New Delhi: Tingling, weakness of hand-grip or foot drop could signal Guillain-Barré Syndrome (GBS), said health experts on Monday, even as the reported cases spike to over a hundred in Pune, Maharashtra.
The Maharashtra health department on Sunday also reported what is suspected to be the first death linked to the GBS outbreak concentrated in Pune.
The Union health ministry has sent a team to Pune’s Sinhgad area, where the outbreak is currently concentrated.
What is GBS?
GBS is a serious illness that often progresses rapidly, making the patient bedridden in a few days. It is associated with damage to nerves causing severe weakness of limbs, trunk, and face.
It is often followed by a bacterial or viral infection (such as diarrhoea causing Campylobacter Jejuni bacteria or viral infections like dengue or chikungunya), that wreaks havoc on the nerves.
In people afflicted with GBS, the immune system mistakenly attacks healthy nerves outside the brain and spinal cord, leading to weakness and, sometimes, paralysis, or even death.
“GBS is a very rare but potentially paralysing nerve disorder caused by the immune system mistakenly attacking the body’s own nerves. It is often triggered by gastrointestinal or respiratory infections,” Rajeev Jayadevan, Chairman of the Kerala State IMA Research Cell, told IANS.
Campylobacter, a bacterial gut infection that spreads through contaminated food and water, has been linked to the current outbreak. The symptoms of GBS typically include gastrointestinal issues like nausea, vomiting, and diarrhoea before GBS onset.
The condition causes “weakness that is progressive, later involving the upper limbs, and can also affect the muscles involved with breathing,” the expert said. However, it is important to note that the vast majority of infections do not result in GBS, said Jayadevan, also a Kochi-based gastroenterologist.
“Improving sanitation, water, and air quality, along with general measures to reduce the spread of infections in communities, can help lower the risk,” he said.
When to seek medical help?
The illness often starts suddenly and can progress over 4 weeks. Some patients may experience rapid worsening, while others may progress more slowly.
While prompt diagnosis and treatment of GBS are crucial, with delays potentially leading to worse outcomes, the symptoms are often common, related to other diseases, and may not always end up as GBS.
“If someone develops new-onset tingling sensation and weakness, especially in the legs with difficulty walking, they should seek immediate attention at a hospital with advanced facilities,” Jayadevan told IANS, adding that “facial weakness can appear with drooping of the eyelid (ptosis) or a smile involving only one side of the face”.
Dr Pawan Ojha, Director – Neurology, from a Vashi-based hospital told IANS that it is important for the public not to panic over simple tingling/ numbness of limbs or face.
“But GBS should be considered only when there is weakness of hand-grip, foot drop, or difficulty in raising hands above shoulder or rising above the ground,” Ojha said.
He noted that some patients also get severe autonomic disturbances, that is, fluctuating blood pressure, heart rate, cardiac arrhythmias, temperature/ sweating/bowel/ urinary disturbances, which can be life-threatening at times.
“Any difficulty in speaking, swallowing, or breathing could also be a sign of severe GBS and should receive urgent medical attention,” the expert said. “Although these symptoms are not unique to GBS, they require immediate and thorough evaluation to determine the exact cause. With modern medical treatment, full recovery is possible in most cases,” Jayadevan noted.
GBS patients should be hospitalised for close monitoring of vital signs or worsening and for urgent treatment. Severe cases of GBS might require ICU admission and ventilatory support. Complications like abnormal heartbeat, infections, blood clots, and high or low blood pressure need early detection and treatment.
Urgent treatment in the acute phase is intravenous immunoglobulin injections over 5 days or plasma exchange over a week. Steroids are usually avoided.
Devices like braces or wheelchairs might be necessary for some time, said Ohja. Physical therapy is necessary for patients to regain strength and movement and avoid secondary infections.
How to prevent GBS?
The state health department in an advisory shared that one can prevent GBS up to a certain extent by taking general precautions such as drinking boiled water/ bottled water, washing fruits, and vegetables thoroughly before eating, properly cooking poultry and meat; avoiding raw or undercooked food, especially salads, eggs, kebabs or seafood.
It also suggested keeping raw and cooked foods separate, disinfecting kitchen surfaces and utensils after handling raw meat, as well as adopting general hygiene measures like frequent hand washing with soap, especially before eating and after using the toilet.
(IANS)
