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GBS, a rare paralysis syndrome, has created a flutter among many
The recent outbreak of Guillain-Barre Syndrome (GBS) in Pune is being claimed to be one of the largest globally. The rare paralysis syndrome has led to a surge in the disease outbreak. As of February 25, at least 23 people have died from GBS with over 210 reported cases in India. The majority of the deaths have occurred in Pune. Though contaminated water has been confirmed by National Institute of Virology (NIV) Pune, the exact cause of GBS still remains in dark. Infections, particularly viral and bacterial, have been linked to triggering the condition. Gastroenteritis infections can increase the risk of developing GBS, making food safety practices essential to preventing these illnesses
GBS, a rare paralysis syndrome, has created flutter among many. First reported by Guillain, Barré, and Strohl in 1916, GBS outbreak has been a rare occurrence. In 2019, Peru in South America reported an outbreak of GBS. The country again witnesses another outbreak in 2023.
However, the outbreak in Pune is noteworthy. Pune became the epicentre of the rare paralysis syndrome with more than 210 cases. There were outbreaks reported in Andhra Pradesh, Kerala, Jharkhand and West Bengal. Isolated cases have been reported from Jodhpur, Nashik, Mumbai, Kochi etc. where patients were in critical condition and were admitted in the ICU.
Till the last month, hospitals in Pune saw a surge in the number of patients. The outbreak in Pune could be one of the largest ever in the globe. Though the number of GBS cases have declined, the World Health Organisation has been supporting officials from Pune in this regard. According to Dr Roderico H Ofrin, WHO Representative to India, WHO is providing technical and on-ground field support to district- and state-level teams to empower responders with adequate resources, training, and support systems.
Symptoms
GBS is a rare life-threatening condition where a person’s immune system attacks the peripheral nerves. Infected people have symptoms ranging from tingling nerves to paralysis, difficulty in breathing, swallowing and speaking.
Though the cause of the disease cannot be fully understood, cases occur post-bacterial or fungal infection. An abnormal immune response sets in. Symptoms include initial weakness often starting in the legs and then moving upwards. Within the next four weeks, the weakness is at its peak. Tingling sensations, difficulty in swallowing, numbness, instability in heart rate and blood pressure results due to GBS. Severe cases lead to respiratory failure where ventilation remains the only hope. Patients suffer from gastroenteritis, vomiting, diarrhoea and nausea.
Causes
Though many are pondering about the exact causes of GBS, the National Institute of Virology has claimed that contaminated water was the main cause of the outbreak.
Amidst unclear transmission, experts have opined about preventive and hygiene measures to be adopted to prevent any further outbreak. Infections like Campylobacter jejuni, that causes diarrhoea and viral illnesses are linked to GBS, however, the exact cause remains elusive.
According to experts one in 100,000 individuals are affected and in majority of the cases influenza like symptoms are to be blamed, Campylobacter jejuni accounts for 15-20 per cent.
Can contaminated food trigger the outbreak?
Experts mentioned that while the exact cause of GBS remains unclear, infections, particularly viral and bacterial, have been linked to triggering the condition. One of the most notable links is with foodborne illnesses, particularly those caused by bacteria like Campylobacter and Salmonella. These infections can increase the risk of developing GBS, making food safety practices essential to preventing these illnesses. Gastroenteritis is most likely to trigger GBS.
While confusion remains about the exact cause of the GBS outbreak, some experts have weighed in on food hygiene. With no cure for GBS, treatments and preventive measures, maintaining food hygiene will help to prevent the disease from spreading.
Says Vikram Kelkar, Managing Director, Hexagon Nutrition and Co-chairman – Food Processing and Value Addition National Council – ASSOCHAM “While the direct link between foodborne illnesses and GBS may still require further research, adhering to these food safety practices is critical not only for preventing GBS but for promoting general health and well-being. Food safety is crucial to protecting public health by preventing foodborne illnesses caused by harmful bacteria, viruses, and parasites. Maintaining proper food safety standards throughout the food production, processing, and handling stages is essential to prevent contamination and ensure safe consumption.”
According to George Cheriyan, Food Safety Expert, Working President, Consumers Protection Association (CPA), (Former Member, Central Advisory Committee (CAC) of FSSAI & Member of FSSAI Expert Group on FoPL), there is an urgent need for administrative actions for enhancing food safety standards in Maharashtra, by enhancing man power, increasing number of labs etc., to deal with violation of laws and to prevent outbreak of any diseases and ensuring quality and hygienic food for all.
Swatee Sandhan, Senior – Dietician, Jupiter Hospital, Baner, Pune mentioned that GBS mostly spreads through undercooked food, poultry items and contaminated water. These cause various viral or bacterial infections. The immune system is activated to fight against these infections. Over the years, our lifestyle has changed. We have opted for outside food. And it has become very common. Due to the excess demand for food, the necessary precautions of hygiene, and good quality raw material is lacking. This increases the risk of food poisoning.”
Echoing same views, Dr Anjali Shinde, Clinical Nutritionist, Ankura Hospital for Women and Child, Pune opined, “To reduce the risk of GBS associated with foodborne pathogens, it becomes crucial to follow proper food safety measures for the betterment of your health. Thoroughly cook poultry to an internal temperature of 165°F (74°C) to significantly kill harmful bacteria. Avoid cross-contamination between raw meat and other foods. Practicing good hand hygiene, especially after handling raw food is vital. Wash your hands thoroughly with soap or hand sanitiser to disinfect your hands. Individuals are advised to store food at the right temperature. Drinking clean water can help prevent bacterial growth and reduce the risk of infection. This can be achieved by using a water purifier or boiling your water before use.”
Hospitals follow strict guidelines for food handling, storage, and preparation to minimise the risk of contamination. In case of a GBS patient being admitted to a hospital, some strict measures need to be followed to ensure that recovery is faster.
Soumita Biswas, Chief Clinical Nutritionist, Aster RV Hospital while giving an outlook about how hospitals adhere to prevent these types of outbreaks added, “Stringent food handling and preparation protocols is the need of the hour. Hospitals conduct regular audits to ensure compliance with food safety protocols and identify areas for improvement. Food temperature control, staff training and patient-specific dietary planning, all help to help patients suffering from diseases like GBS to recover well.
Outlook
Food-related ailments affecting the digestive system is said to trigger GBS. In that case, one should ensure hygiene while consuming food. Though NIV, Pune opined about water contamination, one has to focus on why a section of the population got infected. If water was said to have been contaminated, more people consuming supplied water would have been under the influence of GBS.
Also, one has to note that, GBS outbreaks were reported in other parts of the country but in less numbers. Kerala reported two deaths recently. However, there were no reports of water contamination.
Health and food experts have discussed keeping gastroenteritis at bay as it triggers GBS. It is high time proper food safety measures were followed. Better food hygiene and clean drinking water will help prevent the increase in risk of developing GBS and other foodborne diseases.
Sanjiv Das