Peru is experiencing a rise in GBS cases that might be due to intestinal bacteria.
GBS is a rare neurological disorder that can lead to paralysis.
Asking patients about recent travel and being vigilant about checking for symptoms of diarrhea, infections, and neurological problems may help with early diagnosis.
Peru has been experiencing an unusually high uptick in Guillain-Barré syndrome (GBS) cases this summer. This is Peru's second alarming GBS outbreak since 2019, during which the country reported about 900 cases. At about 130 cases and four deaths between June and July—231 cases so far this year—the current outbreak has not reached 2019 numbers but has nonetheless surpassed the country’s fewer than 20 suspected cases per month.
GBS is a rare neurological disorder that can cause the immune system to attack the nerves, causing muscle weakness and sometimes paralysis, according to the Centers for Disease Control and Prevention (CDC). It impacts one to two per 100,000 people worldwide yearly and can be caused or influenced by several viral and bacterial pathogens, including COVID-19. While people can fully recover from GBS, they can also experience permanent side effects. In some cases, GBS can lead to death.
What caused Peru’s GBS outbreak?
The culprit behind Peru’s GBS spread is unknown, but one suspect may be the Campylobacter jejuni (C. jejuni) bacteria, which was responsible for Peru’s 2019 GBS outbreak. People can contract C. jejuni through food poisoning, which can hurt the intestines and cause diarrhea.
While GBS is not contagious, C. jejuni is. Thus, those at risk for contracting the pathogen could be at risk of contracting GBS.
With the current outbreak at the top of mind, Dr. Santosh Kesari, MD, PhD, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA, says that now is a good time for doctors to be vigilant about asking patients about recent travel plans, especially those experiencing diarrhea. It is important to evaluate patients not only for intestinal symptoms but also “unusual neurological symptoms” and “recent infections of any sort,” says Dr. Kesari.
Neurological symptoms can be subtle and include, for example, double vision or weakness in one appendage or area of the body, he adds. Referring a patient to a neurologist can be helpful in accurately assessing these symptoms.
Will Peru’s GBS outbreak spread to the US?
Despite the high numbers in Peru, the GBS outbreak does not appear to have spread to other countries. Dr. Kesari says this is good news and that the outbreak should be containable with the right health and safety measures.
“Diarrheal infections are usually pretty well controlled with containment, avoiding people who are sick, keeping separate, things like that,” says Dr. Kesari. “It's unlikely that it would spread here if Peru’s government follows standard precautions—and it sounds like it will.”
The Pan American Health Organization (PAHO) issued an epidemiological alert in Peru due to the outbreak. This could increase public health support in stopping the spread. The World Health Organization (WHO) also released an alert due to the situation.
“If the measures taken so far limit exposure to new people, then it should die down pretty quickly,” Dr. Kesari says. However, if numbers continue to rise in the next week or two, he adds that this would indicate a larger problem.
What this means for you
As Peru works to contain a GBS outbreak that may have been caused by an intestinal bacteria, it is important to be extra cautious when assessing patients for diarrhea—particularly those who have recently traveled to Peru.