MUMBAI: As 18 of 140 patients with the debilitating neurological disorder, Guillain-Barre Syndrome (GBS), are on ventilator support in Pune, there is some cold comfort in knowing this isn’t the worst outbreak in the world – yet. It could, however, be considered one of the largest GBS outbreaks as medical literature classified 30 to 50 cases as an outbreak until 2019 when Peru registered the worst flare-up.
The South American country had 1,120 cases in 2019, with 683 cases reported in two months. Its annual caseload stood at 59 in 2017 and rose to 262 in 2018 before peaking in 2019. Cases were recorded from across the country, but there is little data on deaths. The story didn’t end there; Peru witnessed an outbreak again in 2023, when 130 suspected cases were reported between June 10 and July 15.
The problem with GBS, as a professor of medicine in a medical college in Mumbai said, is that it is an autoimmune condition that technically doesn’t seem like an epidemic-causing condition. “GBS has been seen as an independent disorder that is sporadically seen across the country, but we now need to change our mindset and accept it can emerge as an outbreak and study it epidemiologically to look for links between the patients,” he said.
The only link between Peru and Pune is microbe Campylobacter jejuni. Smaller studies from across the world show GBS following this infection is linked with higher disability and mortality rates.
GBS has been so rare – India has a reported annual incidence of 1.75 to 2 per lakh population – that there are few in-depth studies. The first-ever detailed analysis of the prevalence and disability burden of GBS was conducted in 2021. Using data between 1990 and 2019, the analysis showed that Japan, Brunei Darussalam, Singapore, South Korea, the US and Mexico had much higher than expected burdens, while countries and territories such as China, Fiji, Taiwan, and Guam had much lower than expected burdens.