New Delhi: In response to an alarming outbreak of Guillain-Barré Syndrome (GBS) in India, leading experts convened for a recent ETHealthworld webinar, “Guillain-Barré Syndrome (GBS) Explained: When the Immune System Turns Against You,” to discuss the complexities of the condition, its possible triggers, and the urgent need for improved surveillance and preventive strategies.
GBS is a rare neurological disorder in which the immune system mistakenly attacks the peripheral nerves, causing muscle weakness and, in severe cases, paralysis. Though its exact cause remains unclear, several infections have been linked to its onset.
Dr. Raman Gangakhedkar, former Indian Council of Medical Research (ICMR) scientist and Distinguished Professor at Symbiosis International University, explained that about 30 per cent of GBS cases are associated with Campylobacter jejuni, a bacterial infection, while various viral infections also play a role. However, pinpointing a definitive causative organism remains a challenge.
“Clusters are occurring in the community, but they are not reflected within families, suggesting that the transmission pathway remains elusive,” he noted.
Dr. Shekar Mande, Former Director General, CSIR, highlighted that the autoimmune response in GBS may be triggered by molecular mimicry, where antibodies produced against infections also attack nerve cells. “Why this autoimmune disorder arises is still being studied, but many cases have been linked to prior infections,” he added.
Dr. Mukesh Kumar, Director and Head of Neurology at Max Super Speciality Hospital, Saket, provided insights into the prevalence of GBS. He stated that while GBS is a sporadic condition rather than endemic, cases occur consistently across all seasons. “Statistically, one in 100,000 individuals is affected. Around 60 per cent of cases follow influenza-like symptoms, while Campylobacter jejuni accounts for 15-20 per cent,” he noted.
Dr. Kumar explained that GBS can present with varying severity, with early indicators emerging within the first few days. “The progression of weakness in the first four days determines severity. If a patient can walk by the tenth day, the prognosis is generally favorable. However, severe cases may require ventilatory support,” he said.
He also emphasised the importance of rehabilitation for GBS patients. “Ninety-nine point five percent of GBS cases are completely curable, but recovery depends on intensive physiotherapy. Patients require six to eight hours of rehabilitation daily to regain mobility.”
A major concern highlighted during the webinar was the absence of a structured surveillance system for GBS. Dr. Mande stressed that effective surveillance is typically focused on diseases with known causes. “If we can establish a link between GBS and Campylobacter outbreaks, targeted surveillance and water treatment measures can be implemented in affected areas,” he said.
However, Dr. Gangakhedkar cautioned against diverting resources from other priority diseases. “While GBS is a concern, the government must focus on achieving the 2030 disease elimination targets, where we are already lagging,” he noted.
Prevention strategies were a key focus, with public health lawyer Leena Menghaney underscoring the importance of clean water and hygiene interventions (WASH). “Poor and marginalized communities often lack access to safe drinking water, increasing the risk of infections that may trigger GBS. Strengthening WASH programs can reduce mortality and antibiotic resistance while also helping prevent outbreaks,” she said.
The ongoing GBS outbreak underscores the need for deeper research into its triggers, improved surveillance, and a greater emphasis on preventive public health measures. While most cases are treatable, early detection, better hygiene, and strong rehabilitation support remain crucial in mitigating the disease’s impact.
