A patient at the 2 de Mayo Hospital in Lima, Peru, during a peak in Guillaume Barré cases in 2019. Martin Mejia (AP)
Guillain-Barré Syndrome (GBS) is an autoimmune disease that has claimed four lives and recorded 211 cases in Peru this year. It is not contagious, but those who develop it experience progressive muscle weakness that increases over the days, with loss of strength in the extremities, and numbness and tingling that spreads to the upper trunk and face. GBS is usually mild if treated early. However, according to neurologist Ivan Dueñas Pacheco, nearly 25% of cases end up with paralysis that causes the person to be unable to breathe on their own, requiring the use of a mechanical ventilator.
GBS is nothing new in Peru. According to the National Center for Disease Epidemiology, Prevention and Control (CDC PERU), the average monthly number of cases nationwide is less than 20, or around 200 in a full year. The outbreak in 2023 worries authorities because that number has been reached in half the time and there is a possibility that cases will increase.
On June 26, the Peruvian authorities issued an epidemiological alert due to the increase in cases of the syndrome in some regions of the country. Days later, the Ecuadorian government activated epidemiological surveillance due to about twenty GBS cases on the border with Peru.
Causes of Guillain-Barré Syndrome
Ivan Dueñas, a member of the Peruvian Society of Neurology, explains to El País that there have already been two outbreaks of Guillain-Barré syndrome in Peru, the first in 2018 with 52 cases and the second in 2019 with more than 900. The doctor points out that SGB outbreaks have occurred during such outbreaks. According to Dueñas, in most situations, GBS occurs a week or two after an infectious disease, whether viral or bacterial.
“It depends on the immune system. If it’s strong enough to fight the bacteria or the virus, it won’t develop Guillain-Barre.” But if the immune system is very weak, other illnesses or comorbidities are present, then the risk is greater,” says Dueñas.
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Although the exact cause of Guillain-Barré syndrome in Peru is unknown, the Ministry of Health and GBS CIDP Foundation International advise that Campylobacter jejuni infection (which caused the 2019 outbreak) is one of the most common risk factors for developing the syndrome.
Campylobacter jejuni is a bacterium that causes an intestinal infection after ingesting contaminated food or water. Foods that are commonly contaminated are raw poultry, unpasteurized milk, and fruits and vegetables. However, a person can become infected through contact with infected people or animals. Syndrome prevention campaigns therefore include washing hands properly, drinking water from safe sources, cooking food well, and sanitizing fruits and vegetables to avoid gastrointestinal infections. In addition, cover yourself with a handkerchief or forearm when you sneeze and get the flu shot to prevent diseases that weaken the immune system.
It’s not known for certain why only some people develop GBS, but the Genetic and Rare Diseases Information Center (GARD) says some people may have a genetic predisposition. There is currently no cure for the syndrome, but plasmapheresis and immunoglobulin treatments have proven effective in reducing the severity and duration of symptoms.
Guillain-Barré Syndrome in detail
Guillain-Barré syndrome is a rare autoimmune disease. Normally, the immune system only fights foreign invaders such as viruses or bacteria. The word “auto” refers to “itself”. So, autoimmune refers to a disease in which the immune system attacks the body itself, particularly the peripheral nerves. Peripheral nerves are a type of “wires” that allow us to control muscles and sense stimuli from the environment. Nerves are surrounded by the myelin sheath, a kind of protective layer that facilitates the transmission of electrical impulses.
GBS causes the body to make antibodies that attack the myelin sheath. And when this is damaged, signal transmission between the brain, spinal cord and muscles is impeded, leading to muscle weakness, numbness and tingling and, in severe cases, paralysis. Some people even require hospitalization to avoid cardiac and respiratory complications.
Muscle weakness and other typical GBS symptoms
The main symptom of Guillain-Barré syndrome is muscle weakness that begins in the feet and spreads upwards. Numbness and tingling can also occur, which can increase in intensity until the muscles can no longer be used at all. It is important to go to your nearest health center if you experience any of the following warning symptoms:
- Numbness in hands and feet.
- Increasing muscle weakness.
- Progressive ascending paralysis of hands and feet.
- Other symptoms include back pain, shortness of breath, difficulty swallowing, and heart rate or blood pressure problems.
dr Dueñas points out that a timely diagnosis can make a difference. “Once we identify a GBS patient, they should be treated to prevent disability. The natural course of the disease is weakness and numbness. This can increase and ideally the person should be treated in the first week of symptoms. Recovery takes up to six months on average, and a small percentage of people are left with a severe disability.
Children can also develop Guillain-Barré. Dueñas points out that minors report muscle pain and then show progressive weakness. Muscle weakness progresses over the days. “It’s the number one symptom to see a doctor about,” he says.
How is Guillain-Barré Syndrome treated?
GBS is treated with plasmapheresis and intravenous immunoglobulin (IVIg) and is free in health centers. The Peruvian Ministry of Health also announced which facilities offer treatment for GBS to the entire population. You can also contact 113 Health Line 24 hours a day, 24 hours a day, or call 955557000 and 952842623 via Telegram and WhatsApp.
Ivan Dueñas asks not to be concerned. “Sometimes you think it’s a contagious disease, but that’s not the case. With early and timely diagnosis, treatment of the patient can help to fully restore his motor functions and prevent motor disabilities. There’s no need to sound the alarm by saying it’s a contagious disease and start a social panic. It doesn’t go there. You have to know how to recognize muscle weakness, it’s the most important symptom,” he concludes.
PREVENT GUILLAIN BARRÉ
The central government declared a national health emergency on July 7 with Supreme Decree N 019-2023SA due to the unusual increase in Guillain-Barré Syndrome cases
Read the full notice at the following link: https://t.co/F3rnZ0eMU3 pic.twitter.com/pHjDN9PrIt
– Municipality of La Punta-Oficial (@LapuntaOficial) July 21, 2023
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