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Jonathan E. Kaplan, MD; Joel R. Greenspan, MD; Mona Bomgaars, MD; Ned Wiebenga, MD; Robert D. Bart, Jr, MD; Kenneth Robbins, MD; Robert Wiebe, MD; Frank Tabrah, MD; John Stewart, MD; Lawrence B. Schonberger, MD

JAMA. 1983;250(19):2635-2640.

Abstract
Simultaneous outbreaks of Guillain-Barré syndrome (GBS) and Bell's palsy occurred among residents of Hawaii during the three-month period June through August 1981. The outbreak of GBS (six cases) involved children, while the outbreak of Bell's palsy (22 cases) involved primarily adults. Four of the six patients with GBS had serological evidence of recent infection with cytomegalovirus (CMV) v none of 24 control subjects; no such association with CMV infection could be demonstrated for patients with Bell's palsy. The patients with GBS and Bell's palsy lived in widely scattered areas within the population centers of Hawaii, and no common exposures to specific places or events were identified. Testing for antibodies to respiratory pathogens suggested that a variety of antecedent viral infections, in addition to CMV infection, may have been associated with this unusual simultaneous cluster of illnesses.

(JAMA 1983;250:2635-2640)

Author Affiliations
From the Division of Viral Diseases, Center for Infectious Diseases (Drs Kaplan, Stewart, and Schonberger), and the Field Services Division, Epidemiology Program Office (Dr Greenspan), Centers for Disease Control, Atlanta; and the Hawaii Department of Health (Drs Greenspan, Bomgaars, and Wiebenga), the Kapiolani Children's Medical Center (Drs Bart, Robbins, and Wiebe), and the Straub Clinic and Hospital, Inc (Dr Tabrah), Honolulu. Dr Robbins is now with the Department of Pediatrics, Fifth General Hospital (US Army), Stuttgart, West Germany.

Footnotes
Deceased.

Reprint requests to Division of Viral Diseases, Bldg 6, Room 127-B, Centers for Disease Control, Atlanta, GA 30333 (Dr Kaplan).

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ABSTRACT