The government of Peru declared a 90-day health emergency earlier this month following an outbreak of Guillain-Barré Syndrome (GBS) that has killed at least four people in the country. According to the Institute of Neurological Sciences (INCN) in Lima, Peru, the emergency was declared because the cases “have unusual and atypical characteristics that require rapid or immediate initial treatment.”1 2
On June 9, 2019, Minister of Health Zulema Tomás, MD said that there were a total of 206 cases of GBS reported in Peru, mostly in the regions of Junin, La Libertad, Lambayeque, Lima, and Piura. Two of the deaths from the polio-like illness were reported in the region of Piura and the other two in the regions of La Libertad and Junin.1 3
An emergency declaration allows the Peruvian government to justify increasing its health services budget to enable public hospitals in the country to provide free treatment for patients diagnosed with GBS. A recent article in the Andean Air Mail & Peruvian Times, referring to comments by Hugo Umeres, MD of Cayetano Heredia University hospital in Lima, said that one of the treatments is called plasmapheresis—a procedure that removes the plasma from the blood and replaces it with other fluids.” That treatment reportedly costs up to $15,000.2
The U.S. Centers for Disease Control and Prevention (CDC) describes GBS as a, “rare disorder where the body’s immune system damages nerve cells, causing muscle weakness and sometimes paralysis.” It acknowledges that the cause of GBS is “not fully understood,” but that the “syndrome often follows infection with a virus or bacteria.”4
In more scientific terms, GBS is an “autoimmune disorder involving the loss of the myelin sheaths encasing peripheral nerve axons, leading to a loss of nerve signaling and typically ascending paralysis.” It is known to be the “leading cause of acute flaccid paralysis” (also known as acute flaccid myelitis or AFM) in the U.S. and worldwide.5 6
According to the CDC, there are an estimated 3,000 to 6,000 cases of GBS reported in the United States each year.4 The annual incidence of GBS has also been estimated at up to 3 in 100,000 people in the U.S., or about 9,600 cases per year. Members of the U.S. military are known to be at higher risk of GBS compared to the rest of the U.S. population.5 7
The CDC notes that there have been several studies linking a higher risk of GBS after receiving the influenza vaccine. The agency states: “On very rare occasions, people develop GBS in the days or weeks after getting a vaccination.”4
As of June 13, the number of reported cases of GBS in Peru had spiked to 548.8
1 AFP. Peru declares health emergency over Guillain-Barre outbreak. France 24 June 10, 2019.
2 Vaccine Sch Emergency health warning issued on Guillain-Barré syndrome cases. Andean Air Mail & Peruvian Times June 10, 2019.
3 Zulema Tomás. Wikipedia.
4 Centers for Disease Control and Prevention. Guillain-Barré Syndrome. CDC.gov.
5 Nelson L, Gormley R, Riddle MS, Tribble DR, Porter CK. The epidemiology of Guillain-Barré Syndrome in U.S. military personnel: a case-control study. BMC Research Notes 2009 2:171.
6 CentNguyen TP, Taylor RS. Guillain Barre Syndrome. StatPearls Publishing Jan- 2019.
7 Andary MT, Klein MJ. What is the incidence of Guillain-Barre syndrome (GBS) in the US? Medscape Oct. 6, 2017.
8 Center for Infectious Disease Research and Policy. Peru notes Guillain-Barre spike in first half of 2019. University of Minnesota CIDRAP June 20, 2019.