Simultaneous outbreaks of Guillain-Barre syndrome and Bell's palsy in Hawaii in 1981
J. E. Kaplan, J. R. Greenspan, M. Bomgaars, N. Wiebenga, R. D. Bart Jr, K. Robbins, R. Wiebe, F. Tabrah, J. Stewart and L. B. Schonberger
Simultaneous outbreaks of Guillain-Barre 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.