No more a rarity

What has caused widespread outbreak of the rare Guillain-Barré syndrome cases from seven states of the country?

- SEBASTIAN THEVAR PUNE AND HIMANSHU N NEW DELHI

ON JANUARY 14, six-year-old Vivan (name changed) of Pimpri Chinchwad, a satellite town of Pune district in Maharashtra, struggled to get out of bed and use the toilet. Later while playing, he fell and was unable to get back up. A few days earlier, when Vivan was refusing to hold a pencil and write, his mother mistook this act and thought that her son was doing it just to avoid studying. Little did she know that Vivan was experiencing limb paralysis linked to Guillain-Barré syndrome (GBS) and would not only require hospitalisation but intensive care with ventilator support. Since then, his condition has marginally improved, and he can now talk and hold a glass, say his mother.

GBS is a rare neurological condition (affecting one in 100,000 people) in which the immune system attacks the nerves, leading to weakness in the upper and lower limbs, neck, face and eyes. From the first week of January to February 9, 2025, India has reported over 280 confirmed GBS cases and 13 deaths (suspected or confirmed) from seven states (see ‘Simultaneous outbreak’). Pune was the first and the worst hit, with 155 confirmed cases reported during the period, as per Maharashtra health department.

GBS is triggered by certain infections, including Campylobacter jejuni, Haemophilus influenza, Mycoplasma pneumoniae, Epstein–Barr virus, cytomegalovirus (CMV), hepatitis E and influenza virus. The infection produces an immune response which damages the nerves fibres causing weakness and loss of sensation. In milder disease, the damage only affects the sheaths of the nerve fibres (like the coating round an electric wire). This blocks the transmission of nerve impulses, but the patients can recover completely in a few weeks. In severe form of the disease, the immune response damages the conducting cores of the nerve fibres (like the electric wires themselves). Such patients take long to get better and the weakness may be permanent.