# 5694
Since the end of June the diligent newshounds on FluTrackers have been following reports of a growing number of `flaccid paralysis’ – sometimes described as Guillain-Barré Syndrome (GBS) – cases reported in Sonora Mexico and Southwestern Arizona.
The tracking thread, which as of today contains 35 – mostly Spanish-to-English translations - may be viewed here.
Those with good memories may recall that late last year another cluster of unexplained GBS-like cases occurred some 1500 miles to the south-east in Veracruz, Mexico.
I wrote about that outbreak twice (see Guillain-Barre Syndrome in Mexico, More On the Veracruz Paralysis Outbreak). Despite the detection of 38 cases, and several months of investigation, no definitive cause was determined.
Vaccines were eliminated from the suspect list, and the focus was on testing water, food, and environmental samples for toxins and bacterial contamination.
The Veracruz cluster dwindled in early 2011, and since then there have only been a few scattered cases of GBS in that region.
Since late last month Spanish Language newspapers in Sonora have been reporting on an unusual number of `flaccid paralysis’ cases and an elevated level of diarrheal diseases in their community.
Guillain-Barré Syndrome is an autoimmune disorder that causes muscle weakness ands sometimes paralysis. Most patients recover after a few weeks, although permanent nerve damage can remain. On rare occasions, patients can die from the illness.
While all of the causes of GBS are not known, doctors do know that it often follows a bacterial or viral infection.
This from the CDC’s Guillain-Barré syndrome (GBS) Q&A page.
What causes GBS?
Many things can cause GBS; about two-thirds of people who develop GBS symptoms do so several days or weeks after they have been sick with diarrhea or a respiratory illness. Infection with the bacterium Campylobacter jejuni is one of the most common risk factors for GBS.
People also can develop GBS after having the flu or other infections (such as cytomegalovirus and Epstein Barr virus). On very rare occasions, they may develop GBS in the days or weeks after getting a vaccination.
Late Wednesday afternoon the Yuma (Arizona) County Health Department issued a statement on the recent rise in diarrheal/Campylobacter cases and cluster of GBS-like cases in Southern Arizona and neighboring Sonora, Mexico.
Rare Condition Sparks Investigation
Posted Date: 7/13/2011 4:00 PM
Yuma County, Arizona, and San Luis, Sonora, have recently seen an increase in Campylobacter infection/acute diarrheal illness and Guillain-Barre’ Syndrome within their respective communities.
Campylobacter infection/acute diarrheal illness usually comes from a food or water source(s), and it causes diarrhea; sometimes with abdominal pain, and fever.
Campylobacter infection/acute diarrheal illness is one of the most common causes of diarrheal infection. Guillain-Barre’ Syndrome is a rare complication that can cause muscle weakness and sometimes paralysis. This condition is thought to be caused by an immune reaction response to a recent illness/infection.
The Yuma County Health District, along with the Arizona Department of Health Services, the Centers for Disease Control and Prevention (CDC) and Sonora health officials are working together to conduct an investigation into the source(s) of these health conditions.
“An investigation of this nature takes a lot of time and a lot of people. It’s like putting a puzzle together. You need all the pieces before you see the picture,” said Becky Brooks, Director of Yuma County Health District. “The response from all agencies has been great, and the expertise from each has certainly contributed to the investigation.”
Health officials from Arizona and Sonora have also conducted outreach and education and have asked physicians and hospitals to watch for the signs of GBS or Campylobacter infection and quickly contact their local health department with any possible cases.
It is important to note that GBS is not passed person to person and the best thing to do is to prevent gastrointestinal infections in the first place.
Good hand washing habits and safe food preparation go a long way to prevent common illnesses. Everyone should wash their hands thoroughly after using the bathroom, before and while they are cooking, and before eating.
Be sure to follow the four food safety tips: Clean, Separate, Cook, and Chill.
Clean: Wash hands, cutting boards, utensils, and countertops.
Separate: Keep raw meat, poultry, and seafood separate from ready-to-eat foods ( fruits, vegetables, food that do not require cooking).
Cook: Use a food thermometer to ensure that foods are cooked to a safe internal temperature: 145 F for whole meats (allowing the meat to rest for 3 minutes before carving or consuming), 160 F for ground meats, and 165 F for all poultry.
Chill: Keep your refrigerator below 40 F and refrigerate food that will spoil. Keep cold things cold and hot things hot.
- Seek medical care if you develop Gastrointestinal symptoms.
- Don’t prepare food for others if you have diarrhea or vomiting.
- Be especially careful preparing food for children, pregnant women, those in poor health and older adults.
- Washing your hands is the single most important thing you can do to prevent illness.
Since this release, the local media has picked up on the story. A few examples include:
Mystery diarrhea outbreak in Yuma County, Mexico
Diarrhea Cases on the Rise, Yuma Health Officials Investigates
CDC investigating increase in illnesses in Yuma County
While fairly rare, GBS affects between 3,000 and 6,000 Americans every year. Campylobacter infections, on the other hand, are very common, with an estimated 2.4 million cases in the U.S. every year.
This from the CDC’s NCZVED information page on:
Campylobacter
What is campylobacteriosis?
Campylobacteriosis is an infectious disease caused by bacteria of the genus Campylobacter. Most people who become ill with campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within two to five days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts one week. Some infected persons do not have any symptoms. In persons with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and causes a serious life-threatening infection.
Although a campylobacter link has not yet been established, this GBS outbreak will likely subside once the outbreak of diarrheal disease can be stemmed.
The newshounds on FluTrackers will continue to follow the story in the U.S. and Mexican press, and if anything unusual comes out of the CDC’s investigation, I’ll report on it here.
