Guillain Barré Syndromepronounced as (Ghee-Yan-Bah-Ray Syndrome) has become a major public health issue due to the sudden rise in the cases of this rare neurological disorder in Maharashtra, especially clustered in Pune, Pimpri Chinchwad and nearby villages. Cases have also been reported in a few other cities like Nagpur, Solapur, etc, in Maharashtra.
The first case of GBS was reported in Maharashtra on 9th January, 2025 in Pune. Currently, there are 166 reported cases of GBS syndrome, with 61 patients requiring treatment in intensive care units and 21 patients on ventilatory support. Tragically, five people have lost their lives so far. 52 patients have been successfully recovered and discharged from the hospital.
In this article, we are going to provide information about what exactly is Guillain Barré syndrome to generate awareness about it,
This article will explain:
What is Guillain Barré syndrome? Is it infectious or Non-infectious?
How does it develop?
What are the signs and symptoms?
How can we identify it early, and what are the current treatment options available for those suffering from it?
What are the preventive measures for GBS?
What is Guillain Barré syndrome? Is it Infectious?
Guillain Barré Syndrome (GBS) - Pronounced as (Ghee-Yan-Bah-Ray Syndrome), is not an infectious or contagious disease.
It is an autoimmune neurological disorder that affects the peripheral nervous system of the human body (Nerves carry neurological signals about pain, temperature, touch, muscle movements, etc., from the Brain and spinal cord to the rest of our body).
It particularly develops within a few days after recovering from an episode of infectious (Respiratory or Gastrointestinal) disease.
In this illness, a person's immune system mistakenly attacks peripheral nerves and damages their protective covering (Nerve sheath).
It happens due to the resemblance of chemicals seen on bacteria and viruses with the coverings (Sheath) of the nerve cells, which, unfortunately, our immune cells fail to recognize in susceptible individuals.
It can affect any gender or can occur at any age. Still, it is most seen in adults, mostly Male gender above 50 years of age, according to some studies.
This disease can develop suddenly and become intense in hours, days, or weeks.
It can vary from mild (mild weakness) to severe form, presenting as paralysis of limbs and respiratory muscles, making the individual unable to move or breathe independently.
It is a potentially life-threatening condition, but fortunately, a complete recovery is possible even in the most severe cases if symptoms are identified and treated at the earliest.
How does Guillain Barré Syndrome develop?
As we have seen before, it is an autoimmune disease that usually develops after recovering from a gastrointestinal or respiratory tract infection.
The common infections which increase the risk of GBS are:
Gastrointestinal infection: Most commonly due to Campylobacter Jejuni (According to studies, 1 in every 20 people with GBS had a history of recent Campylobacter Jejuni infection) and due to other infective bacteria, e.g Campylobacter Coli. The infection manifest with symptoms such as: Diarrhoea, Abdominal cramps, fever, nausea and vomiting.
It can also develop in an individual with a recent history of surgical procedures.
Rarely, GBS develops after vaccination, but the risk is very low compared to the risk after viral or bacterial infections.
What are the risk factors for Campylobacter Jejuni Infection?
The risk factors which can predispose a person to the Campylobacter jejuni infection are:
Eating raw or undercooked meat, poultry, eggs, Shellfish, etc.
Eating raw or improperly washed vegetables.
Eating cooked rice from outside in any form (Provides a good medium for bacterial growth, especially Campylobacter Jejuni)
Consuming Raw, unpasteurized improperly stored milk and other dairy products (E.g. Paneer, Cheese, Packed curd, Yogurt, Butter, Mayonnaise etc.) as it presents as a good medium for the campylobacter growth.
Using the same cutting board or utensils for raw meat, poultry, or vegetables without washing.
Drinking unclean, unfiltered or untreated water.
Improper hand hygiene after using the bathroom (Person to person spread).
Not maintaining hygiene protocols after handling animals or their faeces.
What are the symptoms of Guillain Barré Syndrome:
Guillain-Barré syndrome can be potentially life-threatening if not identified and managed early, as it can become severe within a short period. Thus, it is necessary to determine the symptoms that can indicate the development of Guillain-Barré syndrome.
As we have discussed in Guillain Barré Syndrome the (covering/sheath) nerve cells get damaged causing impairment of the signal transmission from the Brain and Spinal cord to the muscles. The common symptoms are:
Muscle weakness: Muscular weakness develops initially in the feet but sometimes in the arms first and then gradually spreads to involve the body's other muscles, including breathing (Respiratory) muscles. The muscular weakness worsens progressively from mild to severe within a few hours to days or weeks. It manifests in the form of -
Difficulty in climbing stairs.
Difficulty in walking
Decrease in the grip strength of the hands.
Unsteadiness and loss of balance while walking and problems with coordination.
Visual problems due to involvement and weakness of the muscles surrounding eyeballs.
Difficulty in swallowing, speaking and chewing due to the weakness of facial muscles.
Difficulty in breathing, which can become severe and can be life-threatening (Due to the involvement of Breathing/respiratory muscles).
Damage to the nerves.
Unpleasant sensations like numbness, tingling, pricking, or Pins and needles (Starting in the toes, feet, or legs and then spreading to the hands and arms).
Deep muscular pain in the back and /or legs. (Can be severe and particularly at night)
Loss of Bowel and bladder control.
Abnormal heart rate and blood pressure in previously normal individuals.
How is Guillain-Barré Syndrome Diagnosed?
If one experiences symptoms of Guillain-Barré Syndrome (GBS), especially after a recent stomach or respiratory infection, seeking medical attention immediately is necessary, as early intervention can make a significant difference in recovery.
Step 1: Clinical Assessment Doctors begin by evaluating:
Medical History – Any recent gastrointestinal or respiratory infections.
Symptom Progression – When the weakness started, how it has spread, and any related neurological signs.
Physical Examination – Assessing muscle strength, nerve function and reflexes.
Step 2: Diagnostic Tests To confirm the diagnosis, doctors may perform:
Nerve Conduction Velocity (NCV) Test – Measures how well nerves transmit signals. Damaged nerves show slower or weaker signals.
Lumbar Puncture (Spinal Tap) – A small cerebrospinal fluid (CSF) sample is collected from the spine to check for abnormalities commonly seen in GBS.
MRI of the Brain/Spinal Cord – Helps rule out other conditions that may cause similar symptoms.
Why Early Diagnosis Matters?
Since GBS can progress rapidly, early detection and medical care are critical to managing symptoms and improving recovery outcomes. If you or someone you know is experiencing muscle weakness or unusual neurological symptoms, consult a healthcare professional immediately.
Is Guillain Barré Syndrome treatable? What are the treatment options?
The treatment can be effective if started within two weeks of the development of the symptoms.
The treatment aims to interrupt the immune system-mediated nerve damage caused by this disease.
Two modalities currently used by the treating physician are equally effective. These are
Plasma exchange (Plasmapheresis):
In plasma exchange, blood is removed from the body.
Plasma (The fluid component of the blood) is separated (The damaging immune cells are present in the plasma) from the blood cells.
Then, these blood cells are transferred back to the body along with healthy replacement fluid.
A specialized device is necessary for the plasma exchange process.
Intravenous Immunoglobulin Therapy:
Immunoglobulins are the proteins naturally produced by our immune system to fight infective organisms.
The immunoglobulins are developed from the pool of thousands of healthy donors for intravenous Immunoglobulin therapy. They are injected intravenously in the patient suffering from GBS.
It dilutes and reduces the number of self-harming immune cells and the severity of immune attacks on the nervous system.
In addition to the medical management, supportive treatment is also necessary for the patient suffering from GBS, Such as:
Mechanical ventilatory support in an Intensive care unit: For those whose breathing is affected due to severe weakness/Paralysis of the respiratory muscles.
Those suffering from changes in Heart rate and blood pressure may need to be closely monitored in a healthcare setting using monitoring devices.
Rehabilitation:
Once people suffering from GBS start showing improvement with the treatment, it is necessary to provide rehabilitative care and support to help them regain strength and resume regular activities.
Physiotherapy: To keep muscles flexible, prevent their shortening and gradually improve their strength.
Occupational/Vocational Therapy: To help people learn new ways or modalities to handle everyday functions affected by GBS with the help of assistive devices, adaptive Equipment and technology, etc.
Recovery from GBS can be slow and can take a few weeks to a few years, depending on the severity.
There is always a possibility that few patients may not recover completely even after treatment, they may continue to have mild muscular weakness, fatigue, pain and numbness.
If not identified and treated in time, GBS can become life-threatening, which can be even fatal.
Still, most of the patients from GBS can fully recover with timely medical management, intensive care and effective management of severe complications like respiratory failure.
How to prevent GBS?
Guillain-Barré syndrome is an autoimmune disease that commonly develops after recovery from an episode of certain gastrointestinal or respiratory tract infections.
Prevention of these infections can help in reducing the risk of Guillain-Barré syndrome.
The preventive measures include:
To prevent Gastrointestinal Infection due to Campylobacter Jejuni and other Microorganisms:
Avoid eating outside food due to the risk of poor hygiene standards and contamination.
Avoid eating raw or undercooked food, especially eggs and meat.
Avoid drinking raw or unpasteurized milk.
As per the recent recommendations by Indian physicians, it is better to avoid eating milk products from outside, such as paneer or cheese (They are more susceptible to bacterial growth due to high moisture content).
Do not keep cooked rice at room temperature as it is more prone to bacterial growth, keep it in the refrigerator.
Avoid drinking contaminated/untreated water (Drink filtered/ safe drinking water). Practise boiling water before consumption.
Avoid eating raw vegetables (Always wash vegetables thoroughly).
Keep utensils clean and always wash them properly before using.
Keep utensils used for cutting or chopping meat separately and clean them properly after every use.
Follow proper hand hygiene (Wash hands thoroughly with soap and water after using the bathroom or touching animals, including their food, water, faeces, belongings, and habitat).
To prevent Respiratory Tract Infections:
Maintain social distancing.
Use face masks while going into crowded places whenever necessary.
Always cover your mouth and nose with a handkerchief while coughing or sneezing.
Follow proper hand hygiene guidelines as recommended during the COVID-19 pandemic.
