It was New Year’s Eve, and I had eaten chicken outside that had probably not been cooked well. A few days later, my hands began to get stiff. By the second week of January, I could feel all the energy slipping out of my body. I tried to get off the sofa but couldn’t move a muscle. I was taken to hospital the next day. The 42 year old was diagnosed with the neurological disorder Guillain-Barre syndrome (GBS).
The recent GBS outbreak in Pune — one of the biggest in the world — has put this syndrome in the headlines. GBS typically occurs when the immune system, in an overdrive to fight off an infection (either bacterial or viral), mistakenly attacks the body’s nerves. Symptoms include diarrhea, fever, nausea and tingling sensations in the hands and feet. Extreme cases can lead to paralysis and even ventilator support. After ruling out factors like vaccines, blood transfusions, and surgery, doctors had said the cause could be an infection from POORLY COOKED POULTRY.
Pune is still trying to unravel t he mystery behind its current outbreak, but the most common reason for GBS is a recent viral or bacterial infection. Five common infections linked to the disorders in India — C. jejuni, chikungunya, dengue, influenza and Japanese encephalitis.
“Our study found that 79% of GBS patients had evidence of a prior infection, with 32% testing positive for jejuni (Campylobacter jejani). Most patients had multiple infections, and only 6% had C. jejuni as the sole infection. A combination of chikungunya and other infections was the most common finding. This shows that while C.jejuni is a key contributor, other infections also influence GBS risk.”
C.jejuni and norovirus were both found in Pune’s GBS patients, and health authorities are now investigating whether the outbreak could have been caused by contaminated water or poultry.
It started with a stomach bug that caused severe abdominal cramps and diarrhea. Within five days, had difficulty in walking after complaining of breathing difficulties, where a neurologist diagnosed a patient with GBS.
“A Campylobacter-linked GBS outbreak in the US and Mexico was traced to inadequately disinfected drinking water.” Other possibilities can be improperly handled or undercooked poultry, unpasteurized milk or dairy products. “It’s through a process called molecular mimicry. In simple terms, the bacteria have components that resemble parts of body’s nerves. This confuses the immune system, causing it to attack the nerves by mistake, leading to GBS-induced paralysis.”
Does that mean all GBS cases preceded by loose motion are likely to be caused by C. jejuni, while those with upper respiratory symptoms are more ften viral induced It can’t be differentiated that easily as various microorganisms can cause diarrhea. To confirm the underlying cause accurately, clinical diagnosis must be supported by serological tests and other investigations.
That GBS linked to C. jejuni is often more severe. It’s because it involves axonal damage (damage to the brain’s core nerve fiber) as well as injury to the myelin (protein and fat sheath that surrounds nerve fibers). This results in slower nerve regeneration and longer recovery time compared to viral-induced GBS.” When GBS is triggered by viruses, the immune system mainly damages the myelin, allowing for quicker recovery since the axon remains intact.
Also, once diagnosed, managing GBS has its own share of challenges. Intravenous immunoglobulins and plasma exchange treatments can prove to be very expensive in India and are often inaccessible, especially in rural areas.
“It’s natural to get psyched out as one moment you are running and the next moment, you can barely move. Once the treatment is done, patients must do strength training and lead an active life to keep their energy levels up.”
WHAT IS GBS?
Guillain-Barre-Syndrome is an inflammatory disorder of the peripheral nervous system caused by an abnormal immune response against the nerves.
WHAT ARE THE CAUSES?
GBS can be trigged by either a bacterial or viral infection. Infection with the bacteria Campylobacter jejuni, which causes diarrhea, is one of the most common triggers of GBS. Some people with GBS have had chikungunya or other viral infections. In very rare cases, people have developed GBS in the days or weeks after getting certain vaccines or after a surgery.
COMMON OUTBREAK CAUSES INCLUDE:
- Contaminated water supplies.
- Unpasteurized milk or dairy products.
- Improperly handled or undercooked poultry.
- Person-to person spread (rare but possible in close-contact settings).
