Written and Reviewed by Team Pharmacally
Pune is currently facing a significant outbreak of Guillain-Barré Syndrome (GBS). This rare neurological disorder occurs when the body’s immune system attacks the peripheral nervous system. As of January 23, 2025, there have been 67 reported cases of GBS, affecting 43 men and 24 women. Notably, 13 of these patients are on ventilator support due to severe symptoms.
Most cases have been reported in the Sinhagad Road area of Pune. Health officials have noted that many patients experienced gastrointestinal symptoms, such as nausea, vomiting, and diarrhoea, before the onset of GBS. Investigations by the National Institute of Virology (NIV) have detected the presence of norovirus and the bacterium Campylobacter jejuni in samples from 21 patients. Both pathogens are known to cause gastrointestinal issues and have been linked to triggering GBS.
What is Guillain-Barré Syndrome?
Guillain-Barré Syndrome (GBS) is an autoimmune disorder in which the immune system mistakenly attacks the peripheral nervous system. This can result in muscle weakness, tingling sensations, and, in severe cases, paralysis. Although the exact cause of GBS is not fully understood, it is commonly preceded by infections, particularly respiratory or gastrointestinal illnesses. In rare cases, it has also been linked to vaccinations or surgeries.
Symptoms and Progression
Guillain-Barré Syndrome (GBS) often starts with weakness or tingling in the legs, which can then extend to the arms and upper body. Symptoms can progress rapidly, leading to severe muscle weakness, difficulty breathing, and even complete paralysis. Early detection and treatment are essential, as GBS can be life-threatening in its most severe cases.
The Situation in Pune
In light of the recent outbreak, the Pune Municipal Corporation (PMC) has launched a comprehensive epidemiological survey, mobilizing 100 teams to evaluate around 200,000 households in the impacted regions. These dedicated teams are meticulously collecting water samples from diverse sources such as tankers, restaurants, and hotels to pinpoint possible contamination. Initial findings indicate that contaminated water could be a significant factor in the rise of GBS cases. Your support in addressing this critical issue is vital for safeguarding community health.
The recent spike in Guillain-Barré Syndrome (GBS) cases in Pune is particularly unusual, as this condition typically affects about 1 to 2 individuals per 100,000 people each year. Local hospitals and clinics have reported a significant increase in patients displaying symptoms consistent with GBS. Health authorities indicate that most of these cases seem to have developed after viral infections, with some being associated with post-COVID-19 complications or other seasonal illnesses.
Potential Causes of the Surge
While the exact cause of GBS remains unknown, it is often preceded by bacterial or viral infections. In Pune’s recent cases, many patients reported gastrointestinal symptoms like vomiting and diarrhoea before the onset of GBS symptoms. This pattern has led health officials to suspect that contaminated water might be a contributing factor. Consequently, the Pune Municipal Corporation is conducting extensive surveys and collecting water samples from affected areas, particularly along the Mutha riverbank, for detailed analysis.
As claimed by the authorities, since the commencement of the outbreak, 7,262 water samples from various locations in the city have been submitted for chemical and biological examination for the public health laboratory analysis. The contaminated samples consist of 144 water sources from both private and public wells/RO plants borewells, as well as PMC and PCMC water supply sources.
Treatment and Management
Intravenous Immunoglobulin (IVIG): A standard treatment that helps reduces the immune system’s attack on the nervous system.
Plasmapheresis: A procedure that removes harmful antibodies from the blood.
Supportive Care: This includes physical therapy, respiratory support, and close monitoring in severe cases.
Most patients recover fully, but the process can take weeks to months, and some may experience long-term complications such as weakness or fatigue.
Public Health Response
Health authorities in Pune are urging the public to take preventive measures against viral infections. They recommend maintaining proper hygiene, using mosquito repellents, and seeking timely medical attention for illnesses. Hospitals are equipped to handle cases of Guillain-Barré Syndrome (GBS), with dedicated teams focused on early diagnosis and treatment.
Residents are advised to take additional preventive measures, including boiling water before consumption, ensuring food is prepared hygienically, and seeking immediate medical attention if they experience symptoms such as persistent diarrhoea, vomiting, or muscle weakness. The Neurological Society of Pune has emphasized that while GBS is a serious condition, it is treatable, and early intervention can lead to significant recovery.
Public Health Update as in march 2025
As of March 18, 2025, the outbreak of Guillain-Barré Syndrome (GBS) in Pune has significantly subsided, with no new hospital admissions reported in recent days.
Conclusion
The rise in GBS (Guillain-Barré Syndrome) cases in Pune emphasizes the intricate connection between infections and autoimmune responses. While this condition is still rare, raising awareness and ensuring timely medical intervention can greatly enhance patient outcomes. Public health officials and medical professionals are diligently monitoring the situation to determine the underlying causes and protect the safety of the community.
References:
1. 26 cases of Guillain Barre Syndrome identified in Pune: Know why doctors are concerned, what are its symptoms, Times of India, published on 22 January 2025
2. Guillain-Barre Syndrome Cases In Pune: Are Vaccines Or Infections The Cause Of The Rare Nerve Disorder? Expert Weighs In, Times Now, published on 22 January 2025
3. Dhamne MC, Benny R, Singh R, et al, Guillian–Barre’ Syndrome in Patients with SARS-CoV-2: A Multicentric Study from Maharashtra, India. Ann Indian Acad Neurol. 2021 May-Jun; 24(3):339-346. Doi: 10.4103/aian.AIAN_1303_20. Epub 2021 Jul 9. PMID: 34446994; PMCID: PMC8370175.
4. Guillain-Barré Syndrome, National Institute of Neurological Disorders and Stroke
5. Guillain-Barré Syndrome, John Hopkins Medicine
6. Guillain-Barré Syndrome, World Health Organization
7. Jacobs BC, Rothbarth PH, van der Meché FG, et al, The spectrum of antecedent infections in Guillain-Barré syndrome: a case-control study. Neurology. 1998 Oct;51(4):1110-5. Doi: 10.1212/wnl.51.4.1110. PMID: 9781538.
8. Hartung H, Infections and the Guillain-Barré syndrome, Journal of Neurology, Neurosurgery & Psychiatry1999; 66:277.
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