Pune GBS outbreak: Quick muscle failure raises alarm; doctors explain why 'each case is different'

GBS in Pune

The outbreak of Guillain-Barré Syndrome (GBS) in Pune and the ninth death due to the disease in the city have surprised the doctors.

An unusually rapid disease progression is being reported in some patients. The latest casualty, a 34-year-old Wagholi resident, succumbed to the illness on February 15.

According to the doctors at Sassoon General Hospital and YCM Hospital, while GBS is not new, the speed at which paralysis spread in recent cases was alarming. The Wagholi patient first experienced loose motions from January 23 to 25, followed by tingling sensations and loss of power in his lower limbs by February 2. Within six hours, the symptoms spread to his upper limbs — a rare and aggressive progression. Despite intensive medical intervention, he showed no signs of recovery.

GBS symptoms typically progress over days, according to the neurologists, but in recent cases, paralysis has advanced within hours. It affects not only the limbs but also respiratory and facial muscles.

"Usually, it takes 8-10 days for the symptoms to move from the lower limbs to the upper limbs and respiratory muscles. But recently, we’ve seen this happening in just 1-2 days," said Dr. Niranjan Pathak from YCM Hospital.

According to the Times of India, a severe GBS variant known as Acute Motor Axonal Neuropathy (AMAN), has been identified by doctors as a possible explanation for the rapid deterioration in some Pune patients. This form of GBS is known for its faster progression and higher severity.

Pune's GBS outbreak is believed to be linked to a mass Campylobacter infection, a bacterial illness that can precede GBS. In the past, similar outbreaks have followed viral infections such as the Zika virus in other countries. Experts are now investigating whether a specific infection triggered the surge in cases.

Pune, so far, has reported 11 confirmed or suspected GBS deaths. Many patients require ventilator support due to respiratory failure.

"Of the total GBS patients admitted, about 15% may need ventilator care, which is what we're seeing now," said Dr Sameer Jog, senior neurologist at Deenanath Mangeshkar Hospital.

The Pune Municipal Corporation (PMC) is conducting an audit to verify the cause of each GBS-related death. Some deaths have been confirmed as GBS-related; others have been ruled out.

Dr Nina Borade, PMC's chief health officer, said: "Initially, a Nerve Conduction Test (NCT) was used to confirm GBS cases, but now a panel of neurologists, microbiologists, and general physicians is reviewing each case for a definitive diagnosis.".

What is Guillain-Barré Syndrome?

Guillain-Barré Syndrome is a condition in which the body's immune system attacks the nerves. The different forms of GBS are commonly known as Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), Miller Fisher Syndrome (MFS), Acute Motor Axonal Neuropathy (AMAN), and Acute Motor-Sensory Axonal Neuropathy (AMSAN). According to reports, GBS can cause numbness, weakness, or paralysis. The first symptoms include weakness and tingling in the hands and feet.

What is the line of treatment?

Treatments such as intravenous immunoglobulin (IVIG) and plasma exchange have revolutionized outcomes, but timely intervention remains critical. According to doctors, 80% of affected patients regain the ability to walk unaided within six months of hospital discharge, though some may take a year or longer to fully recover limb function.