Guillain-Barre Syndrome Outbreak in Maharashtra
Maharashtra has seen a sudden spike in Guillain-Barré Syndrome (GBS) cases, with the number rising to 163 on February 3, 2025, up from 158 the previous day. The number of suspected deaths remains at 5. GBS is a rare neurological disorder that can cause muscle weakness and paralysis.
Confirmed Cases: 127 confirmed GBS cases, with 28 on ventilator support, according to the State Public Health Department.
Geographical Distribution:
- 29 cases from the Pune Municipal Corporation (PMC)
- 82 from newly added PMC villages
- 17 from Pimpri Chinchwad Municipal Corporation
- 13 from Pune Rural
- 8 from other districts
Age Group: 90% of suspected cases are in the 0-59 age group, with the highest number (35) in the 20-29 age group.
Actions taken
- 63 serum samples have been sent to NIMHANS in Bengaluru to test for antiganglioside antibodies, a common feature of GBS.
- 168 water samples were sent for chemical and biological analysis, and eight water sources were found to be contaminated.
Possible Causes and Concerns
While the exact cause of this increase remains under investigation, several factors are being considered:
- Water Contamination: The possibility of bacterial or viral contamination of the water triggering GBS.
- Seasonal Patterns: Some studies suggest that season can influence GS, especially the autumn season can cause a surge in cases.
- Viral Mutations: The emergence of new viral strains could influence the rise in cases.
What is GBS?
Guillain-Barré syndrome (GBS) is a rare neurological disorder in which the immune system mistakenly attacks part of the peripheral nervous system—the network of nerves that sends signals from the brain and spinal cord to the rest of the body. This causes musle weakness, paralysis, and breathing difficulties. It can develop suddenly and worsen over days or weeks, with some cases leading to life-threatening complications. Most people recover, though some may experience long-term weakness.
Symptoms of GBS
- Weakness & Paralysis – Often starts in the legs and may move up to the other parts of the body, including the arms, face, and breathing muscles.
- Tingling and Pain – GBS can cause the brain to receive distorted sensory signals from the body due to nerve damage, resulting in unusual sensations such as pins and needles, burning, or intense muscle pain.
- Coordination Issues – Unsteady walking, difficulty with eye movements, and balance problems.Difficulty swallowing, speaking, or chewing.
- Autonomic Dysfunction – This can affect heart rate, blood pressure, digestion, and bladder control.
Types of GBS
Nerves have a central axon that carries signals, surrounded by a myelin sheath that speeds transmission.
- In Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), the immune system attacks myelin, which surrounds and protects nerve fibers.
- In Acute Motor Axonal Neuropathy (AMAN) and Acute Motor-Sensory Axonal Neuropathy (AMSAN), it damages the axons. This disrupts nerve signal transmission, leading to muscle weakness and loss of reflexes.
Who is at Higher Risk for Guillain-Barré Syndrome?
- GBS can affect anyone but is more common in adults over the age of 50. It is not contagious or inherited.
- It often follows an infection, as the immune system mistakenly attacks nerves, due to similarities between bacteria/viruses and nerve cells.
- Common triggers include respiratory or gastrointestinal infections, especially Campylobacter jejuni, surgery, and rarely, certain vaccines or viruses like COVID-19 and Zika.
Diagnosis & Treatment
Diagnosis
- History & Physical Exam: Doctors assess symptoms, reflexes, and muscle function to differentiate GBS from other disorders.
- Nerve Conduction Test: Measures transmission of nerve signal to detect damage to the myelin.
- Cerebrospinal Fluid & Imaging: Elevated protein levels in spinal fluid and MRI scans help confirm GBS.
Treating GBS
- Acute Care: Hospitalization with close monitoring for complications like respiratory failure. Treatments include plasma exchange (PE) or intravenous immunoglobulin (IVIg).
- Supportive Care: Breathing support, heart monitoring, and therapy for swallowing and autonomic system issues.
- Rehabilitation: Physical and occupational therapy recovery and adaptation to daily activities.
Long-Term Outlook
- Most people recover fully, although recovery can take weeks to years. Some may experience lasting weakness, fatigue, or pain. Emotional support and therapy help cope with challenges during recovery.
Public Health Response
In response to the situation, health authorities have intensified surveillance and are conducting thorough investigations to identify the root cause. Residents are being advised to maintain strict hygiene practices, consume boiled water, and seek immediate medical attention if they experience symptoms such as sudden weakness in the limbs or persistent diarrhea..
Should We Be Worried?
While the increase in GBS cases is concerning, it’s important to note that GBS is not contagious. Timely identification and swift medical treatment can greatly enhance the chances of recovery. Public health officials are actively managing the situation, and with appropriate measures, the impact can be controlled.
Stay Informed and Vigilant
As investigations continue, staying informed through official health advisories and practicing preventive measures are crucial to safeguarding public health.