2023-07-12 08:51:53
A state of emergency has been declared in Peru for 90 days by the government in the face of an increase in the number of cases of Guillain-Barré syndrome. But how to explain this outbreak?
Dr. Charlotte Tourmente
Written on 07/12/2023, updated on 07/12/2023
Guillain-Barré syndrome can cause paralysis of the respiratory muscles. —Shuttertsock
“The Guillain-Barré syndrome appears every year and there has been a significant increase in recent weeks that requires us to take action as a state to protect the health and life of the population“, declared the Minister of Health, César Vásquez on the site of the National Center for Epidemiology, Prevention and Control of Diseases of Peru.
In effect, 182 cases of Guillain-Barré have been declared, including four deaths, since the beginning of 2023. This is a higher increase than that observed in previous years, and more marked in certain regions.
Guillain-Barré syndrome, a progressive paralysis
Guillain-Barré syndrome is an autoimmune disease, characterized by the reversal of the immune system once morest the body. It causes tingling and muscle weakness first affecting the legs, then rising to the upper body. The main risk is the attack of the respiratory muscles: in 5 to 10% of the cases, it requires the help of a respirator.
The paralysis usually subsides following three to four weeks. But 5% of those affected die and 10% retain motor sequelae.
How does Peru hope to stem this outbreak?
In response to the observed increase, the Center for Epidemiology, Prevention and Disease Control of Peru, “intensify the epidemiological surveillance of the syndrome, its prevention and response in public and private health establishments“.
Guillain-Barré syndrome requires rapid treatment in order to limit the sequelae. An intravenous immunoglobulin drug may be given.
If this fails, plasmapheresis can be performed. It consists of replacing the patient’s plasma (the “liquid part” of the blood) with healthy plasma.
Dengue fever in Peru?
Two-thirds of patients suffer from Guillain-Barré within three to five days of a mild infection (such as mononucleosis, the herpes virus or more rarely Covid-19).
“Guillain-barré syndrome is a disease that has many triggers.
The link is scientifically established between arboviruses, transmitted by certain mosquitoes, such as Zika, dengue, chikungunya” recalls Dr. Benjamin Davido, infectious disease specialist.
However, Peru, like other Latin American countries, is bearing the brunt of a dengue fever outbreak for many months.
“There are precedents, continues the infectiologist. First, in 2016, Professor Fontanel published a study on the cases of Guillain-Barré during the Zika epidemic, which affected two-thirds of the population in 2013 and 2014, in French Polynesia. The risk was multiplied by 20.
Another example in Baïa in 2015 and 2016, an increase in Guillain-Barré was observed in connection with three diseases belonging to the family of arboviruses (zika, dengue fever, chikungunya).
Can vaccination also be involved?
More rarely, surgery or vaccination may be responsible for this syndrome. In the latter case, the risk remains inferior to that observed during an infection and the occurrence of this serious adverse effect is considered to be very rare.
During the vaccination campaign once morest Covid-19, theWorld Health Organization communicated in 2022 on certain associated risks. Guillain-Barré syndrome was one of them, along with the AstraZeneca, Janssen, Gamaleya and CanSino Biologics vaccines, with a frequency of the order of one person in 100,000. As during an infection, the vaccine leads to a stimulation of the immune system, which would participate in the appearance of the syndrome.
Nevertheless, some posts highlight that the development phase of the paralysis is much shorter and regresses more quickly. In other words, the current outbreak of Guillain-Barré in Peru occurs too long following the anti-Covid vaccination campaigns for us to be able to make a link between these two events.
Should we fear such an outbreak in France?
In France, regarding 1,700 people are affected each year by Guillain-Barré syndrome, all causes combined.
Until recently, “Dengue and Zika were considered diseases of developing countries” notice Dr Davido. “But with climate change, European countries will find themselves with an increase in these emerging infectious diseases and potentially Guillain-Barré, he also warns.
Figures on dengue fever cases in mainland France are already beginning to illustrate this finding: 378 imported cases and 66 indigenous cases (not having traveled to risk areas) in 2022. While only 48 indigenous cases had been observed during the decade previous year, between 2010 and 2021, according to a new report by Public health France.
The health authority is also concerned regarding the viability of the current surveillance system, the tiger mosquito continuing to spread on French territory.
The tiger mosquito invades France! — The Mag of Health – France 5
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