Analysing Trends of Guillain-Barre Syndrome (GBS)and Dengue cases in Hong Kong

Objective:  To study the trends of GBS and dengue in Hong Kong, the ecological associations between GBS, dengue, and local meteorological factors. To examine the non-stationary oscillating association among these factors. Introduction:  Guillain-Barre Syndrome (GBS) is a severe paralytic neuropathy associated with virus infections such as Zika virus and Chikungunya virus. There were also case reports of dengue fever preceding GBS. With the aim to understand the mechanisms of GBS and dengue outbreaks, this ecological study investigates the relationships between GBS, dengue, meteorological factors in Hong Kong and global climatic factors from January 2000 to June 2016. Methods:  The correlations between GBS, dengue, Multivariate El Nino Southern Oscillation Index (MEI) and local meteorological data were explored by Spearmanu0027s Rank correlations and cross-correlations. Three Poisson regression models were fitted to identify non-linear associations among GBS, dengue and MEI. Cross wavelet analyses were applied to infer potential non-stationary oscillating associations among GBS, dengue and MEI. Results:  We found a substantial increasing of local GBS and dengue cases (mainly imported) in recent year in Hong Kong. The seasonalities of GBS and dengue are different, in particular, GBS is low while dengue is high in the summer. We observed weak but significant correlations between GBS and local meteorological factors. MEI could explain over 17% of dengueu0027s variations based on Poisson regression analyses. We report a possible non-stationary oscillating association between dengue fever and GBS cases in Hong Kong. Conclusions:  We report increasing patterns of both local GBS cases and imported dengue cases in Hong Kong, and investigate the possible mechanism behind these patterns.This study has led to an improved understanding about the timing and ecological relationships between MEI, GBS and dengue.