Epidemiology

Guillain-Barre syndrome (GBS) is identified throughout the western hemisphere without geographic clustering, but with minor seasonal variations.[10] Population-based studies give crude mean annual incidence rates varying from 0.6 to 1.9 per 100,000 population. A few outbreaks have been reported, including the 1976 outbreak in the US after the swine influenza program (although the link between the influenza immunization and incidence of GBS is unclear).[11][5]

GBS is slightly more common in men than women, with an estimated male-female ratio of 1.78.[5][12]

Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) is the most common form in North America and Europe and accounts for 85% to 90% of cases.[13][14] AIDP can occur at any age, although rarely in infancy, and incidence increases with age; mean age of onset is approximately 40 years.[12][15] GBS is the most common cause of acute flaccid paralysis in children.[16]

The acute motor axonal neuropathy (AMAN) subtype of GBS is more common in Japan and China, particularly in young people. It occurs more frequently during summer.[17] Sporadic AMAN worldwide affects 10% to 20% of patients with GBS.[18]

Miller-Fisher syndrome affects between 5% and 10% of patients with GBS in western countries, but is more common in eastern Asia, affecting 25% of patients with GBS in Japan and 19% in Taiwan.[19]

GBS is associated with Zika virus outbreaks. One meta-analysis estimated that 1.23% of people with Zika virus develop GBS, and another estimated that incidence of GBS in Latin America and the Caribbean rose 2.6-fold during Zika virus outbreaks.[20][21] One study in the Americas found that just under half of 51 deaths associated with Zika virus were related to GBS.[22]

There have been multiple reports from a number of countries of patients with confirmed coronavirus disease 2019 (COVID-19) infection developing GBS.[23][24][25] The reported mean age (55 to 59 years) and male predominance of patients developing GBS appear to be typical of hospitalized COVID-19 patients.[23][24][25] More evidence is needed about whether the incidence of GBS in patients with COVID-19 is higher than that in the general population.[24] There have also been reports of GBS after COVID-19 vaccination.[26]

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