Recently, Pune  reported nine more suspected cases of Guillain-Barré Syndrome (GBS), taking the tally in Maharashtra’s second largest city to 110

Guillain-Barré Syndrome (GBS)

• About: GBS is a rare, autoimmune neurological disorder where the immune system attacks the peripheral nervous system, leading to muscle weakness, numbness, and paralysis, often in the arms and legs.
• Causes: GBS can be triggered by either viral or bacterial pre-infections, according to the World Health Organization (WHO).
  • Campylobacter jejuni, a bacterium found in contaminated food and water, has been identified as the cause of the first cluster of cases.
• Symptoms: Prior to the onset of GBS, patients exhibited symptoms of gastroenteritis, including vomiting, diarrhea, and nausea. These were followed by the characteristic peripheral numbing and paralysis of GBS.
• Fatalities: One death due to suspected GBS was recorded from a patient who had visited Pune.
• Global Prevalence: GBS is reported in 1-2 cases per 100,000 population, with a higher prevalence in adult males.
• India-Specific Data: Epidemiological studies on GBS in India are scarce due to challenges in testing. However, a 1993 WHO report estimated 138 cases annually in seven major teaching hospitals, with about 75% of cases in adults.

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Investigation and Transmission

• Source of Infection: The outbreak is linked to Campylobacter jejuni, typically transmitted through contaminated food and water.
• Health Implication: This outbreak highlights weaknesses in urban health infrastructure and surveillance systems in India, allowing pathogens to breach safety measures and cause significant health issues
• Scale of the Outbreak: This may be India’s largest recorded GBS outbreak, potentially exacerbated by seasonal weather changes, which have been linked to rising GBS cases globally.
• Urban System Vulnerabilities: The outbreak underscores systemic weaknesses in urban health infrastructure and the need for stronger surveillance to detect and manage such health threats.

Treatment and Recovery

• Treatment Methods: Patients with Guillain-Barré Syndrome (GBS) are treated using plasma exchange or intravenous immunoglobulin therapy.
• Effectiveness: These treatments are most effective when administered within two weeks of the onset of symptoms, making early detection and timely treatment crucial for recovery.
• Response Efforts and Measures: In Pune, teams have been deployed to collect water samples and conduct extensive community surveillance.
  • A central team has also been sent to the affected areas to assist with management and monitoring.
• Importance of Early Detection: Prompt identification of cases and the immediate initiation of treatment are key to improving outcomes.
• Role of Local and State Governments: It is the responsibility of local and state authorities to ensure the availability of safe drinking water to all residents. 
  • Governments must regularly disseminate information on avoiding contaminated and unhygienic food to prevent further outbreaks.

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Conclusion

Timely intervention, community vigilance, and proactive governance are essential to managing the GBS outbreak and preventing future health crises.

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