Talk:Guillain–Barré syndrome

message: "a result of an acute polyneuropathy"
 --  I have found several sources that call this a "polyradiculopathy" Tmbirkhead (talk) 21:21, 8 November 2015 (UTC)
thread_title:  Header 

message: "These two treatments are equally effective"
  No problem with this
"and a combination of the two is not significantly better than either alone."
  Big problem with this
I had Guillain-Barre (and 100% recovery, thank goodness) and received both treatments. It is very important to realize that the two treatments are completely incompatible. That is, they absolutely cannot be administered simultaneously, but if administered consecutively, the end result can be superior to just using one of them (or not).
With intravenous immunoglobulins (aka IVIG) you are getting other people's white blood cells, in the hope that it makes your own white blood cells behave themselves, as opposed to what they are doing (destroying your peripheral nervous system's myelin sheath). With plasmapheresis, on the other hand, (almost) all of your white blood cells are being removed from your blood, in the hope that the new white blood cells generated by your system (bone marrow) will behave themselves. Stay with me here, either you are getting a whole bunch of extra white blood cells, or you are losing a whole bunch of the white blood cells you already have. You cannot do both at the same time, don't you agree?
The idea is to (a) use IVIG to shock the system into some kind of stability, although it is not a cure then (b) once stability but not cure is achieved, to use plasmapheresis to effect a cure. At least, that is what my doctors told me they were doing. And it worked.
So my experience is that IVIG, followed by plasmapheresis, *is* significantly better than either alone.
Not too sure what to do about providing a reference. IVIG is extremely expensive, so may not be an option in every health-care context. Plasmapheresis is, essentially, just a form of dialysis, so it is not that expensive and should be generally available.  — Preceding unsigned comment added by Gsa703 (talk • contribs) 19:09, 7 October 2013 (UTC)
replies: text: Very nice that the combination worked for you. We prefer to base wikipedia on scientific research. The immunoglobulins are way smaller particles than white blood cells, so plasmapheresis of just the white blood cells (and not the plasma fluid with the ivig in it) can be done simultaneosly to ivig administration. But if you're convinced otherwise, please provide scientific sources that contradict the currently used reference. PizzaMan (♨♨) 15:22, 11 December 2014 (UTC)
thread_title:  Treatment 

message: This section does not appear to have rigorous references.
"Recovery usually starts after the fourth week.."
I had Guillain-Barre. My experience with my doctors was that my recovery time was a direct reflection of my time-to-diagnosis. That is, the sooner I was diagnosed, the less my recovery time. In my case, I was diagnosed in about 50 hours and had a recovery time of about 50 weeks. So one week for every hour until diagnosis (and treatment).
That said, let's talk about when recovery starts. Presumably that means when things start stabilizing. Again, I suggest that it totally depends upon how fast the patient gets to a knowledgeable physician. In my case, I think my recovery started after the second week, but that is not a reflection of Guillain-Barre, nor of the physician, but solely of how fast I noticed that I had a problem, and did something about it.
"About 80% of patients have a complete recovery.."
Where does this come from? My doctors said that 98% of patients have a recovery in which there are no long-term disabilities, such as having to use a cane, or a walker, or take medication, etc. Aside from the fact that I should probably not donate blood, I have zero effects upon my well-being from having had Guillain-Barre.  — Preceding unsigned comment added by Gsa703 (talk • contribs) 19:39, 7 October 2013 (UTC)
replies: text: I've added a reference and a little bit of text based on the reference. Note that the reference doesn't support the statement of recovery starting after four weeks. As for the 98%, that's a bit optimistic. For example: "Among severely affected patients, 20% remain unable to walk 6 months after the onset of symptoms." (NEJM 2012). Unfortunately, the appendix doesn't contain the prognostic models it's supposed to when i try to download. And you're right that the onset of therapy is a prognostic factor: "Days between onset of weakness and admission, Medical Research Council sum score, and presence of facial and/or bulbar weakness were the main predictors of mechanical ventilation" (Walgaard, Ann Neurol. 2010).PizzaMan (♨♨) 15:41, 11 December 2014 (UTC)
thread_title:  Prognosis 

message: I feel that it would be a good idea to add a "not to be confused with" label at the top of the page to distinguish between Gilbert's and Guillain–Barré syndromes. The latter is often pronounced like "gillie-bear" while Gilbert's is sometimes pronounced "jill-bear" (apologies for the bad formatting), opening up the possibility of people looking at the incorrect article, so I'm going to add a  tag to both articles. I leave this section open to discussion of the topic as both can be confusing to spell given their non-English etymologies. Zedtwitz (talk) 02:32, 18 February 2014 (UTC)
replies: text: I really doubt that anyone will make the confusion, because Gilbert is one name, and "Guillain-Barré" is always used together. Wikipedia:Hatnote describes the guidance. JFW | T@lk 14:25, 20 February 2014 (UTC)
thread_title:  Distinguishing between Gilbert and Guillain–Barré Syndromes 

message: ■  Ms. Sil – Primary reference: The article in question was published in The Medical Post, issue 29(5):32. This journal "gives priority to doctors"; it is their stated mandate. The Medical Post doesn't typically accept patient accounts. That type of writing is left to home-style magazines and media reports; note such consumer sources have a blunting similarity with respect to GBS accounts; all sound the same apart from a change of name, job, and city. By contrast, The Medical Post accepts only articles of interest to doctors, which means that article must teach something new, even to doctors.
■  Ms. Sil – Secondary reference #1: The Saskatoon Star Phoenix newspaper reprinted Ms. Sil's entire article. Reference: What to Do When Doctor Doesn't Know Best, Star Phoenix, Lifestyle cover story, 24 September 1994.
■  Ms. Sil – Secondary reference #2: In the same edition of the Star Phoenix, in-depth editor Katheryn Warden devoted her entire column to discussing that piece. Reference: Informed Patients Involved in Medical Decisions, Star Phoenix, page C9, 24 September 1994.
■  Shortly, these secondary references will be available online. For independent verification visit a University Library, or any large Public Library, and consult their newspapers stored on micro-fiche.
■  Academic Qualifications: Ms. Sil earned an M.Sc. from the University of British Columbia in the field of Physics (Lasers and Nonlinear Optics).
■  Peer Review: The Medical Post – before publication as it does for any article – vetted at length the medical information from Ms. Sil. As did the journalist Ms. Sil collaborated with at the Star Phoenix.
■  The notable concept in Ms. Sil's article is the role reversal between doctor and patient. Many patients struggle to get diagnosed, but very few do the work themselves, with no medical training. Ms Sil applied for and obtained her own medical chart while she was in the hospital and used that chart to work alongside her doctors. She wrote notes to correct errors in her chart; these were accepted. This had the full blessing of Hospital Administration.
■  Ms. has, on her website Tuum Est, her diagnostic results for Guillain-Barre. Not just word reports, but graphs of Nerve-Conduction Velocity (EMG) tests. There are two sets of graphs, for tests done 3 weeks apart, giving a very clear picture of how the peripheral nerves demyelinate. Since the disease is rare, this would interest doctors (and med students), perhaps most in less advanced countries of the world. Medical Rights (talk) 04:35, 19 October 2014 (UTC)
thread_title: Re Ms. Sil's Guillain-Barre Reference

message: (1) Wikipedia is an encyclopedia, and the standard should be academic. On the Guillain-Barre page, the focus should be "Notable Cases" – the section's actual title. The title is not "Notable People." Whether a person is a rock star, football coach, or politician has little to do with whether readers will absorb anything of value from the reference. Stars likely receive better medical care during the acute stage of their disease, because then MDs and nurses are under a media magnifying lens, and don't want to be skewered for mistakes or neglect. Thus media reports of "star" cases may not mirror the average patient's experience. Later on when the media report becomes a simple reference, know this: Doctors are not star-struck and neither are most people searching for medical information. An "interesting case" refers to medical interest; doctors care not a jot about the glamor level of a patient's life.
(2) Perhaps there could be three lists: / Notable Cases (Academic) / Notable People (Stars) / GBS Patients Who Published Books /
(3) JDWolff removed Ms. Sil's reference from the Guillain-Barre page on Wiki. On his personal page, JDWolff says he is a “doctor of acute medicine.” If that is true (and I assume it is), then that places JDWolff in a conflict-of-interest position. Physicians as a group have a reputation for being highly sensitive to criticism – any criticism – of other doctors, of clinical skills, of hospitals. I expect JDWolff is no different. JDWolff should not be allowed to remove items that criticize health care, without a backup opinion from an objective administrator at Wiki (objective = someone not connected with health care).
(4) Recently, B.C. doctors began a campaign to increase the medical worth and accuracy of Wiki. Source: Wikipedia’s Medical Errors and One Doctor’s Fight to Correct Them (CBC News, 21 August 2014) at
http://www.cbc.ca/news/canada/british-columbia/wikipedia-s-medical-errors-and-one-doctor-s-fight-to-correct-them-1.2743268  That news report says: "Studies have shown that, on average, at least 50 per cent (or more) of doctors use Wikipedia in their practice. Heilman says the website is an easy way for physicians to jog their memories. For medical students, Wikipedia is their second most used information source."  Therefore, in the public interest Wiki has a duty on medical pages not to be star-struck, or to simplify the topic to pablum. Post updated. Medical Rights (talk) 04:35, 19 October 2014 (UTC)
thread_title: Hold Wikipedia to an Academic Standard

message: Ms. Sil's case of Guillain-Barre is supported by secondary sources. We produce these sources which Wiki instructs are important. Tuum Est scanned the original newspaper pages to form electronic JPG or PNG images. Our small scanner size meant we had to separately scan the top and bottom half of each newspaper page. Then we had to make a single document from the two halves. The methods we tried: (a) Concatenate the images in Apple Automator and output the result as a PDF. The result, however, looked very grainy for these old newspaper pages. (b) Then we tried an HTML webpage as a container; the code has a header plus two <img> tags to vertically align the two halves of the newspaper page on a white background. This worked well. You can obtain the individual images by clicking the image on the webpage and choosing "Save As". Medical Rights (talk) 12:29, 20 October 2014 (UTC)
replies: text: And all of these "secondary sources" (all authored by you) take us to your website. Am I missing something or misinterpreting :the "Primary Source" portion of the program? (I may be wrong, but not all the time.) I'll ask for help again. BTW... Thank You to JFW and Huon for their assistance. Regards,  Aloha27 talk  17:09, 20 October 2014 (UTC)
replies: text: Well, if Tuum Est has outgrown Wikipedia, we're clearly done here. There's one secondary source in all this, a Star Phoenix article not written by Sil herself. The others are all the same article written by Sil herself and re-published in various places. That's no better amount of coverage than for the celebrities Medical Rights objected to. Huon (talk) 17:56, 20 October 2014 (UTC)
replies: text: I thought we were done here as well when Medical Rights (talk) stated on their talk page that they no longer had interest in this article. An hour and six minutes later, the talk page here was edited. Thanks Huon and sorry to have had to ask again. Regards,  Aloha27 talk  18:37, 20 October 2014 (UTC)

text: I still see no evidence that Ms Sil (who I'm presuming is the same as ) has independent notability. Not everyone is sufficiently famous to get mentioned on Wikipedia. JFW | T@lk 23:14, 20 October 2014 (UTC)
thread_title: Secondary Sources are Now Online

message: This article has needed tidying up for some time.
#  Signs and symptoms - needs to be more detailed on the clinical distinction between subtypes
#  Causes - currently not written; this needs to list the common infectious triggers (chlamydia, campylobacter, herpesviruses, mycoplasma)
#  Mechanism - needs updating in general, especially with some discussion about the serological signals
#  Diagnosis - better sourcing for the importance of each test
#  Treatment - good sources are available, need more about the rehabilitation aspects
#  Prognosis - recently some information added, although some more QOL information would be valuable
#  Epidemiology - vaccine triggers should be discussed here discussed under "causes" instead
#  History - good secondary sources exist for this
#  Notable cases - should be migrated to its own subarticle
#  Research directions - we may need to talk about eculizumab
#  References
#  Further reading - should be integrated in the content; the book listed there currently is a good candidate for this section
#  External links - should be minimalist
Sources:
* doi:10.1038/nrneurol.2014.138 (2014), Nat Rev Neurol consensus group on classification
* doi:10.1038/nrneurol.2014.121 (2014), Nat Rev Neurol general review
* doi:10.1002/mus.24192 (2014), Muscle Nerve mostly about the subtypes with disialosyl antibodies (Miller Fisher syndrome, ataxic GBS and ASAN). 
* doi:10.1111/jns5.12051 (2014), J Peripher Nerv Syst about HRQOL
* doi:10.1097/MOP.0b013e328365ad3f (2013), Curr Opin Pediatr GBS in children (not covered currently)
* doi:10.1016/S1474-4422(13)70215-1 (2013), Lancet Neurol axonal GBS
* doi:10.1586/1744666X.2013.811119 (2013), Expert Rev Clin Immunol infectious and noninfectious triggers
* doi:10.1111/jns5.12020 (2013), J Peripher Nerv Syst general update
* Epidemiology sources listed above
*  and  - review about rehabilitation
Will try to do some stuff here. Help appreciated as always. JFW | T@lk 00:00, 2 November 2014 (UTC)
replies: text: I've got that book "Guillain-Barré:From diagnosis to recovery". I'll get more info up and cite it. Let me know if/when I do that incorrectly? Regards,  Aloha27 talk  13:24, 3 November 2014 (UTC)
replies: text: Review in children (in addition to Ryan2013). I have no access: doi:10.1542/pir.33-4-164 JFW | T@lk 08:43, 1 January 2015 (UTC)
thread_title:  Updating 

message: Epidemiology[edit]
In Western countries, the incidence (number of episodes per year) per 100,000 people has been estimated to be between 0.89 and 1.89 cases. The risk increases by 20% for every decade.[29] 
My concern is that the sentence "The risk increases by 20% for every decade" could be misinterpreted to mean that the risk of GBS is increasing with every decade for the population as a whole, rather than as the age-related increase observed. The cited study says that "GBS incidence increased by 20% for every 10-year increase in age." http://www.karger.com/Article/FullText/324710
I've not done any editing on Wikipedia, which is why I'm commenting rather than editing myself. 
Wikimol03 (talk) 06:02, 5 December 2014 (UTC)
replies: text: Thanks . I will rephrase. Always feel free to change something yourself; great articles come about because folk like yourself are BOLDly updating pages. JFW | T@lk 21:11, 6 December 2014 (UTC)
thread_title:  Epidemiology 

message: I removed the following:
* Acute panautonomic neuropathy is the rarest variant of GBS, sometimes accompanied by encephalopathy. It is associated with a high mortality rate, owing to cardiovascular involvement, and associated dysrhythmias.  Frequently occurring symptoms include impaired sweating, lack of tear formation, photophobia, dryness of nasal and oral mucosa, itching and peeling of skin, nausea, dysphagia, and constipation unrelieved by laxatives or alternating with diarrhea.  Initial nonspecific symptoms of lethargy, fatigue, headache, and decreased initiative are followed by autonomic symptoms including orthostatic lightheadedness, blurring of vision, abdominal pain, diarrhea, dryness of eyes, and disturbed micturition. The most common symptoms at onset are related to orthostatic intolerance, as well as gastrointestinal and sudomotor dysfunction. Parasympathetic impairment (abdominal pain, vomiting, constipation, ileus, urinary retention, dilated unreactive pupils; loss of accommodation) may also be observed.
The reason for this removal is the fact that none of the reviews (NEJM2012, NatRevNeurol2014 and others) mention it as a GBS subtype, and doi:10.1136/jnnp-2012-302833 states that inclusion is "disputed". A very recent classification system (still need to cite) by Wakerley et al does not include it (doi:10.1038/nrneurol.2014.138). I am happy to be corrected, but for now I will stick to the classifications introduced by the key sources. JFW | T@lk 22:06, 7 December 2014 (UTC)
thread_title:  Acute autonomic neuropathy 

message: Thanks to user:TylerDurden8823 for the contribution. But why remove babinski reflexes from the Bickerstaff symptoms? That's not just a decreased reflex. PizzaMan (♨♨) 08:17, 12 December 2014 (UTC)
replies: text: The source I saw describing BBE did not mention Babinski at all. If you have a source for Bickerstaff that mentions Babinski sign (not a symptom but a medical sign), feel free to add it back in. I didn't think that was something a major review would gloss over and if it were really a prominent feature of BBE, I figured the Nature Review would probably have at least mentioned it once. I'm not opposed to adding it back in though if you or someone else can demonstrate it is part of BBE with a reputable source. TylerDurden8823 (talk) 13:48, 12 December 2014 (UTC)
replies: text: Recent reviews point out that hyperreflexia may occur in the early stages of all cases. I don't think Bickerstaff's is unique. JFW | T@lk 15:32, 12 December 2014 (UTC)
replies: text: So, we don't need to mention it specifically then for BBE? TylerDurden8823 (talk) 22:48, 12 December 2014 (UTC)
replies: text: Very interesting for a disease of the peripheral nervous system. And so would a babinski be, because that's typically caused by a damaged piramidal tract. But yes, in that case it should be mentioned in general then in stead of specifically with Bickerstaff. JFW, can you point us to one of those reviews? Again, TylerDurden8823, thank you for contributing to this article. PizzaMan (♨♨) 13:29, 13 December 2014 (UTC)

text:  The finding of hyperreflexia is already mentioned in "Signs and symptoms". The NEJM2012 and NatRevNeurol2014 sources do not actually mention abnormal plantar reflexes, so perhaps that finding is unique to BBE. JFW | T@lk 20:22, 13 December 2014 (UTC)
replies: text: If we do find a good review that does specifically mention this, I have no objection to saying that Babinski is part of BBE. I just want to see verification. TylerDurden8823 (talk) 22:39, 13 December 2014 (UTC)
thread_title:  Babinski in Bickerstaff 

message: The cited NEJM article and 15 July 2014 Nature Neurology review on Guillain-Barré by van den Berg et al. states that BOTH AMAN and AIDP are caused by antibody formation, albeit directed towards different peripheral nerve targets. AIDP is less well characterized, but involves antibodies formed against unidentified antigens of the Schwann cell itself. AMAN is caused by antibodies against GM1 and GD1a gangliosides located in the node of Ranvier. These antibodies are formed via molecular mimicry from Campylobacter lipo-oligosaccharide outer membrane. Please see Figure 2 in the cited NEJM article or Figure 2 in the Nature review.
Nature Reviews Neurology 10, 469–482 (2014) doi:10.1038/nrneurol.2014.121
Published online 15 July 2014  — Preceding unsigned comment added by 173.165.81.169 (talk) 15:57, 2 May 2015 (UTC)
replies: text: The NEJM review uses guarded language ("autoantibodies may bind to myelin antigens") and in the text itself does not mention the antibodies nor their possible epitopes. The van den Berg review similarly is vague on this (apart from discussing anti-GM2 in CMV infections). I will have a look at the wording. Presumably someone has tried to demonstrate the actual presence of IgG on the myelin sheath, but the reviews don't cite this evidence. Thanks for bringing this up. JFW | T@lk 21:40, 23 June 2015 (UTC)
thread_title:  Guillain-Barré mechanism 

message: So, having some time available, I might just be able to finish the work on this and get it nominated for GA:
*  Address the point of the anonymous editor in the previous section
*  Finish the "neurophysiology" section with sources listed above (Uncini in particular) - a neurology colleague has explained the key points of NCS/EMG
*  "Citation needed" in "clinical subtypes" with regards to Bickerstaff
*  Complete the "rehabilitation" section, replacing the content that is based on primary sources.
*  In "prognosis", incorporate the HRQL discussion from doi:10.1111/jns5.12051
*  In "prognosis", address the "citation needed" tags
Help appreciated as always. JFW | T@lk 20:54, 22 June 2015 (UTC)
replies: text: I wasn't planning on adding more sources, and you will find that I've referenced the relevant Cochrane reviews. JFW | T@lk 18:26, 26 June 2015 (UTC)
thread_title:  Another push 

message: *review 
*systematic  (page)
*books  (page)
*position statements 
*Cochrane reviews 
*American Association of Neuromuscular & Electrodiagnostic Medicine 
*WHO 
I would also recommend this image in symptoms section as half of those affected experience cranial nerve involvement
perhaps these can help--Ozzie10aaaa (talk) 22:18, 25 June 2015 (UTC)
replies: text: I wasn't planning on adding more sources, and you will find that I've referenced the relevant Cochrane reviews. JFW | T@lk 18:26, 26 June 2015 (UTC)
thread_title: possible references

message: Currently states "...This life-threatening scenario is complicated by other medical problems such as pneumonia, severe infections, blood clots in the lungs and bleeding in the digestive tract in 60% of those who require artificial ventilation"
I think the "and" in that list of complications should be an "or" - I presume 60% of patients with respiratory involvement do not get all those complications and a rereading of the sentence implies that ("such as..."), but perhaps not and they get all these and more that have not been fully included (I don't have access to the NEJM article) ? 
(Well done on the Good article) David Ruben  Talk  21:50, 12 July 2015 (UTC)
thread_title:  Respiratory Failure 

message: I couldn't find any reference to whether there's a genetic predisposition to this syndrome. Presumably there is a genetic correlation, but how strong is it? Jonathan Tweet (talk) 23:13, 29 February 2016 (UTC)
replies: text: That's because the key sources do not discuss this at all. What makes you think there should be a genetic correlation? I am not saying that there isn't, but it looks like it hasn't been studied well. JFW | T@lk 08:58, 1 March 2016 (UTC)
replies: text: Now that we've mapped the genome and now that personal gene mapping is efficient, epidemiologists are finding genetic correlations to lots of syndromes. Not this one yet, I guess. I would imagine that someone whose blood relative has this condition might want to know to what extent it runs in families. Here's a site that says, "Some studies show that normal variations in certain genes may be associated with an increased risk of developing Guillain-Barré syndrome; however, more research is necessary to identify and confirm associated genes." link The site specifies the TNF gene as associated with GBS. Here's a site where a doctor says that familial predisposition to GBS is real but slight link. That's what I figured because it's really common for genes to influence susceptibility to syndromes even when a syndrome is not strictly speaking heritable. Jonathan Tweet (talk) 20:05, 3 March 2016 (UTC)
thread_title:  heritability? 

message: Currently still in "online first" - doi:10.1016/S0140-6736(16)00339-1 JFW | T@lk 20:00, 9 June 2016 (UTC)
thread_title:  Lancet review 

message: I am confused by the two pronunciations in the box:  Wouldn't the L be pronounced as an L in either language?  173.91.88.197 (talk) 06:28, 12 February 2017 (UTC)
replies: text: After doing a bit of legwork, it appears that the French name Guillain is pronounced with L in French, but because that spelling could be pronounced /j/ within the framework of French orthography (and to my ear, it would be), that pronunciation has taken hold widely, at least outside of French-speaking places. (My mother is a GBS survivor and speaks fluent French, and she uses the /j/ pronunciation...) — tooki (talk) 01:14, 26 November 2019 (UTC)
thread_title:  Pronunciation 

message: what is the point of showing the picture of the spirometer device? It does not seem all that specific to this disease and instead seems an advertisement for a handheld pulmonary device. It is agreed that GBS patients can and do have breathing issues but that the device is only a subset of the breathing issue, which breathing issues are a subset of the neurological issues.  — Preceding unsigned comment added by 23.249.100.250 (talk) 15:43, 16 October 2018 (UTC)
replies: text: I replaced this image with the animation of how GBS damages nerves. Tornado chaser (talk) 02:30, 17 October 2018 (UTC)

text: And I was reverted because animations apparently can't go in the infobox. Tornado chaser (talk) 03:11, 17 October 2018 (UTC)
thread_title:  introduction picture 

message: The Causes section only mentions infections as the cause for "two thirds" of the cases.  The rest of the section mentions nothing but infections ... except maybe vaccinations as a separate cause; though I'm not sure if this is being considered here as a totally separate one.
Is it the intention to leave the reader "in the dark" as the exact cause is unknown, as stated in the opening?  If that's the intention, it may be a good idea to address again that the remainder of the cases have no known causes — which would be the remaining 1/3 of the whole.
Thanks!
LordJair (talk) 01:35, 23 January 2019 (UTC)
thread_title:  Causes and Proportions 

message: The current title uses an en dash between Guillain and Barré. The article was originally created with a hyphen, but was moved with "en dash connects two names" as the justification. But the relevant section of WP:MOS states: "Generally, use a hyphen in compounded proper names of single entities", and gives the example of Wilkes-Barre, PA, which is named after two people. That's the same situation as here. (The en dash serves to show a separation between the two, as opposed to the hyphen linking them.) As such, I believe this article should be moved back to the hyphenated version. Thoughts? — tooki (talk) 01:17, 26 November 2019 (UTC)
thread_title:  Title formatting 

message: I have removed the following:
:A 2018 outbreak of GBS in Peru, triggered a state of emergency and was linked to an enterovirus. 
Neither this source or any other sources in English about this outbreak are precise about the enterovirus involved. The Enterovirus group is huge and without more detail I don't think this should be mentioned. JFW | T@lk 15:17, 19 August 2020 (UTC)
thread_title: Peru

message: The U.S. CDC is going to announce that the Johnson & Johnson COVID-19 vaccine has a slight risk of GBS. The editors of this article should be prepared for an influx of edits and pageviews. Madcoverboy (talk) 19:40, 12 July 2021 (UTC)
replies: text: I was inclined to agree that any mention of this news in the page is an WP:UNDUE WP:RECENTism, but I hadn't realized that this actually echoes an event in the 1970s. The fact that there's long-term and sometimes high-volume coverage of a connection between vaccination against flu-like diseases and onset of this syndrome suggests that some discussion of the Covid vaccine news in this page is probably warranted. But I think you're both right that the discussion should be kept short (and obviously meticulously WP:VERIFIABLE) for now. - Astrophobe (talk) 23:39, 12 July 2021 (UTC)
thread_title:  J&J COVID-19 vaccine 

message: I noticed an inconsistency in the article where it reads in the 1st paragraph:
"Both sexes and all parts of the world have similar rates of disease."
And, in the section called Epidemiology, it reads:
"Men are more likely to develop Guillain–Barré syndrome than women; the relative risk for men is 1.78 compared to women."
Which statement is correct? Zarp (talk) 15:59, 15 August 2023 (UTC)
thread_title:  Epidemiology and prevalence in sexes 

message: Do not see a stand alone article or one in here that explains the medicine / scientific perspective of person-years. Just one on productivity as a stand alone article so that is not helpful for medical information and figured it could be added in this article and on here: https://en.wikipedia.org/wiki/Man-hour#Similar_units which is a redirect of person years. 68.48.113.58 (talk) 19:40, 13 October 2023 (UTC)
thread_title:  Person-Years