Contaminated water identified as cause of GBS outbreak in Pune

The National Institute of Virology (NIV) confirmed contaminated water is the primary cause of the recent spike in Guillain-Barré Syndrome (GBS) cases in Pune. With four new contaminated sources identified on February 6, the total of unsafe water sources has risen to 37. Another fatality has been reported, bringing the death toll to six.

Contaminated water causes GBS spike

Under the Integrated Disease Surveillance Programme, the Public Health Department collected 3,868 water samples from Pune. These samples were sent for analysis, revealing 37 contaminated sources. Additionally, 80 serum samples were sent to NIMHANS, Bengaluru, for Antiganglioside Antibodies testing to understand the outbreak’s impact.

Experts suggest the outbreak could indicate widespread water contamination. Dr. Jessy Skaria, a doctor and independent researcher, pointed to large gatherings like the Maha Kumbh Mela as possible infection sources.

"The antecedent infections triggering GBS could have spread among crowds through faecal-oral or droplet transmission, resulting in this rare outbreak of over 100 cases," she said.

Investigations found Campylobacter jejuni and norovirus in affected patients—two microbes linked to contaminated water.

"Both microbes can be abundant in water with faecal contamination, and their potential to cause gastroenteritis can trigger GBS," Skaria explained.

GBS cases in Pune and nearby districts—Satara, Sangli, Khed, and Talegaon—peaked at 163 in late January. The spread of cases suggests a common contamination source affecting multiple locations.

"If the outbreak were limited to Pune, we could focus on the city's main water supply or a local event. But cases are emerging in different states, suggesting a larger, single source of infection," Skaria added.

The Pune Municipal Corporation has shut down 19 contaminated private RO purification plants.

Since GBS isn’t a notifiable disease in India, its true scale remains unknown. Reports indicate GBS cases in West Bengal, Rajasthan, Assam, Telangana, Tamil Nadu, Jharkhand, Haryana, and Delhi, raising alarms about a nationwide issue.

“One report of Delhi hospitals accounting for over 100 cases. I’m at a loss why nobody is concerned about that,” Skaria told Down To Earth.

Possible link to Kumbh Mela

Dr. Skaria suggested that even those who didn’t attend the Maha Kumbh Mela could have been exposed through indirect contact.

"GBS itself is not contagious, but the infections that trigger it are. A person could have acquired the infection from someone with mild symptoms, like diarrhea, and unknowingly spread it," she explained.

She stressed the importance of testing water sources at multiple locations where devotees have bathed, especially at the Ganges in Prayagraj.

“With millions at the Maha Kumbh Mela, despite the best cleanliness efforts, such events can become hotspots for infectious diseases,” she warned.

Public health authorities are determining if different strains of the microbes are more pathogenic.

"The National Institute of Virology is investigating the Campylobacter and norovirus strains in patient samples. This is a crucial step," Skaria noted.

Authorities are urged to act swiftly to prevent further spread and ensure clean water supplies in affected regions.

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