Guillain-Barré syndrome in Peru: what is known about the origin of the outbreak that declared a public health emergency

Peruvian Health Minister Cesar Vazquez said that “there has been a significant increase in recent weeks, which forces us as a state to take measures to protect the health and life of the population.”

The decree provides for a specific action plan to ensure the supply of what is needed to fight the disease, as well as to conduct educational and information campaigns for medical workers and the general population.

Most cases are still concentrated in the regions Lima, La Libertad, Lambaeque and Cajamarca.

The government has yet to rule on what triggered the outbreak.

This is not the first time that Peru has faced a significant outbreak of the disease. As early as 2019, the Ministry of Health had to declare a public health emergency due to the outbreak.

Then flash it has been characterized by rapid spread since its first discovery.

This time, the disease coincides with an epidemic of dengue fever, which for several months affected mainly the north of Peru, so some experts raised hypothesis that there is a causal relationship between dengue fever and GBS.

The disease, transmitted by the Aedes aegypti mosquito, was responsible for 248 deaths in the first half of 2023 alone, with the number of cases already exceeding 146,000, according to official figures, and the health crisis cost then Health Minister Rosa Gutiérrez.

Raquel Stucchi, an infectologist at the State University of Campinas in Brazil, told the BBC that “dengue could be the explanation, but a broader analysis is needed to make sure no other agents are behind this situation.”

Ciro Maginha, an infectologist at the Peruvian Medical College, told BBC Mundo that “There is no scientific evidence causal relationship between dengue fever and GBS in the current outbreak in Peru”.

In fact, the expert notes, “it is difficult to determine the exact cause, because GBS is a neurological complication that takes time to develop,” so time has passed since the infectious elements that could have caused it came into play.

Decades ago, various microbes were identified as the cause of this syndrome.

During the 2019 outbreak, tests conducted by the Peruvian National Institute of Health in collaboration with the U.S. Centers for Disease Control and the Pan American Health Organization found the presence of the bacterium Campylobacter Jejuni in samples from twelve patients. In the current outbreak, it has been detected in eleven cases, making it the most suspected pathogen.

This bacterium usually causes diarrhea and other frequent and minor intestinal problems, but it can also lead to complications such as GBS.

In any case, says Dr. Maginha, their presence is in “the contexts of poverty, overcrowding and poor hygienewhich is typical for northern Peru, where the most affected regions were concentrated in 2019 and where they are now.”

In fact, the departments most affected are those showing the worst socioeconomic reality and those most affected by the dengue epidemic and the current GBS outbreak.

For the infectious disease specialist Ciro Maginha, the repetition of the picture “reveals the painful situation of poverty and health insecurity in our country.”

“This new outbreak of GBS shows that we have serious health problems that have not been addressed for decades.”

Guillain-Barré syndrome is a rare neurological disorder in whichThe immune system attacks the peripheral nerves.

It is classified as an autoimmune disease in which the immune system itself begins to attack certain parts of the human body, in this case the peripheral nervous system responsible for the connection between the brain and various areas and structures of our body.

The syndrome is usually provoked by a previous infectious process.

A number of viruses and bacteria have been identified as triggers, including pathogens that cause Zika virus, dengue fever, chikungunya, HIV, hepatitis A, B and C, and covid-19.

However, health authorities note that although many viruses and bacteria are temporarily associated with the development of Guillain-Barré syndrome, it is difficult to prove the true cause of the disease.

The data show that the disease is more common in the 20 to 40 age group.

Experts point out that early detection is critical to the patient’s recovery.

The main diagnostic methods include clinical tests, nerve conduction studies, and cerebrospinal fluid analysis. Treatment may include supportive care, intravenous immunoglobulin, or plasmapheresis.

Timely treatment prevents the progression of the disease and damage to vital muscles such as the diaphragm, which plays a key role in breathing. The few patients with GBS who die usually die with difficulty breathing.

The first symptoms are usually weakness and tingling in the arms and legs.

These sensations can spread rapidly and eventually paralyze the entire body.

Most people who suffer from it require hospitalization. Although most patients recover, the most severe cases can be fatal.

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