رابطه بین بروز سندرم گیلن باره و ایمن سازی همگانی با واکسن سرخک و سرخجه در کودکان 14-5 ساله ایران

Objective: Several case reports and epidemiologic studies have reported a relation between different vaccines including measles، rubella، and mumps and Guillain-Barre syndrome (GBS). In this study we investigated relation between receiving measles and/or rubella vaccines and occurrence of Guillain- Barre syndrome after national immunization campaign in 2003 in Iran.
Material & Methods: In this study we used National Surveillance system for acute flaccid paralysis data from the beginning of 2002 to the end of 2004. We studied 5-14 year-old children. Three-year time span of the study was divided into fifteen 10 weeks periods، and number of reported and approved cases of Guillain-Barre syndrome in each time period has been analyzed supposing their distribution was according to Poisson distribution. One of time periods has been chosen in a manner that its first 4 weeks included embedded National Immunization and following 6 weeks were designated for covering incubation period of Guillin- Barre syndrome.
Findings: Of total 553 reported flaccid paralysis cases in 5-15 year-old children 370 were approved to be Guillain- Barre (~67%). Estimated average incidence of Guillain-Barre syndrome in <15 year-olds is 1/100،000/year (95% CI: 0.88-13)، and in 5-15 year-old children is 0.6/100،000/year (95% CI: 0.58-083). Thus، number of expected cases in 25 cases each 10 weeks time period was 23.8 of GBS that were reported in the time period which coincided with immunization campaign. Probability of occurring ≥25 cases of GBS in that time period according to Poison distribution with expected case numbers of 23.8 is equal to 0.43 (P=0.43).
Conclusion: Yearly incidence rate of GBS in this study was similar to other studies. According to our results، there was no increase in GBS incidence in the 4 weeks national Immunization Campaign and 6 weeks after it in comparison to other 10 weeks periods before or after this time period.