Volume 94, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The epidemiology of Guillain–Barré syndrome (GBS) in tropical areas is different compared with developed countries. We investigated the epidemiology of GBS on the Caribbean island of Aruba. Data were collected retrospectively from all 36 patients hospitalized with GBS between 2003 and 2011 in Aruba. We observed a seasonal distribution of GBS cases with a peak in February. The incidence rate (IR) fluctuated heavily between individual years. The overall IR was 3.93/100,000, which is higher than that observed in developed countries. Serological studies indicated a possible relation of GBS cases with dengue virus infections. We also observed a relation between the annual number of dengue cases in Aruba and the number of GBS cases in the same year. We conclude that the epidemiology of GBS in tropical areas can be different from temperate climate regions and that dengue may be a trigger for developing GBS.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. McGrogan A, Madle GC, Seaman HE, de Vries CS, , 2009. The epidemiology of Guillain-Barré syndrome worldwide. A systematic literature review. Neuroepidemiology 32: 150163.[Crossref] [Google Scholar]
  2. Alter M, , 1990. The epidemiology of Guillain-Barré syndrome. Ann Neurol 27 (Suppl): S7S12.[Crossref] [Google Scholar]
  3. Govoni V, Granieri E, , 2001. Epidemiology of the Guillain-Barré syndrome. Curr Opin Neurol 14: 605613.[Crossref] [Google Scholar]
  4. Van Koningsveld R, Van Doorn PA, Schmitz PI, Ang CW, Van der Meche FG, , 2000. Mild forms of Guillain-Barré syndrome in an epidemiologic survey in The Netherlands. Neurology 54: 620625.[Crossref] [Google Scholar]
  5. Hughes RA, Cornblath DR, , 2005. Guillain-Barré syndrome. Lancet 366: 16531666.[Crossref] [Google Scholar]
  6. Hughes RA, Rees JH, , 1997. Clinical and epidemiologic features of Guillain-Barré syndrome. J Infect Dis 176 (Suppl 2): S92S98.[Crossref] [Google Scholar]
  7. Rees JH, Soudain SE, Gregson NA, Hughes RA, , 1995. Campylobacter jejuni infection and Guillain-Barré syndrome. N Engl J Med 333: 13741379.[Crossref] [Google Scholar]
  8. Jacobs BC, Rothbarth PH, van der Meche FG, Herbrink P, Schmitz PI, de Klerk MA, van Doorn PA, , 1998. The spectrum of antecedent infections in Guillain-Barré syndrome: a case-control study. Neurology 51: 11101115.[Crossref] [Google Scholar]
  9. Visser LH, van der Meche FG, Meulstee J, Rothbarth PP, Jacobs BC, Schmitz PI, van Doorn PA, , 1996. Cytomegalovirus infection and Guillain-Barre syndrome: the clinical, electrophysiologic, and prognostic features. Dutch Guillain-Barre Study Group. Neurology 47: 668673.[Crossref] [Google Scholar]
  10. Orlikowski D, Porcher R, Sivadon-Tardy V, Quincampoix JC, Raphael JC, Durand MC, Sharshar T, Roussi J, Caudie C, Annane D, Rozenberg F, Leruez-Ville M, Gaillard JL, Gault E, , 2011. Guillain-Barré syndrome following primary cytomegalovirus infection: a prospective cohort study. Clin Infect Dis 52: 837844.[Crossref] [Google Scholar]
  11. Susuki K, Odaka M, Mori M, Hirata K, Yuki N, , 2004. Acute motor axonal neuropathy after Mycoplasma infection: evidence of molecular mimicry. Neurology 62: 949956.[Crossref] [Google Scholar]
  12. Ratnam I, Leder K, Black J, Torresi J, , 2013. Dengue fever and international travel. J Travel Med 20: 384393.[Crossref] [Google Scholar]
  13. Puccioni-Sohler M, Soares CN, Papaiz-Alvarenga R, Castro MJ, Faria LC, Peralta JM, , 2009. Neurologic dengue manifestations associated with intrathecal specific immune response. Neurology 73: 14131417.[Crossref] [Google Scholar]
  14. Sejvar JJ, Leis AA, Stokic DS, Van Gerpen JA, Marfin AA, Webb R, Haddad MB, Tierney BC, Slavinski SA, Polk JL, Dostrow V, Winkelmann M, Petersen LR, , 2003. Acute flaccid paralysis and West Nile virus infection. Emerg Infect Dis 9: 788793.[Crossref] [Google Scholar]
  15. Solomon T, Dung NM, Vaughn DW, Kneen R, Thao LT, Raengsakulrach B, Loan HT, Day NP, Farrar J, Myint KS, Warrell MJ, James WS, Nisalak A, White NJ, , 2000. Neurological manifestations of dengue infection. Lancet 355: 10531059.[Crossref] [Google Scholar]
  16. Van Koningsveld R, Rico R, Gerstenbluth I, Schmitz PI, Ang CW, Merkies IS, Jacobs BC, Halabi Y, Endtz HP, Van der Meche FG, Van Doorn PA, , 2001. Gastroenteritis-associated Guillain-Barré syndrome on the Caribbean island Curacao. Neurology 56: 14671472.[Crossref] [Google Scholar]
  17. Asbury AK, Cornblath DR, , 1990. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol 27 (Suppl): S21S24.[Crossref] [Google Scholar]
  18. Sejvar JJ, Kohl KS, Gidudu J, Amato A, Bakshi N, Baxter R, Burwen DR, Cornblath DR, Cleerbout J, Edwards KM, Heininger U, Hughes R, Khuri-Bulos N, Korinthenberg R, Law BJ, Munro U, Maltezou HC, Nell P, Oleske J, Sparks R, Velentgas P, Vermeer P, Wiznitzer M, , 2011. Guillain-Barré syndrome and Fisher syndrome: case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 29: 599612.[Crossref] [Google Scholar]
  19. Vucic S, Kiernan MC, Cornblath DR, , 2009. Guillain-Barré syndrome: an update. J Clin Neurosci 16: 733741.[Crossref] [Google Scholar]
  20. Govoni V, Granieri E, Tola MR, Casetta I, Ruppi P, Vaghi L, , 1999. The frequency of clinical variants of Guillain-Barre syndrome in Ferrara, Italy. J Neurol 246: 10101014.[Crossref] [Google Scholar]
  21. Arami MA, Yazdchi M, Khandaghi R, , 2006. Epidemiology and characteristics of Guillain-Barré syndrome in the northwest of Iran. Ann Saudi Med 26: 2227. [Google Scholar]
  22. Rocha MS, Brucki SM, Carvalho AA, Lima UW, , 2004. Epidemiologic features of Guillain-Barré syndrome in Sao Paulo, Brazil. Arq Neuropsiquiatr 62: 3337.[Crossref] [Google Scholar]
  23. Jiang GX, Cheng Q, Link H, de Pedro-Cuesta J, , 1997. Epidemiological features of Guillain-Barré syndrome in Sweden, 1978–93. J Neurol Neurosurg Psychiatry 62: 447453.[Crossref] [Google Scholar]
  24. Leslie T, Martin NJ, Jack-Roosberg C, Odongo G, Beausoleil E, Tuck J, Raviprakash K, Kochel TJ, , 2014. Dengue serosurvey in Sint Eustatius. PLoS One 9: e95002.[Crossref] [Google Scholar]
  25. Soares CN, Faria LC, Peralta JM, de Freitas MR, Puccioni-Sohler M, , 2006. Dengue infection: neurological manifestations and cerebrospinal fluid (CSF) analysis. J Neurol Sci 249: 1924.[Crossref] [Google Scholar]
  26. PAHO, 2003–2011. Number of Reported Cases of Dengue and Dengue Hemorrhagic Fever in the Americas, by Country. Washington, DC: PAHO. [Google Scholar]
  27. van Koningsveld R, Steyerberg EW, Hughes RA, Swan AV, van Doorn PA, Jacobs BC, , 2007. A clinical prognostic scoring system for Guillain-Barré syndrome. Lancet Neurol 6: 589594.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 25 Jan 2015
  • Accepted : 05 Jan 2016
  • Published online : 01 Jun 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error