ASSESSMENT OF GUILLAIN-BARRE-SYNDROME MORTALITY AND MORBIDITY IN THE UNITED-STATES - IMPLICATIONS FOR ACUTE FLACCID PARALYSIS SURVEILLANCE

To estimate age-specific incidences and assess the national morbidity and mortality burden for Guillain-Barre syndrome (GBS) in the United S tates, a national hospital discharge database compiled by the Commissi on on Professional and Hospital Activities (CPHA) and national death c ertificate data reported to the National Vital Statistics System were reviewed. During 1985-1991, 10,453 patients with GBS were discharged f rom CPHA-participating hospitals (estimated annual incidence, 3.0/100, 000 population). The age-specific incidence of GBS increased with age from 1.5/100,000 in persons <15 years old to 8.6/100,000 in persons 70 -79 years old. The total estimated number of GBS-related deaths from 1 985 through 1990 was 3770 (95% confidence interval, 3506-4034), for an average of 628 GBS deaths per year. These rates suggest that the prop osed national surveillance system for acute flaccid paralysis should c apture at a minimum the 796 GBS cases in persons <15 years old. GBS re mains a significant health burden among older adults in the United Sta tes, with a marked increase in risk after age 40.