Pune's Guillain-Barré Syndrome Epidemic Related to Water Quality

Karen McClorey Hackett — Mon, 10 Mar 2025 12:27:00 +0000

Reviewer:

The Maharashtra state has reported the most cases of Guillain-Barré syndrome (GBS), a rare neurological illness that damages peripheral nerves, during India's largest outbreak ever,

Since January 2025, about 300 GBS cases and 21 related fatalities have been reported in eight states in India.

According to a World Report (Volume 405, Issue 10481) published by The Lancet on March 8, 2025, experts have linked these GBS infections with Campylobacter jejuni. This bacteria is one of the most common causes of food poisoning.

Pune, a city of 7 million people, has emerged as the epicenter of the GBS outbreak. Indian Council of Medical Research (ICMR) officials have found C jejuni and norovirus in most patients with GBS who had earlier had acute gastroenteritis or diarrhoea.

"Nearly 20–30% of the samples tested so far have been confirmed positive for C jejuni. These patients suffered from infection caused by the bacteria before developing GBS", said ICMR Director General Rajiv Bahl.

"A contaminated water source supplying Pune and surrounding villages is suspected to be the origin of the outbreak", a senior official in the Maharashtra health department added.

"GBS cases are reported throughout the year, with some seasonal spikes. Up to 70% of GBS cases are linked to a prior infection."

Madhu Nagappa, from India's National Institute of Mental Health and Neuro Sciences, told The Lancet that several bacterial and viral pathogens apart from C jejuni are associated with GBS, including Mycoplasma pneumoniae, Hemophilus influenzae, cytomegalovirus, dengue virus, influenza virus, Japanese encephalitis virus, chikungunya virus, Epstein-Barr virus, and Zika virus.

"Among the numerous microorganisms implicated, C jejuni is considered to be the most common antecedent infectious risk factor for developing GBS", said Nagappa, adding that "in Pune, it is likely that a specific strain of C jejuni with neurotoxic potential is circulating".

However, Nagappa said that only about one in 1,000 individuals infected with C jejuni develop GBS, stressing that not all patients with GBS have a documented preceding infection.

Other factors such as recent surgeries, certain vaccinations, and immunocompromised conditions might trigger GBS.

The current outbreak coincides with India reporting over 1,000 outbreaks of acute diarrheal disease in 2024, the highest number since public data became available in 2009, according to the Ministry of Health & Family Welfare.

The United States is generally the largest source of foreign tourists arriving in India. As of March 10, 2025, the U.S. CDC has not issued a Travel Health Advisory regarding India's GBS epidemic.

In the U.S., 3,000 to 6,000 people develop GBS annually.

Data collected by the CDC regarding the potential association between seasonal flu vaccinations and GBS has been found to vary from season to season. When there has been an increased risk, it has consistently been in the range of 1-2 additional GBS cases per million flu vaccine doses.

Furthermore, the U.S. FDA has not approved vaccines to prevent GBS or norovirus in 2025.

Sub Title:

India Guillain-Barré syndrome outbreak Continues in 2025

References:

The Lancet - India faces major Guillain-Barré syndrome epidemic

Public Health Department

Guillain-Barré syndrome and Flu Vaccine

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Monday, March 10, 2025 - 05:45

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Epstein-Barr Virus Vaccine Strategy Progresses

Don Hackett — Tue, 09 Apr 2019 19:23:14 +0000

Reviewer:

Robert Carlson, MD

Danielle Reiter, RN

Scientists from the National Institute of Health (NIH) say they have determined how several antibodies induced by the Epstein-Barr virus (EBV) block infection of cells grown in the laboratory.

They then used this information to develop novel vaccine candidates that, in animals, elicited potent anti-EBV antibody responses that blocked infection of cell types involved in EBV-associated cancers.

This pre-human research is important since there is no licensed vaccine currently available for the Epstein-Barr virus.

The Epstein-Barr virus, also known as herpesvirus 4, is one of the most common human viruses in the world. It spreads primarily through saliva and can cause infectious mononucleosis.

Additionally, EBV is associated with certain cancers (nasopharyngeal and gastric) of epithelial cells, which form the lining of the body’s surfaces, as well as Burkitt and Hodgkin lymphomas, which are cancers of the immune system’s B cells.

Worldwide, about 200,000 cases of EBV-associated cancers occur annually, resulting in 140,000 deaths.

This new research helps define the contributions of virus-neutralizing antibodies other than those directed at gp350 on B cells.

Among other findings of this study, the team determined that antibodies to viral proteins called the gH/gL complex play a major role in inhibiting EBV fusion with epithelial cells.

These scientists developed 2 vaccine candidates, one designed to elicit antibodies to gH/gL on epithelial cells and another that included gH/gL and another viral protein, gp42.

The team tested the vaccines in a series of experiments in mice and monkeys. In both animal models, each of the experimental vaccines induced antibodies that potently inhibited epithelial cell fusion.

The vaccine containing gp42 induced stronger B cell fusion inhibitory antibodies than the one containing gH/gL alone.

Unlike the gp350 candidate EBV vaccine, which protects only B cells from infection, the candidate vaccines described in the new paper elicited antibodies that could prevent EBV from fusing with both epithelial cells and B cells and thus may provide protection independent of cell type, the authors note.

Jeffrey I. Cohen, M.D., and Wei Bu, Ph.D., both of the NIH’s National Institute of Allergy and Infectious Diseases, led the investigation. Prior efforts to develop an EBV vaccine focused on a viral surface protein, gp350, that the virus uses to enter B cells.

However, EBV infects not only B cells but also epithelial cells that line the mouth and upper throat.

No conflicts of interest were disclosed.

Sub Title:

Epstein-Barr is known as herpesvirus 4 and is associated with mononucleosis and nasopharyngeal and gastric cancers

References:

NIH researchers make progress toward Epstein-Barr virus vaccine

Immunization with Components of the Viral Fusion Apparatus Elicits Antibodies That Neutralize Epstein-Barr Virus in B Cells

About Epstein-Barr Virus

Recent advances in understanding Epstein-Barr virus

Epstein‐Barr virus strain variation and cancer

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