Pune, India, is facing a rise in Guillain-Barré Syndrome (GBS) cases, with around 160 reported since January. The outbreak, linked to Campylobacter jejuni, has left many in intensive care and raised concerns over foodborne infections.
An outbreak of Guillain-Barré Syndrome (GBS), a rare and potentially deadly condition that causes muscle weakness and paralysis, has recently struck the western Indian city of Pune. The outbreak, which has affected around 160 people since early January, is believed to be linked to the bacteria Campylobacter jejuni, a leading cause of foodborne infections. Among those affected is a six-year-old boy who, after struggling to hold a pencil, was diagnosed with GBS and required intensive care and a ventilator.
Rising Cases and Global Concerns
The outbreak in Pune has resulted in five suspected deaths, with 48 patients still in intensive care, 21 of them on ventilators. Symptoms of GBS typically begin with tingling or numbness in the hands and feet, leading to severe muscle weakness and paralysis over a period of two to four weeks. Campylobacter, which is often found in contaminated food, particularly poultry, has been identified as a major cause of GBS, with Campylobacter jejuni being the most common strain. This strain is believed to trigger GBS through a process called molecular mimicry, where the immune system mistakenly attacks the body’s own nerve cells.
A Complex Pathogen and Its Global Impact
While GBS cases linked to Campylobacter are common in countries with lower hygiene standards, outbreaks have also been reported in areas with better sanitation. The global spread of Campylobacter-related GBS cases includes incidents in Peru, Brazil, and the UK. In Pune, a specific strain of Campylobacter with a unique molecular structure may be driving the surge in cases.
Understanding the Risks and Prevention
Researchers suggest that this strain of Campylobacter is more likely to cause GBS when it shares a molecular feature with human nerve cells. This outbreak highlights the need for better hygiene and food safety practices to prevent the spread of the bacteria.
The GBS Risk and Challenges in Diagnosis
Most experts estimate that about one in 100 Campylobacter strains carries the risk of GBS, and only one in 100 people infected with such a strain develops the syndrome, giving an overall risk of roughly one in 10,000. However, this small risk can have devastating consequences, with the immune system attacking the peripheral nervous system, leading to what Prof Willison describes as an "acute neurological tsunami." There is no cure for GBS, and treatment focuses on managing symptoms with "plasma exchange" and intravenous immunoglobulin (IVIG), which help filter out harmful antibodies.
A major challenge in diagnosing GBS is the lack of a single test. Physicians mainly rely on clinical features, and misdiagnosis or delayed diagnosis can easily occur. In rural India, where medical expertise may be limited, GBS is often misidentified as polio or another neurological condition. The World Health Organization (WHO) is working with local health workers in Pune to trace, test, and monitor the outbreak, ensuring effective treatment and providing support for accurate diagnosis.
Global Implications of Campylobacter and GBS
The outbreak in Pune is linked to Campylobacter jejuni, which has been identified as a major cause of GBS worldwide. The bacteria, typically found in contaminated food, especially poultry, can trigger the immune system to attack nerve cells in rare cases. Pune's ongoing surge in GBS cases is tied to a specific strain of Campylobacter, which shares a molecular feature with human nerve cells, leading to a higher incidence of the condition.
Read the full article here.