neurol 1998, 44:913-922.
54. Buchwald B, Weishaupt A, Toyka KV, Dudel J Pre- and postsynaptic blockade of neuromuscular transmission by Miller-Fisher syndrome IgG at mouse motor nerve terminals. Eur J Neurosci 1998, 10:281-290.
55. Halstead SK, O'Hanlon GM, Humphreys PD, et al. Anti-disialoside antibodies kill perisynaptic Schwann cells and damage motor nerve terminals via membrane attack complex in a murine model of neuropathy. Brain 2004, 127:2109-2123.
56. Yuki N, Handa S, Taki T, Kasama T, Takahashi M, Saito K Cross-reactive antigen between nervous tissue and a bacterium elicits Guillain-Barré syndrome: molecular mimicry between gangliocide GM1 and lipopolysaccharide from Penner's serotype 19 of Campylobacter jejuni. Biomed Res 1992, 13:451-453.
57. Yuki N, Taki T, Takahashi M, et al. Molecular mimicry between GQ1b ganglioside and lipopolysaccharides of Campylobacter jejuni isolated from patients with Fisher's syndrome. Ann Neurol 1994, 36:791-793.
58. Aspinall GO, McDonald AG, Raju TS, Pang H, Moran AP, Penner JL Chemical structures of the core regions of Campylobacter jejuni serotypes O:1, O:4, O:23, and O:36 lipopolysaccharides. Eur J Biochem 1993, 213:1017-1027.
59. Aspinall GO, Fujimoto S, McDonald AG, Pang H, Kurjanczyk LA, Penner JL Lipopolysaccharides from Campylobacter jejuni associated with Guillain-Barré syndrome patients mimic human gangliosides in structure. Infect Immun 1994, 62:2122-2125.
60. Neisser A, Bernheimer H, Berger T, Moran A, Schwerer B Serum antibodies against gangliosides and Campylobacter jejuni lipopolysaccharides in Miller Fisher syndrome. Infect Immun 1997, 65:4038-4042.
61. Hidari K, Shimada S, Suzuki Y, Suzuki T Binding kinetics of influenza viruses to sialic acid-containing carbohydrates. Glycoconj J 2007, 24:583-590.
62. Moscona A Neuraminidase inhibitors for influenza. N Engl J Med 2005, 353:1363-1373.
63. Taubenberger J The origin and virulence of the 1918 " Spanish" influenza virus. Proc Am Philos Soc 2006, 150:86-112.
64. Patterson K, Pyle G The geography and mortality of the 1918 influenza pandemic. Bull Hist Med 1991, 65:4-21.
65. Morens D, Taubenberger J, Fauci A The persistent legacy of the 1918 influenza virus. N Engl J Med 2009, 361:225-229.
66. Geiss G, Salvatore M, Tumpey T, et al. Cellular transcriptional profiling in influenza A virus-infected lung epithelial cells: the role of the nonstructural NS1 protein in the evasion of the host innate defense and its potential contribution to pandemic influenza. Proc Natl Acad Sci USA 2002, 99:10736-10741.
67. Guillain G, Barré JA, Strohl A Sur un syndrome de radiculonévrite avec hyperalbuminose du liquide céphalo-rachidien sans réaction cellulaire. Remarques sur les caractères cliniques et graphiques des réflexes tendineux. Bull Mem Soc Med Hop Paris 1916, 40:1462-1470.
68. Draganescu H, Claudian J Sur un cas de radiculu-névrite curable (syndrome de Guillain-Barré) apparue au cours d'une ostéomyélite du bras. Rev Neurol (Paris) 1927, 2:517-521.
69. Howland GW The nervous conditions associated with influenza. Can Med Assoc J 1919, 9:727-731.
70. Walshe FMR Forms of peripheral neuritis among troops serving with the Egyptian expeditionary force, 1915-19. Proc R Soc Med 1920, 13:7-60.
71. Marcus H Die Influenza und das Nervensystem. Studie während der Epidemie in Schweden 1918-1919. Arch Psychiatr Nervenkr Z Gesamte Neurol Psychiatr 1920, 54:166-244.
72. Wexberg E Erkrankungen der peripheren Nerven im Kriege. Arch Psychiatr Nervenkr Z Gesamte Neurol Psychiatr 1919, 49:14-86.
73. Sett E Zur Ätiologie und Symptomatologie der Polyneuritis. Eur Arch Psychiatry Clin Neurosci 1920, 3:563-602.
74. Keelan P Post-influenzal peripheral neuritis. Ir J Med Sci 1962, 438:272-275.
75. Wells C, James W, Evans A Guillain-Barré syndrome and virus of influenza A (Asian strain); report of two fatal cases during the 1957 epidemic in Wales. AMA Arch Neurol Psychiatry 1959, 81:699-705.
76. Sivadon-Tardy V, Orlikowski D, Porcher R, et al. Guillain-Barré syndrome and influenza virus infection. Clin Infect Dis 2009, 48:48-56.
77. Sivadon-Tardy V, Orlikowski D, Rozenberg F, et al. Guillain-Barré syndrome, greater Paris area. Emerg Infect Dis 2006, 12:990-993.
78. Tam C, O'Brien S, Rodrigues L Influenza, Campylobacter and Mycoplasma infections, and hospital admissions for Guillain-Barré syndrome, England. Emerg Infect Dis 2006, 12:1880-1887.
79. Zambon M, Hays J, Webster A, Newman R, Keene O Diagnosis of influenza in the community: relationship of clinical diagnosis to confirmed virological, serologic, or molecular detection of influenza. Arch Intern Med 2001, 161:2116-2122.
80. Falsey A, Hennessey P, Formica M, Cox C, Walsh E Respiratory syncytial virus infection in elderly and high-risk adults. N Engl J Med 2005, 352:1749-1759.
81. Chaari A, Bahloul M, Dammak H, et al. Guillain-Barré syndrome related to pandemic influenza A (H1N1) infection. Intensive Care Med 2010, 36:1275.
82. Kutleša M, Santini M, Krajinović V, Raffanelli D, Baršić B Acute motor axonal neuropathy associated with pandemic H1N1 influenza A infection. Neurocrit Care 2010, 13:98-100.
83. Mule F, Sedati P, Balbo G Two cases of polyradiculoneuritis caused by influenza virus B [Italian]. Minerva Med 1956, 47:450-458.
84. Bertrand A, Janbon F, Clot J, Milane J, Bosc E Guillain-Barré polyradiculoneuritis and influenza virus [French]. Presse Med 1971, 79:2328.
85. Novák M Guillain-Barré syndrome as a sequela of influenza [Czech]. Cesk Neurol Neurochir 1975, 38:314-316.
86. Enders U, Karch H, Toyka KV, et al. The spectrum of immune responses to Campylobacter jejuni and glycoconjugates in Guillain-Barré syndrome and in other neuroimmunological disorders. Ann Neurol 1993, 34:136-144.
87. Adelmann M, Linington C Molecular mimicry and the autoimmune response to the peripheral nerve myelin P0 glycoprotein. Neurochem Res 1992, 17:887-891.
88. Nachamkin I, Shadomy S, Moran A, et al. Anti-ganglioside antibody induction by swine (A/NJ/1976/H1N1) and other influenza vaccines: insights into vaccine-associated Guillain-Barré syndrome. J Infect Dis 2008, 198:226-233.
89. Simpson B, Rajabally Y Sensori-motor Guillain-Barré syndrome with anti-GD1b antibodies following influenza A infection. Eur J Neurol 2009, 16:e81.
90. Sencer D, Millar J Reflections on the 1976 swine flu vaccination program. Emerg Infect Dis 2006, 12:29-33.
91. Haber P, DeStefano F, Angulo F, et al. Guillain-Barré syndrome following influenza vaccination. JAMA 2004, 292:2478-2481.
92. Safranek TJ, Lawrence DN, Kurland LT, et al. Reassessment of the association between Guillain-Barré syndrome and receipt of swine influenza vaccine in 1976-1977: results of a two-state study. Expert Neurology Group. Am J Epidemiol 1991, 133:940-951.
93. Marks J, Halpin T Guillain-Barré syndrome in recipients of A/New Jersey influenza vaccine. JAMA 1980, 243:2490-2494.
94. Kaplan J, Katona P, Hurwitz E, Schonberger L Guillain-Barré syndrome in the United States, 1979-1980 and 1980-1981. Lack of an association with influenza vaccination. JAMA 1982, 248:698-700.
95. Hurwitz E, Schonberger L, Nelson D, Holman R Guillain-Barré syndrome and the 1978-1979 influenza vaccine. N Engl J Med 1981, 304:1557-1561.
96. Vellozzi C, Burwen D, Dobardzic A, Ball R, Walton K, Haber P Safety of trivalent inactivated influenza vaccines in adults: background for pandemic influenza vaccine safety monitoring. Vaccine 2009, 27:2114-2120.
97. Hughes R, Charlton J, Latinovic R, Gulliford M No association between immunization and Guillain-Barré syndrome in the United Kingdom, 1992 to 2000. Arch Intern Med 2006, 166:1301-1304.
98. Juurlink D, Stukel T, Kwong J, et al. Guillain-Barré syndrome after influenza vaccination in adults: a population-based study. Arch Intern Med 2006, 166:2217-2221.
99. Roscelli J, Bass J, Pang L Guillain-Barré syndrome and influenza vaccination in the US Army, 1980-1988. Am J Epidemiol 1991, 133:952-1025.
100. Lasky T, Terracciano G, Magder L, et al. The Guillain-Barré syndrome and the 1992-1993 and 1993-1994 influenza vaccines. N Engl J Med 1998, 339:1797-1802.
101. WHO recommendations for compositions of influenza vaccines Influenza Research Database, (accessed Nov 13, 2009). http://www.fludb.org/brc/vaccineRecommend.do?decorator=influenza.
102. McFarlin DE Immunological parameters in Guillain-Barré syndrome. Ann Neurol 1990, 27(suppl):S25-S29.
103. Kuitwaard K, Bos-Eyssen M, Blomkwist-Markens P, van Doorn P Recurrences, vaccinations and long-term symptoms in GBS and CIDP. J Peripher Nerv Syst 2009, 14:310-315.
104. Kuitwaard K, van Koningsveld R, Ruts L, Jacobs B, van Doorn P Recurrent Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry 2009, 80:56-59.
105. Seyal M, Ziegler D, Couch J Recurrent Guillain-Barré syndrome following influenza vaccine. Neurology 1978, 28:725-726.
106. Pritchard J, Mukherjee R, Hughes RA Risk of relapse of Guillain-Barré syndrome or chronic inflammatory demyelinating polyradiculoneuropathy following immunisation. J Neurol Neurosurg Psychiatry 2002, 73:348-349.
107. Wijdicks E, Fletcher D, Lawn N Influenza vaccine and the risk of relapse of Guillain-Barré syndrome. Neurology 2000, 55:452-453.
108. Blanco-Marchite C, Buznego-Suárez L, Fagúndez-Vargas M, Méndez-Llatas M, Pozo-Martos P Miller Fisher syndrome, internal and external ophthalmoplegia after flu vaccination [Spanish]. Arch Soc Esp Oftalmol 2008, 83:433-435.
109. Moon J, Souayah N Guillain-Barré syndrome triggered by influenza vaccination in a recipient of liver transplant on FK506. Liver Transpl 2006, 12:1537-1539.
110. Aggarwal A, Lacomis D, Giuliani M A reversible paralytic syndrome with anti-GD1b antibodies following influenza immunization. Muscle Nerve 1995, 18:1199-1201.
111. Bowes T, Wagner ER, Boffey J, et al. Tolerance to self gangliosides is the major factor restricting the antibody response to lipopolysaccharide core oligosaccharides in Campylobacter jejuni strains associated with Guillain-Barré syndrome. Infect Immun 2002, 70:5008-5018.
112. Kendal A, Bozeman F, Ennis F Further studies of the neuraminidase content of inactivated influenza vaccines and the neuraminidase antibody responses after vaccination of immunologically primed and unprimed populations. Infect Immun 1980, 29:966-971.
113. Wood J, Levandowski R The influenza vaccine licensing process. Vaccine 2003, 21:1786-1788.
114. Aleccia J Va. teen suffers rare illness after swine flu shot. MSNBC (accessed July 13, 2010). http://www.msnbc.msn.com/id/33845867.
115. Le Monde Grippe: un cas " probable" de syndrome Guillain-Barré après vaccination, (accessed July 13, 2010). http://www.lemonde.fr/planete/article/2009/11/12/grippe-un-cas-probable-de-syndrome-de-guillain-barre-apres-vaccination_1266533_3244.html.
116. Plater R Teen too weak to walk after flu shots. FOX 5 News (accessed July 13, 2010). http://www.myfoxdc.com/dpp/news/seen_on_10_11/teen-flu-shot-reaction-guillian-barre-syndrome-jordan-mcfarland-111209.
117. Preliminary results: surveillance for Guillain-Barré syndrome after receipt of influenza A (H1N1) 2009 monovalent vaccine-United States, 2009-2010. MMWR Morb Mortal Wkly Rep 2010, 59:657-661. Centers for Disease Control and Prevention (CDC).