Widespread water poisoning may be the cause of the Guillain-Barré Syndrome (GBS) outbreak in India, which was observed in Pune and other parts of the country; big gatherings like the Maha Kumbh Mela have emerged as possible locations for infection transmission. According to independent researcher and physician Jessy Skaria, initial infections that could have caused GBS may have spread quickly among millions of followers through droplet or faecal-oral transmission.

Early research has determined that the main causes of the outbreak in Pune and the neighbouring areas are Campylobacter jejuni and norovirus. Skaria noted that both pathogens are common in water tainted by faeces and are known to induce gastroenteritis, which can then lead to GBS. In addition, she stressed that although norovirus is extremely contagious, it is a less well-known cause of GBS than Campylobacter jejuni.

By the end of January, there were 163 GBS cases affecting Pune and other districts, including Sangli, Talegaon, Satara, and Khed. Skaria pointed out that although there are clusters of cases in some places, isolated instances in far-off areas point to a single, massive source of infection that is simultaneously impacting people in several regions.

Widespread Cases and Possible Maha Kumbh Connection to GBS Outbreak in India

After discovering contamination, the Pune Municipal Corporation closed 19 private RO purification facilities as of February 5. However, cases have been documented in Maharashtra, Delhi, Rajasthan, West Bengal, Tamil Nadu, Assam, Telangana, Jharkhand, and Haryana, indicating that the outbreak has spread beyond Pune. The precise number of cases nationwide is unknown because GBS is not an illness that must be reported, except for children under the age of 15 who are being treated for polio.

Skaria emphasized the necessity of looking into a shared source of pollution, speculating that a major gathering of people from all over India, such as the Maha Kumbh Mela, might play a crucial role. She cited data showing that more than 100 cases were reported to hospitals in Delhi alone.

All patients had been screened for travel history and diseases like dengue and Zika, and the results ruled those viruses out as possible triggers, said Nina Borade, the Pune Municipal Corporation’s health commissioner. Skaria clarified that contaminated water, prasad, or contact with infected people might have spread the bacteria; therefore, people did not need to attend the Maha Kumbh Mela to be exposed to the triggering infection. She added that although GBS is not contagious in and of itself, the infections that cause it can be transmitted through respiratory or fecal-oral routes.

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Urgent Need for Investigation and Public Health Response

Skaria noted that there are a number of ways in which these infections can spread from person to person, such as through contaminated public areas like restrooms or shared food or water. Those who experienced only minor respiratory or gastrointestinal symptoms could spread the triggering diseases to people who had no direct link to the Maha Kumbh Mela. According to her, the original outbreak in Pune might have been caused by locals who visited the Kumbh and brought back diseases like C. jejuni, norovirus, or Escherichia coli, which they then unintentionally transferred to contacts in other areas.

She said that rather than several separate small outbreaks, the majority of the current GBS outbreak in India most likely came from a single, sizable, contaminated source. She cautioned that despite government sanitation measures, the Maha Kumbh Mela, which draws millions of people in close proximity over several weeks, could act as a hub for infectious diseases due to its immense scale.

Due to contamination by animal and avian waste, studies show that C. jejuni can be detected in rivers that are otherwise relatively clean. Pathogen levels in the waterways of Prayagraj may rise sharply as a result of widespread human pollution during the Mela and a lack of transparency around waste management. Skaria called on public health officials to examine the water at several locations where devotees had come into contact with river water immediately and thoroughly.

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