India faces a firing of creeping paralysis

Last month, a school teacher in the western Indian city of Pune found her six -year -old son upset by the domestic.

“I had deleted some words and asked him to write them. I assumed he was angry, so he didn’t hold a pencil correctly,” she told The Indian Express.

She never imagined his struggle to hold a pencil was the first sign of Guilen-Barre Syndrome (GBS)A rare disorder in which the immune system attacks nerve cells, causing muscle weakness and paralysis.

Within days the boy was in intensive treatment, unable to move his hands or feet. As his condition worsened, he lost the ability to swallow, talk and eventually breathe, requiring fan maintenance. He is recovering now.

The boy has been among about 160 reports of GBS since the beginning of January in Pune, education, and excited by industrial cities and villages. There are five suspects. Currently, 48 patients are in intensive care, 21 per fan, and 38 are discharged, according to official data.

GBS begins with numbness or tingling in the legs and arms, followed by muscle weakness and difficulty in moving joints. Symptoms worsen more than two to four weeks, usually starting in the arms and feet. Reported mortality It varies between three and 13%, depending on the severity and quality of health support.

The outbreak in Pune is traced to a pathogen called Campylobacter JejuniThe leading cause of food carried infections and the largest GBS engine worldwide. The relationship between the two was discovered in the 90s in rural China, where pathogen is common in chickens, and GBS outbreaks occur every monsoon, as children played in water contaminated by chicken or duck.

GBS is not quite rare in India. Monojit Debnath and Madhu Nagappa, by the National Institute for Mental Health and Neuronuts, based in Bangalore, have studied 150 patients with GBS for a period of five years between 2014 and 2019.

Their findings show that 79% of patients had data on previous infections, with a third test positive for Campylobacter. In particular, joint infections were more common, occurring in 65%, suggesting a complex interaction of bacteria and viruses.

Most recently, pathogen -related foci are reported from all over the world. During the first seven months of 2023, Peru reported Over 200 suspects and at least four GBS deathsprompting the government to declare a national emergency of health and to strengthen public health measures. Two -thirds of the cases were related to Campylobacter.

In countries with good hygiene, less GBS cases are associated with Campylobacter, with respiratory infections being a major contribution, experts say. There are other triggers. In 2015, Brazil reported a clump of GBS cases associated with the Zika virus. It is reported, Several hundred cases of GBS in the UK In 2021

“Campylobacter is endemic with hundreds of thousands of cases that take place all the time. It always exists in the environment,” I told me Hugh Willison, a professor of neurology at the University of Glasgow.

Still, it’s not easy to develop GBS, scientists say.

There is a specific strain of Campylobacter, which has an outer layer covered with sugar, and in rare cases its molecular structure corresponds to the coating of the cells of the human nerve.

When the patient’s immune system attacks the bacteria, it can also be directed to the nerves – a process called molecular mimicry – leading to GBS. However, a small part of the strains of Campylobacter have this nervous layer.

“In Pune, a Campylobacter strain is circulated with this molecular characteristic, and the infection jump with this strain subsequently leads to a larger number of GBS cases,” says Prof. Willison.

Most experts believe that about one in 100 strains Campylobacter carries the risk of GBS, and one in 100 people infected with such a strain develop GBS, which makes the overall risk approximately one in 10,000.

This creates what Professor Willison describes as an “immunological Russian roulette”, which triggered “acute neurological tsunami” that develops through the peripheral nervous system. After the immune response disappears, the attack decreases – but the body still needs time, medical attention and support to repair the damage.

What worsens things is that there is no treatment for GBS.

In GBS, the body produces antibodies against Campylobacter, which then attack the nerves. Doctors use “plasma exchange”, a process that filters blood to remove harmful antibodies, along with intravenous immunoglobulin (IVIG), a therapeutic antibody derived from normal blood to reduce the severity of the disease.

The other challenge is that there is no test to diagnose GBS. The diagnosis, doctors say, is mainly based on clinical characteristics. It is presented as a form of paralysis, which can also be caused by polio, viruses or rare neurological disease.

“The diagnosis is a constellation of clinical characteristics. The wrong diagnosis or no diagnosis or late diagnosis can easily happen,” says Prof. Willison.

The uneven system of public health in India is a challenge as rural doctors can fight to diagnose GBS. One of the reasons, probably why World Health Organization teams (WHO) are in Punecollaborates with federal and state health workers to track, test and monitoring cases and analyze trends to support effective treatment.

Authorities say they have examined more than 60,000 houses, have taken 160 tests of tests and asked people to drink boiled water and eat fresh and clean food and have no “stagnant food and partially cooked chicken or mutton.”

While most GBS cases worldwide come from poultry, it can also spread through water, similar to cholera or salmonella, experts say.

The contaminated water used to wash or prepare street food facilitates the spread of bacteria. It is clear that Pune spreads a strain of Campylobacter with a distinctive molecular characteristic, affecting a large number of people.

What is not clear is whether this is due to the large -scale pollution of the water supply or many people who consume infected poultry. “We turn to people not to panic,” says a healthcare consultant. But it is easier for uncertainty to say than to do.