A Multicentric Prospective Incidence Study of Guillain-Barré Syndrome in Italy. The ITANG Study

Abstract

Background: To assess Guillain-Barré syndrome (GBS) incidence we relied on the Italian Network for the study of GBS (ITANG) established in 2010 in 7 Italian regions to analyse the association between influenza vaccination and GBS. Methods: All individuals aged ≥18 years, presenting with clinical manifestations that suggested GBS according to the universally accepted Asbury's diagnostic criteria (1990) were prospectively notified to a centralised database by ITANG neurologists over the period October 1, 2010-September 30, 2011. Through a telephone survey, 9 trained interviewers followed up the cases to diagnosis and then for 1 year since hospital discharge. Validation of case reporting was performed with the support of administrative data in 5 regions. Results: We found 365 cases fulfilling the definition for GBS or one of its variants over 19,846,068 population ≥18 years of age, yielding an annual incidence rate of 1.84 per 100,000 (95% CI 1.65-2.03), 2.30 (95% CI 1.99-2.60) in men and 1.41 (95% CI 1.18-1.64) in women. A highly significant peak of incidence was observed in February 2011 as compared to reference month (September 2011, rate ratio 3.3:1, p < 0.01). Conclusions: In Italy, GBS incidence was among the highest reported in Europe and higher than previously observed in Italian studies.

Increased incidence of axonal Guillain‐Barré syndrome in La Spezia area of Italy: A 13‐year follow‐up study

“…We also noted a significant cluster in spring months as reported in temperate areas but discordant from what previously reported in Italy …”

“…The results of our study show that the mean annual incidence of GBS in La Spezia area (3/100 000/year) is significantly higher than the incidence reported not only in Italy (;) and in Europe (Figure ) but also in the Caribbean Island of Curaçao …”

“…Axonal forms seem to be more common in Southern than in Northern latitudes. In Italy AMAN/AMSAN accounts for more than 15% of cases, similar to Greece (13%) and western Balcans (12%) …”

“…According to the recent ITANG study, in Italy the annual incidence rate is 1.84 per 100 000, among the highest in western countries, although only a minority of Italian regions was involved in the study. There is not a worldwide consensus on the seasonality of GBS, as higher rates seem to occur in winter in colder regions and in spring in temperate areas .…”

“…There is not a worldwide consensus on the seasonality of GBS, as higher rates seem to occur in winter in colder regions and in spring in temperate areas . In Italy GBS peaks in January and February, possibly related to viral infections and vaccinations …”