Attachments
Situation Summary
On 26 June 2023, the National Center for Epidemiology, Prevention, and Disease Control (CDC) of Peru issued an epidemiological alert due to an increase in Guillain-Barré Syndrome (GBS) cases in different regions of the country.
Between epidemiological week (EW) 1 and EW 27 (until 8 July 2023), 191 cases of GBS cases meeting the country's established case definition have been reported3, 77 of these cases were confirmed, including four deaths (1 in Cajamarca, 1 in La Libertad, and 2 in Lima). The departments that reported the highest number of cases in 2023 are Lima (50 cases), La Libertad (32), Lambayeque (20), Cajamarca (18), Piura (16), Junín (10), Callao (9) and Cusco (7). Reported deaths were registered in January (1), March (1), and May (2).
58.6% of the cases reported in 2023 correspond to males (112 cases) aged between 2 and 86 years, with an average age of 41 years. 40.3% of the cases are adults (77 cases) between 30 and 59 years, followed by the group of older adults (> 60 years), with 26.7% of cases (51 cases). 38 cases are recorded in children under 17 years of age.
According to the historical series (excluding the 2019 outbreak), the average monthly number of GBS cases registered was less than 20 cases per month nationwide. However, between EW 23 and 27 of 2023, 96 cases were reported, of which 77.1% were from the departments of Lima (25 cases), La Libertad (15 ), Lambayeque (14 ), Piura (12 ) and Cajamarca (8 ).
The preliminary clinical manifestations of the cases registered up to SE 27 show that 23% presented gastrointestinal infection (44 cases), 24.1% respiratory infection (46 cases), and 16.2% fever (31 cases). In relation to neurological manifestation, 71.9% of the cases presented upward progression of paralysis (131 cases), and 21.9% presented some type of sequelae.
Samples were collected from the cases according to the technical health standard for epidemiological surveillance and laboratory diagnosis of GBS in Peru. To date, eleven cases have been reported with positive results for Campylobacter jejuni in samples corresponding to the departments of La Libertad (5 cases), Piura (3), Lima (2) and Cusco (1).
In 2019, Peru reported an unprecedented outbreak of GBS that affected several regions of the country, with more than 900 cases reported. From the clinical-epidemiological characteristics and the study of the identified agents, it was concluded that this outbreak was associated with the presence of the Campylobacter jejuni ST2993 genotype. During the year 2020, 448 cases were reported nationally with a weekly average of 11 cases; in 2021, 210 cases were reported with a weekly average of 4 cases, and in 2022, 225 cases were reported with a weekly average of 4 cases.
Public Health Response
On July 8, 2023, the Presidency of the Republic of Peru issued the Decree that Declares a Health Emergency at the national level due to the unusual increase in cases of Guillain Barré Syndrome.
The decree provides:
● The implementation of an action plan that includes financing for the provision of strategic resources in health, including the acquisition of human immunoglobulin as part of the treatment of patients with Guillain Barré syndrome.
● Intensification of surveillance, prevention, and response actions to possible cases.
● Communication of risk to health professionals and issuance of key messages to the population to adopt preventive measures.
● Advice, information, and guidance on Guillain Barré syndrome to health professionals and the general population. PAHO/WHO is supporting the health authorities of Peru in the management of this event.