Following the outbreak of Guillain-Barré Syndrome (GBS) in Pune and four deaths and 45 cases reported in the State, public awareness of the disease has grown significantly.
In an exclusive interview with Bandhavi Annam, Additional Director of Medical Education, Dr Nagarjunakonda Venkata Sundarachary, who is also the Principal of Guntur Medical College, and former head of the Neurology Department at Guntur Government General Hospital (GGH), reassured that GBS is a rare autoimmune disorder, however, not contagious. He elaborated on its symptoms, diagnosis, and recovery to allay fears among people.
Excerpts:
How does GBS affect the nervous system?
Guillain-Barré Syndrome (GBS) is a rare neurological disorder where the body’s immune system mistakenly attacks the peripheral nervous system, which is the network of nerves outside the brain and spinal cord. The immune system targets the myelin sheath, a protective covering that helps transmit signals along nerves. As the immune response causes inflammation and damage to the nerves, it disrupts the communication between the brain and the body. This leads to symptoms such as muscle weakness, numbness, and in severe cases, paralysis.
What are the early symptoms of GBS?
The early symptoms of GBS often begin with tingling sensations, particularly in the toes and fingers. Muscle weakness follows, typically starting in the legs and potentially moving upward to the upper body and arms. Many individuals also experience an unsteady gait, making it difficult to walk or maintain balance. These symptoms can progress quite rapidly, so it’s essential to seek medical attention promptly when they appear.
What could be the reasons behind the surge in GBS cases?
I want to clarify that GBS is not a pandemic or endemic. The surge in GBS cases can have multiple causes. Infections with certain viruses or bacteria, such as influenza, HIV, gastroenteritis, respiratory infections, typhoid, and dengue, have been linked to GBS. Environmental factors and increased awareness, leading to better reporting, could also contribute to a rise in cases.
Is there a connection between recent viral infections, vaccinations or environmental factors and the rise in GBS cases?
Yes, GBS has been linked to viral infections like Zika and bacterial infections like Campylobacter jejuni (associated with poultry). But the talk about Covid-19 affecting GBS is false. Covid-19 pandemic and its vaccination were over a couple of years ago, hence there is no way GBS is caused due to Covid-19. While vaccines are generally safe, rare instances have shown a potential association between some vaccines and GBS.
Environmental factors may also contribute, as these can lead to infections that might trigger GBS. However, ongoing research is still working to clarify these associations more thoroughly.
What is the typical recovery process, and can patients expect a full recovery?
Recovery from GBS can vary significantly from one person to another, despite their age. For some, recovery may take weeks or even several months, and some may experience lingering symptoms for a longer period.
What steps can the public take to reduce the risk of developing GBS?
People should focus on food safety, such as properly cooking poultry to prevent infections like Campylobacter. Good hygiene practices can reduce the risk of infections. Lastly, awareness of the early symptoms of GBS and seeking medical attention promptly can help with early diagnosis and treatment.
Out of the total 301 GBS cases reported in AP last year, 115 were from Guntur GGH. What do you think is the reason?
Guntur GGH serves as a referral hospital with advanced facilities, which is why it tends to receive a higher number of cases from across the State, including those from highly critical patients. Therefore, the number of cases in Guntur GGH is not a cause for concern but rather a reflection of the hospital’s role as a critical care centre.
Given the increasing number of GBS cases in the State, what do you think is the role of the State government in managing and addressing this issue?
The State government is on high alert regarding the rising GBS cases. Chief Minister N Chandrababu Naidu held a review meeting with Health Minister Y Satya Kumar Yadav and experts in neurology to assess the situation. The Chief Minister has directed officials to ensure the availability of required intravenous immunoglobulin (IVIG) treatment. He also instructed them to stock up on these injections to avoid any shortage. The officials have also been asked to increase coverage for GBS under Dr NTR Vaidya Seva scheme, to facilitate immunoglobulin treatment as it could cost between Rs 2.5 lakh and Rs 3 lakh.
Moreover, the Chief Minister has directed officials to conduct a survey based on past GBS cases, helping to identify the disease’s causes and formulate appropriate preventive measures. These steps will help in reducing the mortality rate.