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.