“Guillain-Barré Syndrome (GBS) Outbreak in India: Causes, Symptoms, and Prevention”

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As of February 20, 2025, India is confronting a significant outbreak of Guillain-Barré Syndrome (GBS), a rare neurological disorder. The epicenter of this outbreak is Maharashtra, particularly Pune, where two recent fatalities—a 26-year-old woman and a 37-year-old man—have increased the state’s death toll to 19. Nationally, GBS has claimed 23 lives, with 211 reported cases, predominantly from Pune and its surrounding areas. Other affected states include Andhra Pradesh, Assam, Tamil Nadu, and West Bengal, each reporting one death.

Health authorities have linked the Pune cluster to water contamination, prompting intensified surveillance and preventive measures. This article delves into the causes, symptoms, treatment options, and preventive strategies related to GBS, aiming to provide a comprehensive understanding of the current situation.

Guillain-Barré Syndrome (GBS) is a rare but serious autoimmune disorder where the body’s immune system mistakenly attacks the peripheral nerves, leading to muscle weakness, paralysis, and, in severe cases, difficulty breathing. Research has shown that one of the leading triggers of GBS is infection with Campylobacter jejuni, a bacteria commonly found in raw or undercooked chicken.

This article explores GBS in detail, including its symptoms, causes, how chicken consumption increases the risk, the most affected age groups, and ways to prevent infection.

What is Guillain-Barré Syndrome (GBS)?

GBS occurs when the immune system, which usually fights off harmful bacteria and viruses, starts attacking the body’s own nerves. This leads to inflammation and damage to the myelin sheath, the protective layer around nerves, disrupting nerve signals and causing muscle weakness or paralysis.

How GBS Affects the Body

• The immune system mistakenly attacks the nerves, disrupting communication between the brain and muscles.
• Muscle weakness usually starts in the legs and spreads to the upper body and arms.
• In severe cases, GBS can affect breathing, requiring ventilator support.
• Though most people recover over time, some experience long-term nerve damage.

What are the Symptoms of GBS?

GBS symptoms typically appear a few days or weeks after an infection and can worsen rapidly. The early symptoms  may include tingling or numbness in the hands and feet, weakness starting in the legs and spreading upwards and loss of reflexes. When the disease further progresses the symptoms may include difficulty walking or standing, pain in muscles and joints and weakness spreading to the arms and upper body. In rare cases, the severe symptoms include paralysis affecting the breathing muscles, irregular heart rate and blood pressure and difficulty swallowing and speaking.

Which Age Groups Are Most Affected by GBS?

GBS can occur at any age, but some groups are more vulnerable. 

• Older Adults (50+ years):
  • The highest risk group, with cases increasing with age.
  • Weakened immune systems may contribute to increased susceptibility.
• Young Adults (15–35 years):
  • GBS is also seen in younger adults, often following infections like Campylobacter jejuni from contaminated food.
• Children (under 15 years):
  • Less common but can occur, usually after viral or bacterial infections.
  • More frequent in developing countries where foodborne infections are common.

How is Chicken Consumption Linked to GBS?

The link between chicken and GBS comes from infection with Campylobacter jejuni, a bacteria found in raw or undercooked poultry. Studies suggest that 40%–60% of GBS cases are triggered by a previous Campylobacter infection.

Campylobacter jejuni is a bacteria commonly found in raw chicken, and consuming undercooked poultry or experiencing cross-contamination in the kitchen can lead to infection. When the body detects the presence of Campylobacter jejuni, the immune system responds by producing antibodies to fight off the bacteria. However, due to a phenomenon called molecular mimicry, some of these antibodies mistakenly target the body’s own nerve cells because bacterial proteins closely resemble human nerve proteins. As a result, the immune system attacks the myelin sheath, the protective layer around nerves, leading to nerve damage. This disruption in nerve function causes muscle weakness, paralysis, and other symptoms associated with Guillain-Barré Syndrome (GBS).

How Common is Campylobacter Infection?

Campylobacter infection is a widespread foodborne illness, causing over 1.5 million infections in the U.S. each year. The primary source of infection is contaminated chicken, either through direct consumption of undercooked poultry or cross-contamination in the kitchen. While most infections result in mild food poisoning, including diarrhea, fever, and abdominal cramps, a small percentage of cases can lead to serious complications like Guillain-Barré Syndrome (GBS).

Risk Factors for Campylobacter Infection from Chicken:

One of the biggest risks comes from eating undercooked chicken, as Campylobacter bacteria are only killed when poultry is cooked to an internal temperature of 165°F (74°C). Another major concern is cross-contamination in the kitchen, where bacteria from raw chicken can spread to other foods through shared cutting boards, knives, or unwashed hands. Additionally, drinking contaminated water or unpasteurized milk can expose individuals to Campylobacter, particularly in areas with poor sanitation. Those with a weakened immune system, including older adults, young children, and immunocompromised individuals, are at a higher risk of severe infections and complications.

How to Prevent GBS from Chicken Consumption

Since Campylobacter infection is a major trigger for Guillain-Barré Syndrome (GBS), following safe food handling practices can significantly reduce the risk. Proper cooking is crucial—chicken should always be cooked to at least 165°F (74°C) to kill harmful bacteria, and raw or undercooked poultry should be strictly avoided. Preventing cross-contamination is another key step; using separate cutting boards and knives for raw chicken and other foods helps stop bacteria from spreading. Additionally, never place cooked food on a plate that previously held raw chicken.

Proper food storage also plays a vital role in preventing infection. Raw chicken should be kept in sealed containers at the bottom of the refrigerator to prevent juices from contaminating other foods. Contrary to common belief, washing raw chicken is not recommended, as it can spread bacteria through water droplets. Maintaining good hygiene is equally important—washing hands thoroughly with soap and water for at least 20 seconds after handling raw poultry can prevent bacterial transfer. Ensuring that drinking water is properly treated and avoiding untreated or contaminated water further reduces the risk of Campylobacter infection and, consequently, GBS.

Treatment and Recovery from GBS

GBS is a serious condition, but early medical intervention can improve outcomes. Treatment focuses on reducing immune system attacks and supporting nerve recovery.

1. Plasma Exchange (Plasmapheresis)

• This procedure removes harmful antibodies from the blood, reducing nerve damage.

2. Intravenous Immunoglobulin (IVIG) Therapy

• IVIG provides healthy antibodies that help neutralize the immune attack.

3. Physical Therapy and Rehabilitation

• Physical therapy helps restore muscle strength and nerve function.
• Some patients may need assistive devices like wheelchairs during recovery.

Recovery Outlook:

The recovery process for Guillain-Barré Syndrome (GBS) varies from person to person, but most patients begin to recover within weeks or months after the onset of symptoms. Fortunately, 85% of individuals recover fully or experience only minor nerve damage, allowing them to regain normal function over time. However, in severe cases, some patients may suffer from permanent nerve damage, leading to long-term weakness or mobility issues. In the most critical situations, GBS can affect the muscles that control breathing, requiring ventilator support during the acute phase of the illness. While recovery can be slow, early medical intervention and rehabilitation therapies greatly improve the chances of a positive outcome.

Guillain-Barré Syndrome (GBS) is a rare but serious autoimmune disorder that can develop after bacterial infections, particularly from Campylobacter jejuni. Since Campylobacter is commonly found in raw or undercooked chicken, proper food handling and hygiene are essential to prevent infection.While not everyone who contracts Campylobacter will develop GBS, the risk is significant, especially among older adults and young adults. Understanding the link between chicken consumption and GBS can help reduce the risk of this debilitating condition.