What is Guillain-Barré syndrome, whose cases are increasing in Peru?

For several weeks, the Peruvian health authorities have observed an upsurge in Guillain-Barré syndrome. A state of health emergency has been declared for three months.

Faced with the “unusual” multiplication of cases of Guillain-Barré syndrome in Peru, the authorities declared a state of health emergency for three months on Sunday July 9. The latest report from the Peruvian Ministry of Health reports four deaths and more than 180 cases declared since January. The 33 million inhabitants of this South American state are now under lockdown for 90 days.

A rare condition that affects the nervous system

Guillain-Barré syndrome (GBS), also called acute polyradiculoneuritis, is rare. According to the WHO, the syndrome is a condition in which the patient’s immune system attacks part of the peripheral nervous system of the human body. It can reach, for example, the nerves that control the muscles, but also those that transmit the sensations of pain, heat or touch. This is called an autoimmune disease.

GBS can affect anyone. Although it can affect people of any age, it is more common in adulthood and in male subjects, explains the WHO. GBS is estimated to affect approximately one in 100,000 people each year. It is neither contagious nor hereditary.

Symptoms ranging from tingling to near total paralysis

The most common symptom is muscle weakness or a tingling sensation in the legs, which can spread to the arms and face. Each year, in France, 1,700 people are hospitalized for this syndrome.

While most patients recover after a few weeks or months, there are more serious forms. In some cases, the syndrome can cause paralysis of the limbs, or even damage to the chest muscles. The WHO estimates that in 3 to 5% of cases, patients die from complications of the disease, such as paralysis of the muscles of respiration, sepsis, pulmonary embolism or cardiac arrest.

There is no cure for Guillain-Barré syndrome, but available therapies can relieve symptoms and shorten the duration of the illness.

A most often infectious origin

The exact cause of GBS is not precisely known. Researchers don’t know why it affects some people and not others. According to the WHO, GBS is often triggered by an infection, bacterial or viral, and in much rarer cases it can be triggered after surgery or vaccination.

Recently, a team of French researchers made a link between the appearance of the syndrome and an infection with the Zika virus, mainly transmitted by mosquitoes. They relied on data from the Zika virus epidemic in French Polynesia between 2013 and 2014 and the resurgence of the syndrome during this same period. According to the study, the risk of developing GBS was estimated at 2.4 per 10,000 Zika virus infections.

The multiplication of cases of Guillain-Barré syndrome in Peru comes as the country faces a violent epidemic of dengue fever. The case rate in the country is the second in the world, after Brazil, up 365% compared to the average of the last five years according to the Pan American Health Organization (PAHO).

A “very rare” side effect of certain vaccines

In July 2021, the European Medicines Agency (EMA) listed Guillain-Barré syndrome as a side effect “very rare” of the vaccine produced by Johnson & Johnson. According to the EMA, 108 cases of the neurological syndrome have been reported worldwide as of June 30, 2021, when more than 21 million people had been vaccinated. “The EMA confirms that the benefits of the Covid-19 Janssen vaccine continue to outweigh the risks of the vaccine”, however, underlined the agency located in Amsterdam (Netherlands). Since this report, a warning is included in the product information to educate healthcare professionals and people receiving the vaccine. EMA is also investigating a possible link between GBS and AstraZeneca’s vaccine, after listing the syndrome as a side effect “very rare”in September 2021.

Many Internet users denounce a supposed link between vaccination against Covid-19 and cases of Guillain-Barré syndrome in Peru. In this country, however, the vaccination campaign relied more than 80% on vaccines from Pfizer-BioNTech and Sinopharm. AstraZeneca accounted for 13.2% of vaccinations. And the Johnson & Johnson vaccine was not used.

Others point to a supposed link between GBS and flu vaccination. On this point, the Center for Diseases Control (CDC) explains, with supporting studies, that it is more likely that a person will contract GBS after catching the flu than after vaccination. The CDC warns that the flu can be deadly. And that the best way to prevent influenza infection and its complications is to get vaccinated against influenza.


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