When the first outbreak happened in Pune, all heads turned and started to panic. What was this new infectious intruder? How many more epidemics or pandemics can the human civilisation sustain — Covid was bad enough, wasn’t it? With new cases every day and one reported case in Telangana, a neurologist decodes GBS — Guillain-Barré Syndrome.
What is GBS?
Named after French neurologists Georges Guillain and Jean Alexandre Barré, the Guillain-Barré Syndrome (GBS) is a neurological disorder in which a person’s immune system mistakenly attacks the peripheral nerves.
“When people suffer from viral or bacterial diseases like Covid, chikungunya, or diarrhoea, a segment of those people get GBS post the disease. This is because of molecular mimicry,” explained Dr Suresh Babu P, senior neurologist at Arete Hospitals, Gachibowli.
Molecular mimicry is a simple concept — the outer structure of the bacteria or virus mimics the structures in the nervous system. This sets off a trail of confusion, where the antibodies attack the peripheral nerves. This leads to GBS.
What are the symptoms?
Dr Suresh pointed out that GBS affects the peripheral nerves, which comprise motor, sensory, and autonomic components. In most GBS cases, all three are affected.
Initially, one may have sensory symptoms like tingling, numbness, or a burning sensation that starts in the feet and rapidly spreads upwards through the body. “They cannot sit and stand, and cannot grip, let’s say, a cup of tea. There is a gradual decline in limb power. Sitting, standing, walking…these simple activities become difficult to do,” said the neurologist. There are also autonomic symptoms such as fluctuations in blood pressure, problems with the bladder, and constipation.
Other symptoms include bifacial weakness, where the facial muscles get weaker, and bulbar weakness, where the patient has difficulty swallowing.
Dr Suresh added, “GBS does not manifest in every human body the same way. It is important to note that while for some people, it may take up to four weeks for symptoms to get extreme, for others, all this can happen in just a day.”
What are the causes?
In the Pune outbreak, Campylobacter jejuni (C. jejuni) was the bacteria found in samples from patients with GBS. Essentially, contaminated food or water can be the source for a GBS outbreak. The neurologist noted, “The two main ways to get GBS are respiratory tract infections like throat infections and gastrointestinal tract infections like diarrhoea and dysentery.”
He further added that the genetics of an individual plays a role too, saying that for instance, if C. jejuni enters the bodies of 100 people, 10 will perhaps get GBS due to the genetic conditions allowing this.
GBS is treatable!
Currently, there are two main treatments for GBS, explained Dr Suresh:
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Intravenous immunoglobulin (IVIg): Immunoglobulins are pooled from donors and those antibodies are infused into the patient’s body. They bind to the unwanted antibodies, form a soluble complex, and pass through urine.
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Plasmapheresis: This is a closed-circuit special filter, which takes 3 to 4 litres of blood from the body, filters out the unwanted antibodies, and pushes the clean blood back into the body.
Don’t fear it
With cases on the rise in the rest of the country and one confirmed case in Telangana, citizens and netizens are panicking. “I don’t know what to believe anymore. Different people say different things about this syndrome. Social media also keeps throwing up random information on it,” expressed Ashwini, a homemaker.
Experts across the country assure that GBS is not cause for such fear. “Not everyone will be put on a ventilator if they have GBS. It is completely treatable and you can take some steps to prevent it,” said Dr Suresh. He pointed out that to prevent GBS to an extent, you need to consume hygienic and cooked food at clean eateries and avoid going to very crowded places where you could catch an infection. “It’s really just common sense, something you should practise regardless of GBS,” he advised.
