Guillain-Barré Syndrome (GBS): Symptoms, Risks & Prevention

Guillain-Barré Syndrome (GBS) is an uncommon (neurological) nerve disorder where the immune system wrongly targets the peripheral nerves, resulting in muscle weakness and, in serious instances, paralysis and death. Recently, Pune in India has seen an increase in GBS cases. A lot of these cases have been linked to infections from the bacterium Campylobacter jejuni. Is this a cause of concern? What we need is awareness. This situation highlights the urgent need for early diagnosis and preventive actions to lessen the effects of this condition.

What is Guillain-Barré Syndrome?

GBS is an immune-mediated neuropathy. In this condition, the immune system mistakenly targets the peripheral nervous system—the network of nerves located outside the brain and spinal cord. This misguided immune response due to molecular mimicry damages the myelin sheath, the protective covering of nerve fibers. This interferes with the nerve signal transmission. The result is muscle weakness that typically starts in the lower limbs and can ascend to affect the upper body and facial muscles. In severe cases, GBS can cause complete paralysis and respiratory failure, necessitating mechanical ventilation. ​​If not managed promptly, it may lead to death^[1].

Causes of Guillain-Barré Syndrome

While the exact cause of GBS remains unknown^[2], it is often preceded by certain infections or medical events that trigger an abnormal immune response:​

• Bacterial Infections: Campylobacter jejuni is the most commonly identified bacterial trigger for GBS. This pathogen is often associated with gastroenteritis and can lead to the development of GBS in a small percentage of infected individuals. ​
• Viral Infections: Viruses such as influenza, Epstein-Barr virus, cytomegalovirus, Zika virus, and dengue virus have also been linked to GBS. Notably, during the Zika virus outbreak, an increase in GBS cases was observed, suggesting a strong association between the two. ​
• Post-Surgery Cases: In rare instances, GBS has been reported after surgical procedures. However, the benefits of surgeries generally outweigh the minimal risk of developing GBS. ​
  

Symptoms of Guillain-Barré Syndrome

GBS symptoms^[2] can range from mild weakness to complete paralysis, and early recognition is essential for prompt medical intervention.

1. Early Symptoms:

• Tingling or numbness in the feet and legs
• Weakness in the legs and moving upward
• Pain, especially in the lower back or legs
• Difficulty in climbing stairs due to weakness in muscles of leg

2. Progressive Symptoms:

• Difficulty walking or moving
• Muscle weakness and loss of reflexes
• Increasing weakness that spreads to the arms and face
• Difficulty breathing and swallowing (in severe cases)
• Rapid heart rate and blood pressure fluctuations
• Loss of bladder or bowel control in rare cases

3. Severe Symptoms:

• Paralysis that can affect the respiratory muscles, requiring ventilatory support
• Loss of the ability to speak or swallow
• Persistent fatigue and long-term weakness even after recovery

These symptoms typically last a few weeks, with most individuals recovering without long-term severe neurological complications. However, in approximately one-third of cases, the chest muscles are affected, making breathing difficult. The ability to speak and swallow may also become impaired in severe cases, necessitating intensive care. ​

Diagnosis of Guillain-Barré Syndrome

Diagnosing GBS involves a combination of clinical evaluation and diagnostic tests:​

• Clinical Evaluation: Assessment of muscle weakness, reflexes, and sensory function.​
• Nerve Conduction Studies: To evaluate the speed and strength of electrical signals in the nerves.​
• Lumbar Puncture: To analyse cerebrospinal fluid for elevated protein levels, which are indicative of GBS.​

Early recognition and diagnosis are crucial for initiating appropriate treatment and improving outcomes. ​One should not wait for the symptoms to worsen because the progression of symptoms is very fast. Consult a neurologist or nearest hospital at the earliest if you develop any of the signs mentioned above. 

Treatment Options for GBS

Immediate hospitalisation is essential for individuals diagnosed with GBS to monitor and manage potential complications:​

• Supportive Care: Including respiratory support if breathing is compromised. Monitoring of vitals – breathing, heart rate, BP and oxygen saturation is important. All GBS patients should be monitored for complications, which can include abnormal heartbeat, infections, blood clots, and a rise or drop in blood pressure.
• Plasma Exchange (Plasmapheresis): A procedure that removes harmful antibodies from the bloodstream.​
• Intravenous Immunoglobulin (IVIG): Administration of immunoglobulins to neutralise harmful antibodies.​
• Physical Therapy: To aid in recovery and rehabilitation of muscle strength and function.​
  

Most individuals recover fully from even the most severe cases of GBS, although some may continue to experience weakness. In rare instances, complications such as paralysis of the muscles that control breathing can be life-threatening. ​

Recent Surge in GBS Cases in Pune: The Campylobacter Connection

In early 2025, Pune experienced a notable increase in GBS cases, with reports indicating over 300 cases linked to Campylobacter jejuni infections. This is not just limited to Pune; other cities of Maharashra like Mumbai and nearby areas also reported GBS cases. Andhra Pradesh, Tamil Nadu and a few other states also detected GBS cases after Pune. This surge has raised concerns among health authorities about a potential outbreak of C. jejuni infections, which usually presents as a stomach infection causing diarrhoea, vomiting and abdominal cramps. Investigations suggest that contaminated food and water sources, particularly undercooked poultry, may be the primary vectors for this bacterium. ​

How to Prevent Campylobacter Infection

Preventing Campylobacter infection^[3] is pivotal in reducing the risk of developing GBS. Key preventive measures include:

1. Safe Food Handling:

• Ensure poultry and other meats are cooked to the appropriate internal temperatures to kill harmful bacteria.​ Avoid eating meat for some time (if possible).
• Prevent cross-contamination by using separate cutting boards and utensils for raw and cooked foods.​
• Use pasteurized milk. Avoid consuming unpasteurized milk.

2. Safe Drinking Water:

• Avoid consuming unfiltered water from unknown sources. Make sure the water is safe for drinking. 
• Be cautious with beverages and ice from outside sources, especially in areas with known contamination issues.​

3. Hygiene Practices:

• Wash hands thoroughly with soap and water after handling raw meat or coming into contact with animals.
• Wash fruits and vegetables thoroughly before cutting and consuming.
• As a best practice, carry your own safe drinking water and home-cooked food. Avoid eating raw and undercooked food from outside sources.

Conclusion

Here’s a 60-second short video summarizing the essential information on GBS

The recent surge in GBS cases in Pune and other states of India shows the need for increased awareness and early detection. Since Campylobacter jejuni infection is a leading trigger of GBS, you need to follow safe food handling and proper hygiene and ensure clean drinking water, as these are critical in reducing risks. Choosing home-cooked meals and avoiding contaminated food sources can play a key role in prevention. Early medical intervention remains crucial for improving patient outcomes and minimising long-term complications.

Frequently Asked Questions (FAQs)

References

1. Laman JD, Huizinga R, Boons GJ, Jacobs BC. Guillain-Barré syndrome: expanding the concept of molecular mimicry. Trends Immunol. 2022 Apr;43(4):296-308. doi: 10.1016/j.it.2022.02.003. Epub 2022 Mar 4. PMID: 35256276; PMCID: PMC9016725. [Accessed 10 Mar 2025]. https://pmc.ncbi.nlm.nih.gov/articles/PMC9016725/
2. World Health Organization. Guillain-Barré syndrome [Internet]. Geneva: World Health Organization; 2023 [cited 2025 Mar 10]. https://www.who.int/news-room/fact-sheets/detail/guillain-barr%C3%A9-syndrome
3. Centers for Disease Control and Prevention. Campylobacter: prevention and control [Internet]. Atlanta: CDC; 2024 [cited 2025 Mar 10]. https://www.cdc.gov/campylobacter/prevention/index.html

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.