2023-07-13 12:53:07
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Peru is facing an outbreak of Guillain-Barré syndrome (GBS) and the Peruvian government declared a state of national health emergency last weekend due to the “unusual increase” in cases of this disease.
GBS is a rare nervous system disorder in which a person’s own immune system damages neurons, causing muscle weakness and sometimes paralysis.
Most people make a full recovery from GBS, but some have long-term nervous system damage. In very rare cases, GBS can cause death.
According to the latest official balance, Peru has registered 180 cases and four deaths between January and July.
The Peruvian Minister of Health, César Vásquez, declared that “there has been a significant increase in recent weeks that forces us to take actions as a State to protect the health and life of the population.”
The decree contemplates a special action plan to ensure the supply of what is necessary to deal with the disease and education and awareness campaigns for health professionals and the population in general.
Most of the cases so far are concentrated in the regions of Lima, La Libertad, Lambayeque and Cajamarca.
The government has not ruled so far on what has been the trigger for the epidemic outbreak.
What might have triggered the syndrome?
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Caption,
Guillain-Barré disease affects the peripheral nervous system
It is not the first time that Peru has faced a significant outbreak of this disease. Already in 2019, the Ministry of Health had to declare a health emergency due to an outbreak.
Back then, the outbreak was characterized by rapid spread from its first detection.
This time the disease coincides with a dengue epidemic that has been affecting mainly northern Peru for months, which is why some experts have hypothesized that there is a causal relationship between dengue and GBS.
According to official figures, this disease transmitted by the Aedes aegypti mosquito has caused 248 deaths in the first half of 2023 alone. There are already more than 146,000 cases and the health crisis cost the then Minister of Cheers, Rosa Gutierrez.
Infectologist Raquel Stucchi, from the State University of Campinas, in Brazil, told BBC Brazil that “dengue might be an explanation, but a broader analysis is needed to make sure that other agents are not behind this situation.” .
The infectologist Ciro Maguiña, from the Peruvian Medical College, told BBC Mundo that “there is no scientific evidence of a causal relationship between dengue and GBS in the current outbreak in Peru.”
In reality, the expert points out, “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 might have caused it came into action.
Decades ago, different germs were identified as the cause of this syndrome.
In the 2019 outbreak, tests carried out by the Peruvian National Institute of Health, in collaboration with the United States Center for Disease Control and the Pan American Health Organization, detected the presence of the “Campylobacter Jejuni” bacterium in samples of twelve patients. In the current outbreak it has been found 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. Maguiña, their presence occurs in “contexts of poverty, overcrowding, and poor hygienic conditions, which is common in northern Peru, where the most affected regions were concentrated in 2019 and where they are now.” .
In fact, the departments most affected then are those that show the worst socioeconomic reality and those that have suffered the most from the dengue epidemic and the current GBS outbreak.
For the infectologist, Ciro Maguiña, the repetition of the pattern “reveals the painful situation of poverty and the precariousness of health in our country.”
“This new GBS outbreak reveals that we have major health problems that have not been resolved for decades.”
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What is Guillain-Barré syndrome?
Guillain-Barré syndrome is a rare neurological disease in which the 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 an individual’s body, in this case the peripheral nervous system, responsible for communication between the brain and the different regions and structures of our body.
What causes Guillain-Barré syndrome?
The syndrome is generally triggered by a previous infectious process.
A number of viruses and bacteria have been identified as triggers, including the pathogens that cause Zika, dengue, chikungunya, HIV, hepatitis A, B and C, and covid-19.
However, the health authorities point out that, although many viruses and bacteria have been temporarily associated with the development of Guillain-Barré syndrome, it is difficult to prove the true causality of the disease.
The data shows that the disease is more common in the age group of 20 to 40 years.
image copyrightGetty Images
Caption,
The mosquito that transmits dengue reproduces in water and the proliferation of this virus may be one of the keys.
Experts point out that early detection is crucial for patient recovery.
The main diagnostic methods include clinical tests, nerve conduction studies, and cerebrospinal fluid analysis. Treatment may involve supportive therapy, intravenous immunoglobulin, or plasmapheresis.
Being treated in time prevents the disease from progressing and affecting vital muscles for survival, such as the diaphragm, which plays a key role in breathing. The few GBS patients who die usually do so when breathing difficulties develop.
The first symptoms are usually weakness and tingling in the hands and feet.
These sensations can spread rapidly and, over time, paralyze the entire body.
Most people who suffer from it require hospitalization. Although most sufferers make a recovery, the most severe cases can be fatal.
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