Guillain-Barré Syndrome (GBS), a rare and potentially life-threatening neurological disorder, is currently on the rise in several regions of India. As of late January 2025, three fatalities have been reported in Kolkata, while more than 120 cases have been recorded in Maharashtra, sparking widespread concern among health officials. The sudden surge in GBS cases has raised alarms, and health authorities are investigating possible causes. This disease, which is characterized by the immune system attacking the peripheral nervous system, can lead to paralysis and, in severe cases, death. In this explainer, we delve into the spread of GBS, its symptoms, potential causes, and how it affects patients.
What is Guillain-Barré Syndrome (GBS)?
Guillain-Barré Syndrome (GBS) is an autoimmune disorder where the body’s immune system mistakenly attacks the peripheral nervous system, which includes nerves outside the brain and spinal cord. The attack causes inflammation, which leads to symptoms such as muscle weakness, numbness, and, in severe cases, paralysis.
Although GBS is rare, it is a serious condition that can rapidly progress and may lead to life-threatening complications, including respiratory failure if the muscles involved in breathing become affected. The exact cause of GBS is often unclear, but it is typically triggered by an infection or, in some cases, vaccinations or surgeries.
The condition was first described in 1916 by French neurologists Georges Guillain and Jean Alexandre Barre, after whom it is named. Since then, the condition has been the subject of significant medical research, although its exact mechanisms remain a mystery.
Symptoms of GBS
The symptoms of GBS generally appear following an infection, such as a respiratory or gastrointestinal illness, and can worsen quickly. Common symptoms include:
- Muscle Weakness and Numbness: This usually starts in the feet and hands and may progress to the arms and legs.
- Loss of Reflexes: Reflexes may be diminished or absent as the disease progresses.
- Difficulty Moving: As the disorder affects the nerves that control muscle movement, individuals may have difficulty walking, standing, or moving their limbs.
- Breathing Problems: In severe cases, the muscles responsible for breathing can be affected, requiring ventilator support.
- Pain and Fatigue: Muscle pain, discomfort, and extreme fatigue are common in individuals with GBS.
- Gastrointestinal Symptoms: Stomach pain, diarrhea, and vomiting may also occur.
While most people with GBS experience weakness and loss of coordination, some may face long-term disability. The syndrome’s severity can vary, but prompt medical treatment significantly improves the chances of recovery.
Current Outbreak in Maharashtra
In Maharashtra, particularly in Pune, the Public Health Department has reported a significant rise in GBS cases. As of January 30, 2025, over 120 cases have been recorded in the state, with 23 patients from Pune’s municipal areas, and others from surrounding districts. Among these, 20 patients are reportedly on ventilator support, indicating the severity of the disease in the region.
The outbreak has triggered an investigation into the possible causes, with authorities suspecting contaminated water sources in Pune as a key factor behind the rise in cases. The Pune Municipal Corporation (PMC) and the state health department have been conducting rigorous tests on water samples from various locations in the city. Eight of the 144 samples tested were found to be contaminated, raising concerns about the role of poor water quality in spreading the disease.
The outbreak has also led to two reported deaths, with a 40-year-old man and a 56-year-old woman succumbing to the disease. The man had traveled to Pune from Solapur, where the infection might have been contracted, while the woman passed away while receiving treatment at Sassoon General Hospital. The rapid increase in cases has prompted local health authorities to take immediate actions to prevent further spread, including repairing water leaks, replacing faulty drainage lines, and increasing the availability of medical supplies.
Rise of GBS in West Bengal
While Maharashtra is battling a significant rise in GBS cases, West Bengal has also witnessed a concerning increase in the number of reported cases. Over the past week, health authorities in Kolkata have confirmed three deaths, including that of a child, which has intensified the focus on GBS in the region. In addition to the deaths, several children have been hospitalized with symptoms consistent with GBS.
The first fatality, a 10-year-old child from North 24 Parganas, passed away after a week of treatment at BC Roy Hospital. The second death involved a 17-year-old from the same district, who succumbed to septic shock and myocarditis, with doctors suspecting GBS as the underlying cause. Another man, aged 48, from Hooghly is also suspected to have died due to GBS, though this has yet to be confirmed by the state health department.
In response to the rising number of GBS cases, the state government has deployed medical teams to monitor the situation and provide treatment to the growing number of patients. Children remain particularly vulnerable, with several pediatric cases under intensive care at various hospitals in Kolkata.
How Does Guillain-Barré Syndrome Spread?
The exact mechanism behind the rapid spread of GBS in Maharashtra and West Bengal remains under investigation, but several factors are thought to play a role. It is believed that infections are the primary trigger for the condition, and common culprits include bacterial and viral agents. Among these, Campylobacter jejuni, a bacterium often found in undercooked poultry, has been linked to a significant proportion of GBS cases worldwide.
Other infections that may contribute to the development of GBS include:
- Viral infections: Such as influenza, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and Zika virus.
- Bacterial infections: Apart from Campylobacter jejuni, bacteria like Mycoplasma pneumoniae and HIV have been implicated.
- Surgical procedures and vaccinations: Although rare, there have been instances where GBS has followed major surgeries or vaccinations, though the benefits of vaccination far outweigh the risks.
Given the suspected role of contaminated water in the recent outbreak, it is also possible that certain environmental factors or poor sanitation practices may have contributed to the rapid spread of GBS in certain regions. Health authorities in Pune are focusing on addressing water contamination to mitigate the risk of further cases.
What Are the Treatment Options for GBS?
There is no specific cure for Guillain-Barré Syndrome, but prompt medical treatment can significantly improve the chances of recovery. Most people with GBS require hospitalization, especially if they experience severe symptoms like paralysis or breathing difficulties. Treatment options include:
- Plasma Exchange (Plasmapheresis): This procedure involves removing antibodies from the blood that are attacking the peripheral nerves, which can help reduce the severity of the disease.
- Intravenous Immunoglobulin (IVIG) Therapy: IVIG involves infusing high doses of immune system proteins to suppress the immune response that causes nerve damage.
- Supportive Care: Including ventilator support for those with breathing difficulties, pain management, and physical therapy to help with recovery.
Recovery from GBS can take weeks to months, and while many individuals recover completely, some may experience long-term neurological effects such as weakness or numbness in the limbs.
The recent surge in Guillain-Barré Syndrome cases in Maharashtra and West Bengal has raised concerns among health authorities and the general public. While the exact causes of this outbreak are still being investigated, the role of contaminated water in Maharashtra and the link to bacterial infections such as Campylobacter jejuni are likely contributing factors. As the situation continues to unfold, health officials are working tirelessly to contain the spread of the disease, ensure adequate treatment, and provide critical care to affected individuals. Public awareness and timely medical intervention remain crucial in managing this potentially deadly condition.