The Ministry of Health reported this Tuesday (11) that it is monitoring the health emergency situation caused by Guillain Barré Syndrome in Peru. The folder points out that the disease is not transmissible from person to person, and that, therefore, it is considered that there is low risk for Brazil. Last Saturday (8), Peru declared a national emergency for 90 days due to the high incidence of the disease. According to the alert, until that moment, 182 cases had been registered in 2023. Of these, 31 patients were hospitalized, 147 were discharged from hospital and four died from the disease. Peru borders a large part of Acre and Amazonas, and the Ministry of Health clarifies that “the scenario assessment points out that there is no need to restrict tourism, trade and/or movement of people”, according to a note sent to the Agency. Brazil. “A technical note is being sent to the state health departments reinforcing that the situation so far is of low risk for the country”, he adds. What is the syndrome? The Brazilian Ministry of Health explains that the syndrome is relatively uncommon, of an autoimmune pattern, and affects the peripheral nervous system. The picture can be triggered by several factors, but about 75% of cases occur due to some infectious process. The syndrome is not compulsory notification in Brazil, but epidemic outbreaks are monitored. In 2015, the country recorded an outbreak of the disease in Bahia. Both bacteria and viruses can trigger cases of Guillain Barré, and symptoms of the syndrome can appear during the acute phase of infections or after patients recover. There are records of the syndrome associated with bacteria that cause diarrhea and viral infections such as dengue, zika, chikungunya, cytomegalovirus, Epstein-Barr, measles, influenza A, enterovirus D68, hepatitis A, B and C, HIV, among others. In Peru, the disease had already caused an outbreak in 2019, with 900 cases. In that episode, the illnesses were associated with the presence of the bacteria Campylobacter jejuni, which causes diarrhea. In 2020, 448 cases were recorded, in 2021 there were 210 cases; and, in 2022, a total of 225 cases. So far, there is still no information regarding the infectious agent associated with the current outbreak in Peru. Symptoms The first symptom often reported by patients with Guillain Barré is a numb or burning sensation in the feet and legs, which follows the same sensation in the hands and arms. Also from the lower limbs to the upper limbs, patients begin to feel progressive weakness, which reaches the head and neck. The picture can have different degrees of aggressiveness, and can even cause paralysis of the four limbs. Symptoms of the disease are also considered: drowsiness, mental confusion, epileptic seizures, loss of muscle coordination, double vision, facial weakness, tremors, reduction or loss of muscle tone and itching in the limbs. Patients with these conditions should urgently see a doctor for evaluation, and the Unified Health System has rehabilitation centers and a Clinical Protocol and Therapeutic Guidelines for Guillain Barré Syndrome. Medicine considers that the greatest risk of the syndrome is when weakness and paralysis reach the respiratory muscles. In this extreme case, respiratory support measures are needed to prevent the patient’s death, as the heart and lungs stop working. Neurological damage and sequelae Consultant for the Brazilian Society of Infectology and professor at the State University of Campinas (Unicamp), infectologist Raquel Stucchi explains that the diagnosis and treatment of the disease require a well-structured health system. The investigation needs to rule out other hypotheses, such as poliomyelitis, and the treatment requires a multidisciplinary team and needs to start soon, to avoid more serious sequelae. “When diagnosed early on or with mild forms, patients usually have a good recovery and may not have sequelae. However, the most serious cases can leave a sequel. The person can become paraplegic, for example, as a sequel to Guillain Barré, and this is regardless of the infectious agent”, she mentions, explaining that the disease can also occur without being caused by any infection, with the body itself causing inflammation in the nervous tissue in an autoimmune way. After the start of treatment, most patients begin to recover the strength and sensitivity of the limbs in three or four days, and hospital discharge occurs before three weeks, describes the doctor, who considers that severe cases can have hospitalizations well. longer. The infectologist explains that, if the cause of the outbreak in Peru is the bacteria that caused the wave of cases in 2019, the risk of the disease bringing concern to Brazil is low. She adds that the neighboring country also has a high number of cases of dengue, a disease that has also been associated with the syndrome and may be contributing to the current health emergency. “The disease that people call Guillain Barré cannot be transmitted. Now the infectious agent can be transmitted from person to person, because each infectious agent has its own way of transmission. Can hepatitis B cause Guillain Barré? It can, and is transmitted basically through sexual activity today, or material contaminated with blood. Can Covid-19 give Guillain Barré? It can, and transmission from person to person is respiratory. But is everyone who has hepatitis B or covid-19 going to present Guillain Barré? No. It is a minority that can present this complication, ”she explains. “The concern remains because, in this outbreak in Peru, we still have not established the cause. If eventually it is an agent that can co-occur with other symptoms, we may even have some degree of concern. If it is the same one that has been circulating in Peru since 2019, this does not really cause us great concern, ”she noted. As cases of Guillain Barré Syndrome are considered rare, the infectologist explains that an outbreak associated with an infectious agent can mean a high incidence of that agent in the population, which can be difficult to be noticed when these infections do not produce symptoms that are important enough. to bring infected people to the health system.
Agência Brasil
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