Guillain-Barre Syndrome Outbreak in India – What You Need to Know

India faces an outbreak of creeping paralysis, last month, a school teacher in the western Indian city of Pune found her six-year-old son upset about homework.

“I had erased some words and asked him to write them. I assumed he was angry and that’s why he was not holding the pencil properly,” she told the Indian Express newspaper.

She never imagined his struggle to hold a pencil was the first sign of Guillain-Barre’ Syndrome (GBS), a rare disorder where the immune system attacks nerve cells, causing muscle weakness and paralysis.

Within days, the boy was in intensive care, unable to move his arms or legs. As his condition worsened, he lost the ability to swallow, speak, and eventually breathe, requiring ventilator support. He is now recovering

The boy is among around 160 reported cases of GBS since early January in Pune. There have been five suspected deaths. Currently, in February 2025, 48 patients are in intensive care, 21 on ventilators, and 38 have been discharged, according to official figures.

The fatality counts due to suspected Guillain-Barre’ Syndrome (GBS) rose to 11 as of February 18, 2025 of these 4 deaths were confirmed as GBS and 7 were reported suspected deaths.

What is Guillain Barre’s Syndrome?

Is a rare neurological disorder in which a person’s immune system mistakenly attacks part of their peripheral nervous system- the network of nerves that carries signals from the brain and spinal cord to the rest of the body. The disorder is life-threatening—potentially interfering with breathing, blood pressure, or heart rate.

The outbreak is being traced to a pathogen called Campylobacter jujuni, a common leading cause of foodborne infections, and the biggest driver of GBS worldwide. The link between the two was discovered in the 1990s in rural China, where the pathogen was common in chickens, and GBS outbreaks occurred every monsoon as children played in water contaminated by chicken or duck droppings.

The exact cause is not known. But two-thirds of people have symptoms of an infection in the six weeks before Guillain-Barre’s symptoms begin. Infections can include respiratory or gastrointestinal infections, including COVID-19.

Guillain-Barre Syndrome may be triggered by:

Most commonly, an infection with campylobacter, a type of bacteria often found in undercooked poultry

• Influenza virus
• Cytomegalovirus
• Epstein-Barr virus
• Hepatitis A, B, C and E
• HIV, the virus that causes AIDS
• Zika virus
• Mycoplasma Pneumonia
• Surgery
• Trauma
• Hodgkin Lymphoma
• Rarely, influenza vaccinations or childhood vaccinations
• COVID-19 virus

In GBS, the brain may receive abnormal sensory signals from the rest of the body due to the nerve damage associated with the condition. This results in unexplained, spontaneous sensations, called paraesthesia, that the person may feel as tingling, a sense of insects crawling under the skin (called formications), and pain. Some people with GBS feel deep muscular pain in the back and/or legs. Unexplained sensations often happen first, such as tingling in the feet or hands, or even pain (especially in children), often starting in the legs or back. Children will also begin to have difficulty walking and may refuse to walk.

• Other symptoms of Guillain-Barre Syndrome may include:
  • Difficulty with eye muscles and vision
  • Difficulty swallowing, speaking, or chewing
  • Pricking or pins and needles in the hands and feet
  • Pain that can be severe, particularly at night
  • Coordination problems and unsteadiness
  • Abnormal heart rate or blood pressure
  • Problems with digestion and/or bladder control

GBS is an autoimmune disease and can affect anyone of any sex or age, but most often affects adults and people older than 50. One of the most common risk factors for GBS is infection with the bacteria Campylobacter jejuni, which causes gastroenteritis (including nausea, vomiting, and diarrhea). Most people with the condition need treatment in a hospital.

For GBS patients, key immune nutrients include vitamin B12, omega-3 fatty acids (found in fatty fish like salmon), vitamin C, Vitamin E, antioxidants from brightly colored fruits and vegetables, and proteins from lean meats, fish, eggs, legumes, and tofu; all of which help support nerve health, reduce inflammation, and boost the immune system, aiding in recovery from Gullian-Barre Syndrome

For individuals recovering from GBS, maintaining a balanced and nutrient-dense diet is essential. GBS often leads to muscle weakness, fatigue, and in severe cases, difficulties in swallowing. Proper nutrition can help combat these symptoms by supporting the immune system and aiding tissue repair.

When to see a doctor?

If you have a slight tingling in your fingers or toes that does not seem to be growing worse or spreading, give your doctor a call. If you experience any of these severe symptoms, get emergency medical attention:

• A tingling sensation that began in your toes or feet and is now spreading throughout your body.
• Weakness or tingling those spreads fast.
• Shortness of breath or difficulty breathing while resting flat.
• Choking on saliva.

Guillain-Barre Syndrome is a serious condition that requires immediate hospitalization because it can worsen quickly. The sooner treatment is started, the better the chance of a complete recovery.

Care can be taken to safeguard immunity in order to prevent the occurrence of the syndrome. The following can be moderated prevent bacterial infection:

• Grains such as oats, rye, and wheat – in people who are gluten sensitive
• Eggs – undercooked or raw
• Foods high in trans fats
• Dairy foods such as cheese, butter, and cream – if not stored well
• High-sugar foods such as cake frosting, chocolate, and corn syrup
• Nightshade vegetables such as eggplants – compounds like solanine and lectins in them could potentially contribute to inflammation in the gut, which may trigger an autoimmune response in susceptible individuals
• Potatoes if not properly washed or cooked may harbour bacteria that could trigger GB syndrome
• High-sodium foods
• Rice (they should be kept refrigerated and consumed promptly to reduce the likelihood of bacterial contamination and foodborne illness)

The foods mentioned above can stimulate an immune response, which may worsen the symptoms of GBS. These foods worsen inflammation or exacerbate symptoms, so it’s essential to make dietary adjustments to aid the healing process.

Precautions taken to avoid the risk of GBS

Uncooked poultry: That contains the bacterium campylobacter jeijuni. One of the most common causes of foodborne illness, has been directly associated with GBS. Research suggests that people infected with campylobacter have a significantly higher likelihood of developing GBS. Ensuring that poultry is properly cooked can reduce the risk.
Unhealthy fats and sugars: Research indicates that obesity and increased waist circumference are linked to a heightened risk of GBS. A diet high in unhealthy fats, and sugars can contribute to obesity and metabolic disorders, which may indirectly increase susceptibility to immune system dysfunction.
Nutritional deficiencies: Severe deficiencies in essential nutrients, such as vitamin B12 and D, have been observed in individuals diagnosed with GBS. A study found that patients who experienced significant weight loss or malnutrition before developing GBS had worsened symptoms. Ensuring a well-balanced diet with adequate vitamin and mineral intake is crucial for nerve health.

Unpasteurised dairy products: Avoid raw milk, soft cheese made from unpasteurised milk (like certain types of paneer or local cheeses). Unpasteurised milk and cheese can contain listeria monocytogenes, a bacterium that may contribute to infections triggering GBS. Consuming only pasteurised dairy products minimises the risk of bacterial contamination.

Highly processed foods: Processed foods loaded with preservatives, trans fats, and artificial addictive can contribute to chronic inflammation, which had been associated with various autoimmune conditions, including GBS. Avoiding snacks, fried foods, and fast food can help maintain a healthy immune response.

Excessive alcohol consumption: alcohol weakens the immune system and can negatively impact nerve function. Studies indicate that chronic alcohol consumption is linked to nerve damage and inflammatory response that may worsen autoimmune disorders like GBS. Reducing alcohol intake can promote nerve health.

Immune- nutrients for GBS patients:

Vitamin B12:

Crucial for nerve health, found in animal products like meat (which is very well cooked and hygienically prepared), fish (well cooked and hygienically prepared), eggs, and dairy.

Omega-3 fatty acids:

Possess anti-inflammatory properties, present in oily fish (salmon, mackerel), flaxseeds and walnuts

Antioxidants:

Found in fruits and vegetables like berries, oranges, spinach and sweet potatoes, help combat oxidative stress and inflammation.

Vitamin C:

Supports immune function and can be obtained from citrus fruits, bell peppers, and broccoli.

Vitamin E:

Another important antioxidant, present in nuts, seeds, and avocados.

Zinc: Found in whole grains, pulses and legumes, nuts and seeds and well cooked meat and poultry, it beautifully supports immune function.

Proteins:

Essential for muscle repair and recovery, sourced from lean protein options like fish (especially oily fish), lean meats like chicken and turkey, legumes (beans, lentils), low-fat dairy products and tofu.

Specific dietary considerations:

Hydration: drink plenty of water to stay hydrated and support bodily functions.

Exercise and physiotherapy: the patient needs to be provided with gentle exercising and physiotherapy in order to enhance movement as well as muscle strength.
Fiber intake: include high-Fiber foods like whole grains and vegetables to promote healthy digestion.
Limit processed foods: avoid highly processed foods, excessive sugars and unhealthy fats, as these can contribute to inflammation.

Foods to potentially include for additional immune support:

High-protein foods: Include sources like chicken, fish, eggs and legumes to support muscle recovery and immune function.
Fruits and vegetables: Rich in vitamins and antioxidants, citrus fruits, berries, spinach, and broccoli can help reduce inflammation.
Healthy fats: Avocados, nuts, and olive oil are sources of essential fatty acids, which protect nerve cells.
Whole grains: Oats, brown rice, and whole wheat are full of energy and Fiber that initiate good digestion and health.
Probiotics: Dahi(curd) and buttermilk improve the health of the gut, which is important development for a healthy response.
Bone broth: May help with inflammation and support gut health.
Fermented foods: like yogurt, kimchi, sauerkraut, which contain probiotics beneficial for gut health and immune function
Green tea: Contains antioxidants that may help regulate the immune response.

Guillain-Barre’ Syndrome is a condition in which the body’s immune system attacks the nerves. Weakness and tingling in the hands and feet are usually the first symptoms. These sensations can quickly spread and may lead to paralysis and problem in breathing. In its most serious form, Guillain-Barre’ Syndrome is a medical emergency. Most people with the condition need treatment in a hospital and may need ventilator support. During this time the diet has to be low on carbohydrates, sugary foods, juices, refined grains, highly processed foods. Fats are to be increased, ensuring omega 3 is in good quantity. Some amount of medium chain triglycerides (MCTs) like coconut oil, ghee, and butter commercially available structured MCTs can be used if the cholesterol levels are not elevated.

• Try to eat your 5 fruits and vegetables a day but remember fruit juice should be limited to 150ml a day to avoid too much sugar.
  Sugar is not needed in the diet, so it should be eaten less often and in smaller amounts. A sweet treat is still allowed though!
• Remember to drink 6-8 glasses of fluid a day. Water, low-fat milks, low sugar/sugar free drinks, along with green tea and coffee all count.
• Starchy, fibrous food should make up over a third of what we eat-high fibre or wholegrain varieties of pasta and bread.
• Add protein to your diet through fish (aim at least two portions of fish a week, one of which being an oily fish such as salmon, sardines or mackerel- you will get a lot of Omega-3 from these which helps reduce inflammation) or lean cuts of meat and mince while cutting down on red processed meat. Don’t eat meat? No problem, think pules such as beans, peas, lentils. They are low in fat and help your fibre goals.
• Another great source of proteins is dairy, or dairy alternatives such as soya. Milk, cheese, yogurt and formage frais provide protein and are a strong of calcium.
• Cook with vegetable, mustard oil, olive, and sunflower oils, these are unsaturated fats and therefore healthier. Though they should still be eaten in small amounts as they are high in energy(calories).
• Have adequate energy – which spells out to eating well, having adequate portions and not missing meals.

We have curated some recipes that will help you boost your immune system:

Click Here to see the recipes!

How is Guillain-Barre’ Syndrome diagnosed and treated?

Diagnosing GBS
Cases of GBS begin differently for different people, and there are several disorders with similar symptoms.
Therefore, it may be difficult to diagnose GBS in its earliest stages. Doctor may perform the following:
History and physical exam: A doctor will perform a physical exam and review the person’s medical history. They will assess how the person’s muscle and nerves are working. The doctor will note whether symptoms appear on both sides of the body (which is typical in GBS) and how fast the symptoms appeared. This is helpful because in other disorders, muscle weakness may progress over months rather than days or weeks. They will also check reflexes, as some reflexes are lost in people with GBS.
Nerve conduction velocity test (NCV): This test measures the nerve’s ability to send a signal. In GBS, the signals travelling along the damaged nerves are slowed because of damage to the myelin sheath.
Cerebrospinal fluid analysis: A doctor may also conduct an analysis of the cerebrospinal fluid that bathes the spinal cord. This fluid contains more protein and fewer immune cells in people with GBS.
Imaging: In some cases, an MRI of the spinal cord or even brain may help find any other potential causes of muscle weakness.

Treating GBS
Currently, there is no cure for GBS. However, some therapies can reduce its severity and shorten recovery time. There are also several ways to treat the complications of the disease.
People with GBS are usually admitted to the hospital and treated in the intensive care unit due to possible complications of muscle weakness. At the hospital, people with GBS are closely monitored to track the progression of their muscle weakness, breathing, and heart rate. If an intervention is needed, it can be quickly provided by the hospital staff.

Rehabilitative care

As people with GBS begin to improve, they may be transferred from an acute care unit at a hospital to a rehabilitation setting. They can receive physical rehabilitation and other therapy to regain strength and resume activities of daily living.
Because GBS can affect several parts of the body, different methods and approaches may be needed to prevent or treat complications. For example, a physical therapist can manually move and position the person’s limbs to help keep the muscles flexible and prevent muscle shortening. Muscle strength may not return in the same way. Muscles that get stronger faster may take over a function that weaker muscles normally perform (this process is called substitution). A physical therapist can select specific exercises to improve the strength of weaker muscles so their original function can be regained.

Occupational and vocational therapy can help people learn new ways to handle everyday functions that may be affected. They can also help the person manage work demands and identify the need for assistive devices and other adaptive equipment and technology.

For patients with Guillain-Barre Syndrome, an ideal diet that is rich in nutrient- dense foods would be the preference of course that promotes nerve health, boosts immunity, and gives one enough energy for recovery. Anti-inflammatory food and adequate hydration will also play a great role in this matter.

GBS can be a devastating disorder because of its sudden and rapid, unexpected onset of weakness- and often paralysis. Fortunately, most people with GBS have a full recovery. With careful intensive care and successful treatment of infection, autonomic dysfunction, and other medical complications, even when people who have respiratory failure usually survive.
Recovery can be slow-anywhere from a week to a few years. Some people do not recover completely and experience long-term weakness, numbness, fatigue, or pain. People recovering from GBS may face physical challenges and emotionally painful periods. It can be extremely difficult to adjust to sudden paralysis and dependence on others for help with routine daily activities. Some people with GBS need mental health counselling to help them adapt. Support groups can often ease emotional strain and provide valuable information.
While is no specific treatment to cure Guillain-Barree Syndrome, eating a nutrient-dense, balanced diet can significantly improve recovery and overall well-being. Foods rich in vitamins, antioxidants, and healthy fats can support nerve and muscle health, while avoiding inflammatory and processed foods is equally important.