New Delhi: Indian Council of Medical Research (ICMR) director-general Rajiv Bahl on Tuesday (January 28) said that the cause of spread of Guillain Barre Syndrome (GBS) in Pune is yet to be ascertained.
Speaking at a press conference, organised for health minister J.P. Nadda to highlight the achievements of the National Health Mission (NHM), Bahl said that the government was “testing blood and stool samples, along with antibodies to understand more about the bacteria”.
Answering media queries in the conference, the ICMR director-general said it was probably for the first time that India was witnessing a GBS outbreak at such a scale. As many as 110 cases have been reported. Out of them 15 are reported to be critical and one death has also taken place.
Amid the rising cases, the Union government has also sent a team of officials, consisting of seven experts from National Center for Disease Control (NCDC), National Institute of Mental Health and Neurosciences (NIMHANS), National Institute of Virology (NIV) and regional office of the Union health ministry, to Pune. A team from the Pune-based NIV was already at work.
The Print quoted an anonymous scientist of NIV as saying that some samples of the patients suffering from GBS have been found positive for norovirus. This virus, according to the US-CDC, is ‘very contagious’ and causes vomiting and diarrhoea. Commonly, it is known as stomach flu.
In some other samples, bacteria Campylobacter jejuni has also been found. The US-CDC states that one can get Campylobacter bacteria infection by consuming raw or uncooked food, contaminated food items, drinking untreated water and anything that is unhygienic.
The knowns and unknowns of GBS
The viral or bacterial infections do not fully explain the cause of the GBS spread. GBS is an autoimmune disease. As a result of any bacteria or viral infections, the immune system gets triggered to fight these organisms, which is a natural course.
In the process, the immune system may also end up attacking a healthy part of the body, as some sort of an overdrive. All diseases caused due to this reason are known as autoimmune diseases. The hyperactivity of the immune system, in the case of GBS, affects one part of the nervous system.
In other words, GBS is not directly caused by an infection but due to the action of the immune system which follows these infections. Testing antibodies, which one develops as a protective mechanism following any infection, is therefore, important.
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However, the exact cause of this debilitating syndrome is yet to be determined, the World Health Organisation (WHO) says.
Due to the nervous system being impacted, the muscle movement becomes slightly or badly deranged, depending on the reaction of the immune system. This results in muscle weakness, loss of sensation in the legs and/or arms, and problems in swallowing and/or breathing.
The WHO characterises GBS as a ‘rare condition’ and, therefore, the spread of infection at such a scale in Pune has surprised officials andscientists.
The GBS, per se, is not transmissible. But the bacteria or disease causing infection which precedes this syndrome, may be. However, the spread is generally not on a massive scale.
The NIV so far hasn’t said anything about the genomics of the samples it has tested or clarified if the genome sequencing of the samples has indeed been carried out. This information might provide some clues about the recent spread.
The initial symptoms of the GBS include weakness in legs and a tingling sensation. This can extend to arms and mouth. Some people may also experience paralysis as the nerves are affected.
“In approximately one third of people, the chest muscles are affected, making it hard to breathe,” the WHO states. The swallowing may even become difficult, and at this point the disease may become life-threatening.
While most people recover without a serious disease progression and/or hospital admission, in some cases, the paralysis of muscles in the chest can cause breathing complications and cardiac arrest which ultimately may lead to death.
Like for many other diseases, GBS is treated for the complications that it leads to, and there is no cure for the disease itself. For example, a patient may have to be shifted on a ventilator if breathing becomes too difficult, or if heart muscle is impacted. Blood pressure and cause of any other infection is closely monitored.
