MUMBAI: The Guillain-Barre Syndrome outbreak in Pune that has affected 140 people, with 18 needing ventilator support, could have been controlled in four days had adequate public health measures been adopted, but health officials let it spin out of control, says Dr T Jacob John, a leading virologist and former professor at Christian Medical College in Vellore who has spent decades monitoring outbreaks and infectious diseases in India.
“As soon as the first case was detected, it should have been reported to local health officials, who would then have alerted hospitals to investigate further,” he told TOI. The next crucial step should have been to confirm whether Campylobacter jejuni, a bacterium commonly linked to GBS outbreaks, was the cause. This detection takes 48 hours.
On day 2, Dr John said, health officials should have promptly verified potability of water and tested it for E coli. On the same day, an alert should’ve been issued warning the public of a possible contamination in the drinking water and urging them to boil it before consumption.
By day 3, if the results were confirmed, he said, the municipal corporation should have implemented a hyperchlorination process to disinfect the water and identify the contaminated branches of the water supply.
On day 4, with increasing GBS cases from different hospitals, health officials should have created a spot map, declared an outbreak, and announced that the water supply had been cleaned.
Once these measures were implemented, Dr John noted, the outbreak would have likely subsided. “This is how it happens in developed countries. We need to answer now if India has this protocol – that is what a robust public health system is.”
A former disease surveillance officer said, “The surveillance systems are well established, but they need to be fine-tuned to take into account the urban area’s growing population. In this case, the health department took the necessary steps early on. However, there are many factors beyond the scope of the health department, such as the quality of water supplied in the city.”
He said the outbreak was particularly complex, as GBS itself is not an infectious disease but rather a condition triggered by infectious agents.