Addressing myths about the disease.
Guillain Barre Syndrome (GBS) is a disease characterized by muscle weakness that develops quickly as a result of the immune system attacking one’s own nerve cells. It is an autoimmune disease that is triggered by a viral Or bacterial infection or a vaccine. It is a non communicable disease and most people fully recover from it in a few weeks.
Cause of concern
Over 200 cases of GBS and 11 deaths have been reported from the city of Pune, Maharashtra in the months of January and February. A cluster of cases have also been reported from other cities of Maharashtra and A few scattered cases from other parts of the country.
Cause of outbreak
A general seasonal spike in the number of cases of GBS is often seen due to a seasonal increase in the number of cases of diarrhoea or respiratory tract infections. This outbreak is being linked to an outbreak of gastroenteritis in the city of Pune, presumably due to contamination of water sources in the city by Campylobacter jejuni and other enterobacteriaceae that cause intestinal infections.
A few previous outbreaks of GBS have been reported internationally earlier linked to zika virus infection
Myths about the disease
- GBS does NOT spread from person to person. It is a post-infectious autoimmune disease wherein our immune system accidentally confuses between the infectious agent and our nerve cells.
- GBS is NOT caused by consumption of undercooked poultry. Though undercooked poultry can harbor fatal infections agents,it is not directly linked to the causation of Guillain Barre Syndrome. Few samples of poultry in early investigations turned positive for GBS, but the trend was not maintained by any further samples. Thus, it was speculated that those samples must have got contaminated after washing with water containing bacteria.
- GBS DOES NOT develop in all individuals post-diarrhea. As per available data, it develops in 1 in 1,00,000 individuals affected by diarrhoea or other infectious diseases
- GBS DOES NOT cause neurological deficits. It is essentially a syndrome of muscular weakness due to an auto-immune attack on peripheral nerve cells that results in muscle paralysis. The disease starts to present with weakness and tingling sensations in legs and spreads further to cause paralysis of muscles in limbs and face.
- GBS is NOT a very FATAL disease. Most people usually recover in a few weeks. However a few may die following difficulty in speaking, swallowing and breathing due to involvement of respiratory, laryngeal muscles or other complications of the disease.
- GBS is difficult to diagnose. Well, this is not a myth. Since it is a rare disease, it may often be confused with other more common causes of muscle weakness like vitamin deficiencies, especially prevalent in India and diagnosis may be missed or delayed. Hence, it is important to get checked by a Neurophysician upon noticing any signs of weakness, tingling or muscular paralysis.
- GBS can NOT be prevented. Whether a person will or will not develop GBS post an infection, it is an interplay of genetic and environmental characteristics of a person and cannot be modified by any physical, chemical or medical means per say.
Should we be alarmed?
Yes and No.
Guillain Barre, per say, is not the outbreak of concern here. Because it is only a result, or after effect of the gastroenteritis outbreak in the Pune city. Thus, efforts to contain Gastroenteritis infections by ensuring supply of clean water and consumption of fresh, clean and properly cooked food items is important.
Response to the outbreak
The outbreak, undoubtedly, was a result of public health failure. The city of Pune has limited water resources and their contamination with fecal matter and infectious bacteria can cause a large-scale outbreak of diarrhoeal illness, throwing us back into the era of Cholera epidemics.
However, Government authorities are now vigilantly monitoring the supply of clean water in the city of Pune. The World Health Organisation (WHO) has also stepped in and sent teams of healthcare professionals to train staff, monitor the trends and control the situation.
What can we do?
Though GBS is a non infectious non preventable disease and the diarrhoeal outbreak was essentially a result of public health failure, there are certain measures we can take to protect ourselves from catching diarrhoea.
- Drink properly filtered water only. Preferably use UV-RO filters.
- Boiling of water is a traditional practice that kills most bacteria.
- Eat fresh, clean and properly cooked foods.
- Immediately consult a neuro physician if you experience weakness in limbs, tingling sensations or numbness. Sometimes, the episode of diarrhoea or respiratory illness may be short and self recovering and may not get noticed. So do not rule out the disease based on such a history of subclinical infection.
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