What is the Guillain-Barré Syndrome?

India's western city of Pune is battling rising cases of the Guillain-Barré Syndrome (GBS), with at least 111 identified cases just in the last three weeks, local media outlets reported on Tuesday (January 28).

A 41-year-old man was identified as the first casualty from the outbreak on Monday, a day after the man died from the rare but treatable infection.

The disorder, which affects the body's nervous system, is characterized by muscle weakness and breathing difficulties, and can even lead to total paralysis in extreme situations. 

Experts suspect the cases may be caused by contaminated water. The local government bodies are conducting sample tests and surveys, local media reported.

What is Guillain-Barré Syndrome?

Guillain-Barré Syndrome is a rare neurological disorder where the body's immune system — which normally protects it from infections and other foreign bodies — mistakenly attacks its own peripheral nerve cells. 

More specifically, the myelin sheath — an insulating layer of fat and protein that surrounds the nerve cells — becomes inflamed. 

The myelin sheath enables signals to pass through the nerve tracts at breakneck speed under normal conditions. If the sheath is inflamed, the nerves can hardly transport stimuli.

Simply put, a person with this syndrome will have difficulty speaking, walking, swallowing, excreting, or performing other normal functions of the body. The condition can get progressively worse.

Thus the peripheral nerves — the nerves that branch out from the brain and the spinal cord — get damaged as a result, and the muscles can become weak or paralyzed.

The first symptoms include a tingling sensation in the body's extremities, weakness in the legs that spreads to the upper body, difficulty in facial movements, unsteady walking or inability to walk, pain, and, in severe cases, paralysis.

What causes Guillain-Barré Syndrome?

The exact reasons for Guillain-Barré Syndrome are not yet understood. However, it often develops shortly after a person gets an infectious disease. Rarely, vaccinations can cause it. Guillain-Barré Syndrome, or GBS, also was linked to the cytomegalovirus, Epstein Barr virus, Zika virus, and even the COVID-19 pandemic.

Why does this happen? Scientists say that our immune system is highly specialized to recognize foreign substances such as viruses, bacteria, and fungi. It produces proteins called antibodies that bind to the surface structures of pathogens while building up an immune response against them. 

In an autoimmune disease like Guillain-Barré Syndrome, the invaders camouflage themselves with a surface that mimics the body's own structures. "For example, the surface structures of the bacterium Campylobacter look very similar to the myelin sheath," explained immunologist Julian Zimmermann.

So the antibodies also target the body's own cells and structures as foreign bodies and attach themselves to the surface. This results in a cascade of reactions. The exact nature of these interactions in autoimmune diseases is not yet known.

Occasionally vaccinations can also cause GBS. This is because vaccines tend to have similar weak or inactive structures akin to the pathogens they protect against. The body's immune system then triggers an immune response. 

Is Guillain-Barré Syndrome curable?

The patient's condition tends to worsen for up to two weeks after the onset of the disease. At week four, the symptoms plateau, after which recovery begins. The recovery can extend from anywhere between six to 12 months and occasionally up to three years.

Currently, there is no certain cure for Guillain-Barré Syndrome. The paralysis not only affects the legs and arms, but also important parts of the nervous system that regulate breathing, blood pressure, and heartbeat.

To prevent this, doctors continuously monitor the patient's vital signs and, in case of an emergency, put them on a ventilator.

Two treatments can help recovery and reduce the severity of the disease.

The first is plasma exchange or plasmapheresis. The plasma or the liquid part of the blood is removed and separated from the blood cells, inducing new plasma production to make up for the loss. This treatment is aimed at removing the antibodies that are attacking the peripheral nerves.

The second available therapy is called immunoglobin therapy, where healthy antibodies from blood donors are injected intravenously. The damaged antibodies contributing to GBS are then blocked by the high doses of the immunoglobulins. Apart from this, physical therapy might also be useful in alleviating pain.

Celebrities who have suffered from GBS

Markus Babbel, a former international football player from Germany, lost almost an entire year of his career after contracting GBS. Babbel's case of GBS followed an infection with the Epstein-Barr Virus.

Some neurologists and historians believe that Franklin D. Roosevelt, the 32nd President of the United States, contracted GBS in 1921. And Vicente Fernández Gómez, a Mexican cultural icon who recorded more than 100 albums, also had GBS.

This article was updated on January 28, 2025, to include information about an outbreak of GBS in India.

Edited by: Sushmitha Ramakrishnan