Guillain-Barré syndrome and antecedent cytomegalovirus infection, USA 2009–2015

Objective To describe incidence and clinical characteristics of cases of Guillain-Barré syndrome (GBS) in the USA during 2009–2015, and characteristics of GBS cases with antecedent cytomegalovirus (CMV) infection among persons with employer-sponsored insurance. Methods We analyzed medical claims from IBM Watson MarketScan® databases. GBS patients were defined as enrollees with an inpatient claim with GBS as the principal diagnosis code, based on ICD-9 or ICD-10, and ≥ 1 claim for lumbar puncture or EMG/nerve conduction study. We assessed intensive care unit (ICU) hospitalization, intubation, dysautonomia, and death. We also assessed selected infectious illness within 60 days prior to the first GBS-coded inpatient claim. Results We identified 3486 GBS patients; annual incidence was 1.0–1.2/100,000 persons during 2009–2015. GBS incidence was higher in males (1.2/100,000) than in females (0.9/100,000) ( p = 0.006) and increased with age, from 0.4/100,000 in persons 0–17 years old to 2.1/100,000 in persons ≥ 65 years old ( p