CHILDHOOD GUILLAIN-BARRE-SYNDROME IN PARAGUAY, 1990 TO 1991

During 1990 to 1991, through a national surveillance program for polio myelitis, the Paraguayan Ministry of Health received reports of 50 chi ldren with incident acute flaccid paralysis (< 15 years old). On the b asis of established criteria, 37 were diagnosed with Guillain-Barre sy ndrome. The average annual incidence rate for 1990 to 1991 was 1.1/100 ,000 children. The clinical course was more benign than reported in ot her pediatric series. There were low rates of hospitalization (57%), r espiratory compromise (8%), and intubation (5%). The overall severity, however, was similar to that described in previous reports, with a 3% case-fatality rate and an 81% total recovery rate at 12 months. Seven ty-six percent of patients had symptom onset during January to April, the warmest months of the year. Thirty percent of patients had definit e or possible exposure to organophosphate pesticides, and the peak use coincides with the peak incidence of Guillain-Barre syndrome. There w as no correlation between occurrence of Guillain-Barre syndrome and pr ior immunization.