Marler Clark is representing three dozen of the victims and their families, including the Stevens, the Palmers, the Jones and the Beaches. Just the medical bills alone for these four families were over $600,000.

2011 Jensen Farms Listeria Cantaloupe Outbreak from Marlerclark on Vimeo.

Now, since then three of my Listeria clients, Paul Schwarz (MO), Sharon Jones (CO) and Mike Hauser (CO) have died. Mr. Hauser died today (See, Mike with a grandchild before his illness and Penny watching over Mike while he was hospitalized for over four months).  In addition, I learned last week that Listeria victim, Dale Braddock (NE), also died.

CDC, are you going to update the number of the dead?  Or, are you simply not interested in updating your “statistics?”

UPDATE by Mike Booth of the Denver Post:

The death toll from Colorado's cantaloupe listeria outbreak could eventually reach 36 or more, after a CDC update of the count and reports of listeria-linked deaths not yet included in the tally.

The Centers for Disease Control and Prevention said Wednesday it has updated the death toll from Colorado's cantaloupe listeria to 32, but the two added most recently occurred "well before" Dec. 8.

Here are all Six Parts of The Deadly 2011 Cantaloupe Listeria Outbreak - My View - Download PDF.

You are right, she did not.

Not so for everyone.  In late October 2003, Beaver County ER doctors reported an alarming number of Hepatitis A cases. Investigators from the Pennsylvania Department of Health initiated an investigation immediately and discovered that many, if not all, cases had eaten at Chi Chi’s restaurant in Monaca, Pennsylvania’s Beaver Valley Mall. Along with the health department, the federal Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) conducted further studies of the outbreak. Preliminary analysis of a case-control study suggested that green onions were the probable source of the outbreak. The onions had been shipped to the restaurant in boxes and were stored and refrigerated in buckets of ice. They were eventually chopped up and served in various dishes at the restaurant, often uncooked, as in the preparation of mild salsa. “Preliminary trace-back information indicated that the green onions supplied to Chi Chi’s had been grown in Mexico.” Ultimately, over 650 people were sickened in the outbreak. The victims included at least thirteen Chi Chi’s employees and numerous residents of six other states. Four people died from their injuries, and more than 9,000 people obtained immune globulin shots as protection against the virus. This is the story of one of those cases.

Richard Miller Hepatitis A Food Poisoning Illness and Lawsuit from Marlerclark on Vimeo.

“"Beck recently called the law "the Death Star", adding, "this is what Stalin did," and claiming that America has the safest food supply in the world."

Beck is now being joined by a chorus of Republican’s claiming that the legislation needs no funding because as former ranking Republican Jack Kingston claims “the U.S. food supply 99.99 percent safe.”

In essence the argument is that we can not afford the $1.4 billion (over five years) price tag to implement the legislation which in large part if the cost of hiring more inspectors at FDA to allow inspections of food manufacturing facilities more frequently than the five to seven years that occurs now. Or as Fred Love, a spokesman for Rep. Tom Latham, who sits on the appropriations subcommittee that deals with the FDA, said in an e-mail:

"When one considers the record deficits our country faces and the renewed focus on fiscal restraint in the U.S. House of Representatives, it's going to be very difficult to find the money to pay for implementation of the bill."

Several Republicans point to the “new CDC numbers” as evidence that the Government’s work on food safety is done. Since 1999, the CDC has estimated the number of cases of foodborne illnesses in the USA each year as 76 million, with 325,000 hospitalizations and 5,000 deaths. Now, after almost a decade of work, the CDC released new numbers - 47.8 million cases of foodborne illness, 127,000 hospitalizations and 3,030 deaths.

However, before the Republican’s once again claim “Mission Accomplished,” the CDC says the drop is likely caused by improved surveillance of illnesses, better criteria for determining an actual food-related illness, and exclusion of international travel-related illnesses. Yet, even if the new numbers from the CDC also show improvement, should we really be satisfied that ONLY 48 million of us yearly are sickened by the food we eat?

Setting aside the personal, human, toll for a moment to look at the numbers; In a 2010 report by Robert L. Scharff for the Pew Memorial Trust, medical and other costs to victims amounted to $152 billion a year. This Pew Study (based upon the 1999 CDC estimates), presumably with a 37% reduction in counted illnesses, the costs to victims yearly ONLY are a few billion over $100 billion.

In addition, the Pew Study did not account for recall costs, lost sales, loss of reputation, loss of exports, etc., to the businesses that caused or businesses that were in the chain of distribution of the offending product. However, one only has to remember the Spinach, Tomato, Peanut Butter and Egg outbreaks in the last few years to see $100’s of millions in business losses – independent of the $10’s millions paid in personal injury settlements and verdicts.

So, really, is our food supply “99.99 percent safe?” So, really, is Beck correct that implementing this bill would be akin to Stalin’s food policies or the Star War’s “Death Star?” Is $1.2 billion over five years too much to invest in providing more resources to the FDA, the CDC and State and Local Health Departments to do more inspections and more accurate surveillance of foodborne disease?

Glenn and his Republican minions should ask Linda Rivera and her family:

Now that food safety legislation appears to be dead, the choices for victims is to simply take matters into their own hands.

Elizabeth and Michael Armstrong were extremely health-conscious when it came to feeding their two children—Ashley, 2, and Isabella, 4. There was, as a result, nothing unusual about their feeding them a salad made with Dole-brand baby spinach in August, 2006. Unfortunately, the spinach proved to be contaminated with E. coli O157:H7, and Ashley and Isabella became two of the many victims of a nationwide outbreak of infections linked to Dole’s bagged spinach products. Although Isabella recovered relatively quickly from her infection, Ashley developed a rare and extremely dangerous complication—hemolytic uremic syndrome, or HUS.

2-4-2010

I was on the phone with Richard this morning. Linda has developed a condition called “ascites”. Ascites is when the liver weeps out fluid from itself and the fluid builds up within the abdominal cavity. The fluid buildup can get to the point where the person appears similar to a woman who is pregnant. Linda had around 7 liters of fluid in her belly. The doctors “tapped” out the fluid and sent it for analysis.

Why Linda has this fluid buildup is not certain but, very likely, represents progression of her liver problems to cirrhosis. Other possibilities not related to the liver are possible but cirrhosis leads with the highest possibility. Due to this buildup, they decided not to surgically close the tracheotomy (the breathing opening in her throat). Fluid buildup in the belly interferes with breathing mechanics because the fluid interferes with the diaphragm, the anatomic structure that allows us to breathe in and out. Also, this fluid oftentimes leaks into the cavity surrounding the lungs, which can interfere with her ability to obtain oxygen within her lungs. Rather than risk taking out the tracheostomy device and closing the tracheotomy opening, only to have to potentially put down another breathing tube due to respiratory failure, they have elected to keep the opening for as long as this threat remains.

This is a setback, possibly reflecting onset of end stage liver disease. Please keep Linda and Richard in your thoughts and prayers. It has been a roller coaster ride for sure.

A roller coaster ride for sure. 

On September 18, 2006, the California Department of Health Services (CDHS) opened an investigation of a possible outbreak of E. coli O157:H7 infections after receiving reports of two patients who had been hospitalized with HUS. One was culture confirmed as infected with E. coli O157:H7. Interviews revealed that both patients had consumed unpasteurized cow milk sold by Organic Pastures in the week prior to the onset of illness.

In the following days, four additional cases of E. coli O157:H7 were identified. All of the additional cases had consumed raw milk or raw cow product sold by Organic Pastures. Isolates of the E. coli O157:H7 cultured from the five culture-positive patients had indistinguishable “genetic fingerprints” as determined by pulsed-field gel electrophoresis (PFGE) testing. These PFGE patterns were new to the national PulseNet database. In other words, the pattern associated with all of these children was unique, and had not been seen before in conjunction with any other outbreaks of E. coli O157:H7. In addition, the PFGE pattern differed markedly from the patterns associated with the outbreak of E. coli O157:H7 associated with Dole fresh-bagged baby spinach that had peaked a few weeks prior to these illnesses.

CDHS conducted an epidemiological and environmental investigation of the cluster of illnesses. A review of 50 consecutive E. coli O157:H7 cases reported to CDHS from October 2004 to June 2006 revealed that 46 of 47 cases asked about raw milk consumption reported consuming no raw milk. In contrast, five of the six patients in the cluster being investigated reported definite consumption of Organic Pastures raw dairy products. The sixth denied consuming the raw milk, but his family routinely consumed Organic Pastures raw milk during the suspected time frame. Two of the children developed Hemolytic Uremic Syndrome. This is the video of one of the children in the hospital:

The California Department of Food and Agriculture conducted an environmental investigation. As part of the investigation, fecal samples were collected from dairy cows at Organic Pastures. E. coli O157:H7 was isolated from five of the samples, although the PFGE patterns differed from the pattern associated with the outbreak. Testing of Organic Pastures product revealed abnormally high aerobic plate counts and fecal coliform counts. CDHS ultimately concluded: “the source of infection for these children was likely raw milk products produced by the dairy.”  The CDC published this report in 2008.

On May 12, 2008 the Lawrence County Health Department (LCHD) was notified of a case of HUS in a child with a history of bloody diarrhea. The health care provider reported that the child had consumed unpasteurized goat’s milk obtained from a local store, the Herb Depot, in Barry County, Missouri. The milk had been purchased on April 29, 2008. It was quickly learned that an additional Barry County child that had cultured positive for E. coli O157:H7 had also consumed unpasteurized goat’s milk from the same store. As a result, the LCHD contacted the Missouri Department of Health and Senior Services (DHSS) who began a full epidemiological and environmental investigation of the illnesses. The investigation revealed that the milk consumed by both ill children had been produced at Autumn Olive Farms.

At the conclusion of its investigation, the DHSS ultimately announced that there were four cases of E. coli O157:H7 associated with the outbreak. Of these, three were laboratory confirmed, and one was identified as a probable case. Each of these individuals resided in different counties in Southwest Missouri, and were not known to have any relation to each other. Nonetheless, each shared a common exposure to milk from Autumn Olive Farms. In addition, the three culture-confirmed cases shared a common, indistinguishable genetic strain of E. coli O157:H7. The strain was identified as a unique subtype of E. coli O157:H7, never before reported in Missouri. Each of the four cases had consumed milk from Autumn Olive Farms within 3-4 days of onset of illness. The DHSS reported: “no other plausible sources of exposure common to all four cases were identified [other than the milk.]” The final outbreak report ultimately concluded: “the epidemiological findings strongly suggest the unpasteurized goat’s milk from Farm A [Autumn Olive] was the likely source of infection for each of the cases associated with this outbreak.”

The Victims

Larry Pedersen had just turned one year old when he developed an E. coli O157:H7 in May 2008. When his diarrhea turned bloody, his parents took him for medical treatment. He was admitted to the hospital on May 8. Shortly thereafter, Larry developed hemolytic uremic syndrome (HUS) and was transferred to a specialty care facility. As is typical of HUS, Larry was then suffering from acute renal failure. He was started on dialysis, which was necessary at that point for his survival. He required 15 days of dialysis before his kidneys recovered enough to function on their own. Larry was discharged on May 29, to continue recovery and treatment on an outpatient basis. The medical bills associated with his care approached $90,000. As the result of damage to his kidneys suffered during his bout with HUS, Larry is at significant risk for severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

Nicole Riggs developed an E. coli O157:H7 infection in May 2008 from consumption of raw goat’s milk. She was nine years old at the time. Nicole suffered from symptoms typical of E. coli O157:H7 infections – bloody diarrhea, cramping, and nausea – that quickly intensified and led to her hospitalization on May 8, 2008. Once hospitalized, Nicole developed renal failure, anemia, and thrombocytopenia (low platelet count) indicating that she was developing HUS. She was transferred to a Children’s hospital and started on dialysis in order to save her life. She received dialysis for 18 days. Nicole’s renal function slowly returned to the point that she was deemed healthy enough for discharge on June 1. After discharge, she remained under the care of a nephrologist. In addition, damage suffered during her HUS has required that her gall bladder be removed. Medical costs to this point exceed $180,000. As the result of damage to her kidneys suffered during her bout with HUS, Nicole is at significant risk for severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

In the following days, four additional cases of E. coli O157:H7 were identified. All of the additional cases had consumed raw milk or raw cow product sold by Organic Pastures. Isolates of the E. coli O157:H7 cultured from the five culture-positive patients had indistinguishable “genetic fingerprints” as determined by pulsed-field gel electrophoresis (PFGE) testing. These PFGE patterns were new to the national PulseNet database. In other words, the pattern associated with all of these children was unique, and had not been seen before in conjunction with any other outbreaks of E. coli O157:H7. In addition, the PFGE pattern differed markedly from the patterns associated with the outbreak of E. coli O157:H7 associated with Dole fresh-bagged baby spinach that had peaked a few weeks prior to these illnesses.

CDHS conducted an epidemiological and environmental investigation of the cluster of illnesses. A review of 50 consecutive E. coli O157:H7 cases reported to CDHS from October 2004 to June 2006 revealed that 46 of 47 cases asked about raw milk consumption reported consuming no raw milk. In contrast, five of the six patients in the cluster being investigated reported definite consumption of Organic Pastures raw dairy products. The sixth denied consuming the raw milk, but his family routinely consumed Organic Pastures raw milk during the suspected time frame.  Two of the children developed Hemolytic Uremic Syndrome.  This is the video of one of the children in the hospital:

The California Department of Food and Agriculture conducted an environmental investigation. As part of the investigation, fecal samples were collected from dairy cows at Organic Pastures. E. coli O157:H7 was isolated from five of the samples, although the PFGE patterns differed from the pattern associated with the outbreak. Testing of Organic Pastures product revealed abnormally high aerobic plate counts and fecal coliform counts. CDHS ultimately concluded: “the source of infection for these children was likely raw milk products produced by the dairy.”

 It is time to step up and make Abby and her family the last to suffer this horror.  Mr. President, Senators, Congress Members, do your jobs!

Abby’s illness, and her Grandfather's, were linked to a Class I Recall by FSIS in May 2009 - Illinois Firm Recalls Ground Beef Products Due To Possible E. coli O157:H7 Contamination

I. THE OUTBREAK

On October 2, 2008, the California Department of Public Health (CDPH) issued a report linking an outbreak of Campylobacter illnesses to unpasteurized milk from Alexandre Eco Farms Dairy. The report was the result of an investigation commenced on July 14, 2008, when Dr. Thomas Martinelli, the County Health Officer for Del Norte County, California reported four cases of laboratory confirmed Campylobacter infections and five additional cases of diarrhea in Del Norte County residents. Eight of the original nine sick individuals were members of the Alexandre Eco Farms “cow-leasing” program. Eight of these individuals had consumed milk produced on the farm. The ninth sick individual worked with cattle on the Alexandre Eco Farms Dairy. One of the eight individuals who were sick, Mari Tardiff, had already been hospitalized with GBS, following the onset of acute gastroenteritis after consumption of the milk.

As part of the investigation, health department officials retrieved a refrigerated carton of partially consumed Alexandre Eco Farms milk from Mari Tardiff’s home. Mari had consumed a portion of the milk before her illness. The specimen tested positive for Campylobacter jejuni DNA using a test called polymerase chain reaction (PCR). Testing indicated that multiple strains of Campylobacter jejuni were present in the milk. Del Norte County officials eventually identified 16 cases of Campylobacter jejuni associated with the outbreak. Fifteen of those were persons who consumed milk from Alexandre Eco Farms Dairy. The 16th case was the farm employee. CDPH and Del Norte county officials concluded that “the available epidemiologic and laboratory data support the conclusion that this cluster of acute diarrheal illness in Del Norte County was an outbreak of C. jejuni infections caused by consumption of unpasteurized milk from [Alexandre Eco Farms Dairy.]”

The causal link between Alexandre Eco Farms Dairy and Mari’s illness was so clear, and her injuries so remarkable, that the physicians that treated her published a report on her case in the medical journal. “Investigation of the First Case of Guillain-Barre Syndrome Associated with Consumption of Unpasteurized Milk – California, 2008.” Amy K. Earon, T. Martinelli, W. Miller, C. Parker, R. Mandrell, D. Vugia. The authors explained the laboratory methods used in investigating Mari’s illness:

We reviewed the patient’s medical record and interviewed her husband to assess her symptoms and exposures. We used polymerase chain reaction (PCR) and multilocus sequence typing (MLST) to test a six-week old unpasteurized milk sample, obtained from the cow leasing-program and partially consumed by the patient, for genes encoding the bacterial membrane component lipooligosaccharide (LOS) in GBS-associated Campylobacter jenuni.

In addition to the DNA testing, the authors also tested Mari’s blood for anti-bodies to GBS. The authors then explained that the PCR and MLST testing of the milk detected Campylobacter jejuni gene. In addition, the blood test was positive for anti-bodies that indicated the presence of GBS. The authors concluded, “Combined laboratory and epidemiologic evidence established the first reported association between GBS and unpasteurized milk consumption.”

II. MARI TARDIFF’S ILLNESS

On the weekend after Mari drank raw milk, she developed flu-like symptoms, including diarrhea and vomiting. By Thursday, June 12, the food poisoning was overwhelming her body with an amazingly swift force. First her vision blurred. Then her hands went numb. Mari went to an emergency room, and there lab work was done and abdominal X-rays were taken. But doctors could not determine what was wrong. On Friday, Peter took Mari to a neurologist. An MRI was normal but the doctor and radiologist mentioned a frightening possibility – Guillain-Barré syndrome, or GBS, a potentially fatal inflammatory disorder.

Hours later Mari’s legs were on fire, searing with pain that, ironically, only hot water helped to soothe. Her legs hurt so much that she soon retreated to bed, wrapping her legs in warm towels and a heating blanket. During that night, Mari awoke and realized she could not move. Peter bear-hugged her to lift her to the toilet and then carried her back to bed. In the early hours of the morning, he called for help, which led to an ambulance ride to the small Sutter Coast Hospital, and then a medivac flight to the Intensive Care Unit at the larger, better-equipped Rogue Valley Medical Center (RVMC) in Medford, Oregon. She remained hospitalized for two and one-half months.

Mari was moved to Redding Rehabilitation Hospital and was finally able to come home on November 1, 2008. Today, Mari lives in her family room, which now is equipped with a hospital bed, portable toilet, a Hoyer lift and a stand-up frame, all purchased by the Tardiffs. Using their own resources, they also renovated a downstairs half-bath and laundry room into a handicapped-accessible bathroom and shower. The Tardiffs pay two nurses $10.50 an hour to care for Mari from 7:30 A.M. until 7:00 P.M. five days a week while Peter is at work. Home health physical and occupational therapists also come to the house five days a week.

Mari works very hard at therapy but it is a slow, painful process. Peter has found it so upsetting that he no longer can watch. Every improvement is celebrated, but he knows how much discomfort and frustration goes into each minute, regained movement. Mari may never walk again. She lost her job, she lost her dreams and plans that she held dear. The illness has been a long, arduous journey for Mari, her family and friends, and while she has made progress, there remains a long way to go.

READ MORE ON CAMPYLOBACTER AND GULLAIN BARRE SYNDROME

Campylobacter jejuni (pronounced “camp-e-low-back-ter j-june-eye") is a bacterium that was first recognized as a cause of human gastrointestinal illness in 1975. Since that time, the bacterium has been identified as the most common cause of bacterial foodborne illness in the U.S., ahead of Salmonella – the second most common cause (MMWR Weekly, 2000, March 17; Tauxe, 1992).

Over 10,000 cases are reported to the Centers for Disease Control and Prevention (CDC) each year; however, many more cases go undiagnosed or unreported and estimates are that Campylobacter causes 2 to 4 million cases per year in the United States. Active surveillance for cases indicates that over 20 cases for each 100,000 persons in the population are diagnosed yearly, and 124 deaths are attributed to C. jejuni annually (CDC, 2005, October 6). Current estimates are that each case of campylobacteriosis costs $920 on average due to medical and productivity (lost wages) expenses with an annual total cost of approximately $1 billion (CAST, 1994).

The CDC reported that the incidence of Campylobacter infection decreased by 30 percent in the ten-year period between 1996 and 2006 (MMWR, 2007, April 13).

Campylobacter jejuni is a gram-negative, microaerophilic, thermophilic rod that grows best at 42°C (107°F) and low oxygen concentrations. These characteristics are adaptations for growth in its normal habitat – the intestines of warm-blooded birds and mammals. Several closely related species with similar characteristics, C. coli, C. fetus, and C. upsalienis, may also cause disease in man but are responsible for less than one percent of human infections annually (CDC, 2005, October 6).

Food is the most common vehicle for the spread of Campylobacter, and chicken is the most common food implicated. Contamination occurs during animal slaughter and processing when it comes into contact with animal feces. Ingestion of as few as 500 organisms – an amount that can be found in one drop of chicken juice – has been proven to cause human illness (FSIS, 1996; Tauxe, 1992). Despite this low infectious dose and the prevalence of Campylobacter jejuni in the environment, most cases of Campylobacter infection occur as isolated, sporadic events, and are not usually a part of large outbreaks. But, very large outbreaks (>1,000 illnesses) of campylobacteriosis have been documented, most often from consumption of contaminated milk or unchlorinated water supplies.

Identified common food vehicles for Campylobacter, in addition to poultry include unpasteurized milk, undercooked meats such as beef, pork, lamb, and livestock offal, and occasionally shellfish, fresh produce, and eggs.

IV. GULLAIN BARRE SYNDROME

Guillain-Barré (ghee-yan bah-ray) syndrome (GBS) is a disorder in which the body’s immune system attacks part of the peripheral nervous system. The peripheral nervous system includes the cranial nerves (except the optic [eye] nerve), the spinal nerves, and the autonomic nervous system that governs involuntary actions. The central nervous system is the spinal cord and brain.

GBS includes several subtypes, the most common of which is a multifocal demyelinating disorder of the peripheral nerves referred to as an acute inflammatory demyelinating polyneuropathy (AIDP). Some cases of GBS are associated with a primarily motor axonal process (acute motor axonal neuropathy; AMAN) with axonal degeneration (axons are long, thin extensions of the nerve cells and carry nerve signals) and sparing of the myelin (the myelin is an electrically insulating phospholipid layer that surrounds the axons of many neurons). Other cases appear to involve both sensory and motor axons and such cases are termed acute motor and sensory axonal neuropathy (AMSAN). More than 90% of patients with GBS in Europe and North America have AIDP. AMAN occurs in less than 10% of persons with GBS in the western hemisphere but in more than 40% of those affected in China and Japan. The incidence of AMSAN is very low (less than 10% of that of AMAN). Miller Fisher syndrome (MFS) is another GBS variant that occurs in about 5% of people affected by GBS. It is characterized by opthalmoplegia (eye muscle weakness), areflexia (absence of reflexes), ataxia (the inability to coordinate voluntary muscular movements such as walking), and, in some cases, facial and bulbar palsy (affecting vital functions, like breathing, and swallowing or speech).

GBS can affect anybody. It can strike at any age; men may be more likely to develop GBS than women. Although this syndrome is rare (affecting about one to two persons in 100,000) it is the most common cause of acute neuromuscular paralysis in the world.

GBS often occurs a few days or weeks after a person has had symptoms of a respiratory or gastrointestinal viral or bacterial infection; in fact, two-thirds of affected individuals have had a preceding infection. Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, and Mycoplasma pneumoniae are commonly identified antecedent pathogens. Campylobacter jejuni is the most common pathogen that elicits GBS. Occasionally surgery or vaccinations will trigger the syndrome. GBS is not contagious. It has been reported that GBS occurs more in men than in women and more often in the elderly. Seasonality has not been reported in developed countries like the United States (Church Potter & Kaneene, 2003).

No one yet knows why GBS strikes some people and not others. Nor does anyone know exactly what sets the disease in motion. What scientists do know is that the body’s immune system begins to attack the body itself, causing what is known as an autoimmune disease. Usually the cells of the immune system attack only foreign material and invading organisms.

In GBS, the immune system starts to destroy the myelin sheath that surrounds the axons of many peripheral nerves, or even the axons themselves. The myelin sheath surrounding the axon speeds up the transmission of nerve signals and allows the transmission of signals over long distances. In diseases in which these myelin sheaths are injured or degraded, the nerves cannot transmit signals efficiently. That is why the muscles begin to lose their ability to respond to commands from the brain that must be carried through the nerve network. The brain also receives fewer sensory signals from the rest of the body, resulting in an inability to feel textures, heat, pain, and other sensations.

Alternately, the brain may receive inappropriate signals that result in tingling, “crawling-skin,” or painful sensations. Because the signals to and from the arms and legs must travel the longest distances, they are most vulnerable to interruption. Therefore, muscle weakness and tingling sensations usually first appear in the hands and feet and progress upwards.

Guillain-Barré syndrome can be a devastating disorder because of its sudden and unexpected onset. Most people reach the stage of greatest weakness within the first 2 weeks after symptoms appear, and by the third week of the illness 90 percent of all patients are at their weakest. The recovery period may be as little as a few weeks or as long as a few years. About 30 percent of those with Guillain-Barré still have a residual weakness after 3 years. About 3 percent may suffer a relapse of muscle weakness and tingling sensations many years after the initial attack.