A confidential letter sent by the United Kingdom Health Protection Agency to about 600 senior neurologists on July 29, 2009 warns that the latest Swine Flu Vaccination is linked to the deadly nerve disease Guillain-Barre Syndrome (GBS).
The letter advises doctors that they must be alert for an increase in Guillain-Barre Syndrome (GBS), an autoimmune disease that involves an acute inflammatory demyelenating polyneuropathy (AIDP) of the peripheral nervous system. The disease is frequently severe with an ascending paralysis starting with weakness in the legs, then affects the arms, face and deep tendon reflexes. Frequently, the lower cranial nerves may be affected, leading to bulbar weakness, (oropharyngeal dysphagia, that is difficulty with swallowing, drooling, and/or maintaining an open airway) and respiratory difficulties.
Prompt treatment by removing blood and plasma, separating blood cells from the plasma, treating the plasma by removing disease-causing antibodies, and then returning plasma and blood cells to the patient. In some cases, the plasma is returned from a donor (plasma exchange). The treatment is accompanied by medical and immunosuppressive therapy for long term management to prevent target host nerve tissue from being attacked by antibodies.
The disease process is initiated by foreign antigens from an infectious disease, contaminated vaccine, or possibly the vaccine itself. GBS is a form of autoimmune disorder with a delayed hypersensitivity reaction, or a rare manifestation of serum sickness, or transient syndrome resembling serum sickness with loss of appetite, nausea, vomiting, and stomach pain accompanied by weakness (tired feeling), chills, and low grade fever. There is also possible evidence of brain involvement, indicated by lethargy and migraine headaches, although one theory of the cause of migraine is a central nervous system (CNS) disorder, or Bickerstaff’s brain stem encephalitis, a regional variant of GBS.
Typical pain is occipital or in the back of the head. Alterations of consciousness accompany this headache type. The brainstem is affected and implicated in the maintenance of arousal, but is a worrisome feature with this type of headache, which is called a Bickerstaff migraine. Altered brainstem functions result in clumsiness and gait unsteadiness, such as “pulling to the right” and are associated with Bickerstaff migraine.
Usually recovery starts after 4th week from the onset of the disorder. Approximately 80% of patients have a complete recovery within a few months to a year, although minor findings may persist, such as areflexia. About 5–10% recover with severe disability, with most of such cases involving severe proximal motor and sensory axonal nerve damage with inability of axonal regeneration.
FLASHBACK TO 1976
The United Kingdom Health Protection Agency letter to neurologists refers to a vaccine in the United States in 1976 when more people died (25) from GBS respiratory paralysis than from the flu itself, when about 500 cases of GBS were diagnosed, when symptoms appeared within days of the vaccination, when the vaccine was thought to increase the risk of GBS up to eight times, and when the vaccine was withdrawn in ten weeks after the connection of the vaccine to GBS was recognized.
LOOKING FORWARD: RISK/BENEFIT DECISIONS & SURVEILLANCE
Immunization has been set to start in October 2009. The vaccine is targeted for everyone aged six months to 65 with an underlying health problem, pregnant women and health professionals. Surveillance for GBS during the immunization period will be key, but some experts question taking the risk for a flu that is mild for most healthy individuals.