New Delhi: As some parts of Maharashtra, mainly Pune, struggle with an outbreak of Guillain-Barre Syndrome (GBS), India’s apex health research body says it has detected a common diarrhoea-causing pathogen in 20-30 percent of the samples collected from affected patients.
During an interaction with media persons Thursday, Indian Council of Medical Research (ICMR) director general Dr Rajiv Bahl said the agency had detected the presence of Campylobacter jejuni in about 20-30 percent of the samples. “These patients suffered from infection caused by the bacteria before developing GBS,” Bahl said.
Pune scientists too had earlier said that Campylobacter jejuni had been detected in samples of Pune patients.
GBS is a serious neurological condition that causes muscle numbness and can be life-threatening. It is triggered when a person’s immune system attacks the peripheral nerves. Most GBS cases are reported in people with a recent history of infection, but these cases are mostly sporadic.
The cases reported from Pune and adjoining areas is the biggest outbreak India has recorded. There are very few instances when a high number of GBS cases are reported in a limited geographical area within a short span of time anywhere in the world.
While the ICMR and its National Institute of Virology (NIV), Pune, that have been examining the outbreak, have not officially shared any explanations on what may be causing the outbreak, a contaminated water source that supplies drinking water to Pune and the surrounding villages is suspected to be the source, according to experts.
In most people, GBS is triggered by exposure to an infectious illness, and the most frequently encountered infectious illness is a gastrointestinal infection with Campylobacter jejuni, a pathogen that has been behind stomach infections in India for decades.
Campylobacter jejuni is commonly transmitted through food, particularly undercooked poultry and other meats.
Untreated water sources that use contaminated water from wells, lakes, rivers, and streams can also be a source of Campylobacter infection.
And although GBS is very rare—affecting just about 1 person per 100,000 inhabitants per year—when the triggers for GBS in a community increase, then the occurrence of GBS can also increase.
So far, since January this year, over 200 suspected and confirmed cases of GBS have been detected in some parts of Pune, while the outbreak has claimed 7 lives in the city. A GBS death was also reported from Mumbai Wednesday. The patient had travelled to Pune two weeks ago.
This takes the GBS toll in the current outbreak in Maharashtra to 8.
Also Read: 8 Guillain-Barré Syndrome deaths recorded in Maharashtra, 1st fatality in Mumbai
More questions than answers
GBS leads to progressive weakness of limbs, and while most patients recover fully from even the most severe cases, in a few cases, it can result in near-total paralysis and breathing problems.
Also, as the condition is potentially life-threatening, those affected are advised to be treated and monitored as quickly as possible, and some may need intensive care.
According to government officials, of 205 recorded cases in Pune, as of February 13, 50 were in intensive care units (ICU), while 20 were on ventilator support. The maximum number of cases—44—were seen among people aged 20-29 years.
The World Health Organisation, in a statement issued on 31 January, said that it is supporting health authorities in India to respond to suspected and confirmed cases of GBS.
“WHO teams are on the ground training the health workforce in conducting ‘active case searches’ in the community living in the affected areas to ensure every suspected case is identified, diagnosed and treated,” the United Nations health body had said.
There has, however, been no indication from the international health agency on the reasons behind the trigger.
Some experts, meanwhile, pointed out that the Campylobacter jejuni, which is being linked with the current GBS outbreak, has been a common pathogen behind the diarrheal infections in most parts of the country.
“If the same pathogen was not causing GBS earlier, how come it is suddenly triggering GBS in so many patients in a certain geography?” asked senior epidemiologist Dr Amitav Banerjee.
Dr Banerjee, who has previously been associated with the Armed Force Medical College (AFMC) in Pune, said that the authorities should make public the chemical analysis report of the water supplied in areas reporting the GBS cases.
(Edited by Sanya Mathur)
Also Read: Centre steps in as Pune struggles with Guillain-Barre Syndrome outbreak; no clarity on trigger yet