Doctors are worried about rising cases of GBS
Several doctors have tweeted on X, formerly Twitter, about rising cases of GBS. They say a surge in GBS cases recently is common during this season. Several people have said that their doctors have explained to them that GBS might be due to COVID or vaccination. GBS or Guillain-Barré syndrome is a rare neurological disorder in which the body's immune system attacks parts of the peripheral nervous system. Usually, bacterial or viral infection triggers this disease.
"It is usually seen with the incidence of one to two cases per lakh per year"
"GBS is basically an immune-mediated neuropathy, it is usually seen with the incidence of one to two per lakh per year. Males have a slightly higher predisposition to get it and it usually affects children and young adults and people who are more than 55 years of age," says Dr.Sahil Kohli, Principle Consultant -Neurology, Max Hospital, Gurugram.
"Up to two-thirds of patients have a history of antecedent events"
According to Dr. Puja Kushwah, Sr. Consultant - Neurosciences, Metro Hospitals & Heart Institute, Noida, "When an immune response to an earlier infection or other incident reacts with similar epitopes on peripheral nerves (a process known as molecular mimicry), it causes GBS. Up to two-thirds of patients give a history of such antecedent events." Infections by Campylobacter jejuni infection (most common), Cytomegalovirus, Influenza A and B, HIV, COVID-19 Virus and Zika virus are the reasons behind GBS in many patients. "Varicella-zoster virus, Epstein-Barr virus, herpes simplex virus, hepatitis E, chikungunya virus, Japanese encephalitis virus," are the uncommon pathogens that cause GBS says Dr Kushwah.
What are the signs of GBS?
Dr Kohli explains the symptoms of GBS: The main presentation is usually weakness or pain which starts in the legs. It is more of a distal weakness in the feet which gradually progresses and goes up to the hands; in very severe cases it can involve the respiratory system also and in such cases breathing becomes difficult and patients may go or need ventilatory support.
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It is linked to dengue
"GBS is an autoimmune neuropathy and it is usually seen after infection. It can be an upper respiratory infection in which CMV that is Cytomegalovirus has been implicated in almost up to 18% of the cases. It can be because of a pneumonia-like illness. It can be very commonly seen in the current scenario where we have a lot of dengue cases," says Dr. Kohli. "So, in dengue, it is almost six times more common," he adds.
Is GBS linked to COVID?
"Guillain Barre Syndrome can happen after any viral infection and since COVID-19 is also a viral infection, it can also lead to GBS. During the time when the COVID pandemic was at its peak, there were cases where COVID was coming positive in cases of GBS. So yes, COVID-19 can be associated with the GBS and it is one of the neurological manifestations that we see of COVID-19," Dr. Kohli explains.
Is GBS linked to COVID vaccines?
"GBS has been linked to both COVID-19 infection and COVID vaccines. To elaborate further, rare cases of Guillain-Barre syndrome (GBS) have been reported after COVID-19 infection. Cases of GBS have been observed with the Janssen/Johnson & Johnson and AstraZeneca COVID-19 vaccines in the United States and Europe. Furthermore, observational data has also suggested that the risk of GBS after infection exceeds the risk after vaccination," says Dr. Kushwah.
Other factors that trigger GBS
Apart from COVID, other infections and COVID vaccine, other vaccines like influenza vaccination, meningococcal vaccination and recombinant zoster vaccines and COVID-19 vaccines using an adenovirus vector also trigger GBS. "A tiny proportion of people get GBS following additional triggering experiences such surgery, trauma, or bone marrow transplantation. Additionally, Hodgkin lymphoma, systemic lupus erythematosus, and sarcoidosis have been related to GBS," says Dr Kushwah.
80 to 85% of people can have a very good recovery
On the treatment and recovery, Dr. Kohli explains that almost 80 to 85% of people can have a very good recovery. "There are more cases of GBS which we are seeing. It can be both because people are realizing it more commonly now that it may be a treatable form of neuropathy which can easily get treated with the IVIG or plasmapheresis," he says.
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