Guillain-Barre syndrome: India faces outbreak of creeping paralysis

In India, there is a growing concern about a health issue known as Guillain-Barre Syndrome, or GBS. This rare disorder occurs when the immune system mistakenly attacks the body's own nerve cells, leading to muscle weakness and, in severe cases, paralysis. Recently, the city of Pune, located in western India, has reported a significant number of GBS cases, with around 160 individuals affected since the beginning of January. Tragically, there have been five suspected deaths linked to this outbreak. One particularly alarming case involved a six-year-old boy who initially struggled with his homework. His mother thought he was simply frustrated, but it turned out that his difficulty in holding a pencil was an early sign of GBS. Within days, the boy was hospitalized and lost the ability to move his arms and legs. Fortunately, he is now on the road to recovery. GBS typically begins with sensations of tingling or numbness in the extremities, followed by increasing muscle weakness and difficulty in moving joints. The symptoms can worsen over a period of two to four weeks, often starting in the legs and arms. The severity of GBS can vary, with reported rates of paralysis ranging from three to thirteen percent, depending on the quality of healthcare available. The current outbreak in Pune is believed to be associated with a bacterium called campylobacter jejuni, which is a leading cause of foodborne illnesses and has been linked to GBS cases worldwide. The connection between campylobacter and GBS was first identified in the 1990s in rural China, where children playing in contaminated water were found to be at risk. In Pune, health officials are investigating the source of the outbreak and have identified campylobacter as a potential culprit. Research conducted by experts at the National Institute of Mental Health and Neurosciences in Bangalore revealed that a significant percentage of GBS patients had prior infections, with one-third testing positive for campylobacter. This highlights the complex relationship between infections and the development of GBS. In recent months, other countries have also reported GBS outbreaks linked to campylobacter. For instance, Peru declared a national health emergency in response to a surge in GBS cases, with two-thirds of those cases connected to the bacterium. In regions with good hygiene practices, fewer GBS cases are associated with campylobacter, while respiratory infections tend to be more common. However, there are other factors that can trigger GBS as well. In 2015, Brazil experienced a cluster of GBS cases linked to the Zika virus. Vaccines can also rarely trigger GBS, with one COVID-19 vaccine reportedly associated with cases in 2021. Experts emphasize that campylobacter is a common bacterium, with hundreds of thousands of cases occurring regularly. However, not everyone who is infected with campylobacter will develop GBS. There is a specific strain of campylobacter that has a unique outer layer, which can sometimes resemble the coating of human nerve cells. When the immune system attacks the bacteria, it may inadvertently target the nerves as well, leading to GBS. In Pune, it is suspected that a strain of campylobacter with this nerve-like feature is circulating, resulting in a higher number of GBS cases. Health authorities are taking proactive measures to address the outbreak. Special hospital wards are being established for GBS patients, and health officials are conducting extensive surveillance in the community. They have tested over 60,000 households and collected water samples for analysis. Residents are being advised to drink boiled water and consume fresh, properly cooked food to reduce the risk of infection. While GBS is primarily associated with undercooked poultry, it can also spread through contaminated water, similar to diseases like cholera. The situation in Pune is concerning, as it remains unclear whether the outbreak is due to widespread contamination of the water supply or a high number of people consuming infected poultry. Health officials are urging the public to remain calm and not panic, but the uncertainty surrounding the outbreak makes it a challenging situation for many.