Paralytic diseases are spreading in Gaza as an Israeli blockade continues to prevent medicine and food from coming in.
Since June, 85 suspected cases of Guillain-Barre syndrome (GBS) have been reported, according to the World Health Organization (WHO).
The WHO reported that there have been eight deaths associated with GBS in Gaza.
What is Guillain-Barre syndrome?
GBS is a condition where the body’s immune system attacks the myelin sheath, which protects the peripheral nerves.
This exposes the nerve fibre and causes nerve damage.
Peripheral nerves branch out from the brain and spinal cord to all parts of the body, such as the skin, muscles and organs.
GBS is a very rare condition, affecting about 100,000 people worldwide every year, according to the Cleveland Clinic’s website.
What causes GBS?
The exact cause of GBS is unknown, but it usually affects people who have suffered from a viral or bacterial infection such as the flu, Epstein-Barr virus or Zika virus.
The WHO says a gastrointestinal infection caused by the Campylobacter jejuni bacteria is one of the most common risk factors for GBS. Campylobacter jejuni is commonly found in animal faeces.
Most lab testing samples in Gaza have been positive for Campylobacter jejuni, said Dr Ahmed al-Farra, head of paediatrics at Nasser Medical Complex in Khan Younis, The Independent reported on Saturday.
Al-Farra said samples also came back positive for enterovirus, a group of viruses which typically spread to humans through contaminated water and cause fevers, body aches, sore throats, and rashes.
He explained that these diseases spread because Israel has destroyed the sewage system in Gaza, forcing people to drink water polluted by sewage.
Israeli bombardment destroyed 70 percent of all sewage pumps and wastewater treatment plants in Gaza, global advocacy group Oxfam reported in July 2024. Oxfam has also accused Israel of restricting the entry of Oxfam’s water testing equipment.
Occasionally, GBS may also be triggered by surgery.
What are the symptoms of GBS?
Symptoms can vary according to how severe the illness is.
GBS typically begins with tingling, numbness or muscle weakness in the feet and legs, which can then progress to the rest of the body.
Other symptoms include muscle pain in the back or legs; weakness of chest muscles, which can lead to breathing difficulties; difficulty moving the eyes; and difficulty speaking or swallowing.
In extreme cases, paralysis of the legs or even the entire body can occur. It can also cause paraesthesia, a sensation of numbness, pricking, burning or chilling of the skin.
Symptoms can last a few weeks, and most people recover without lasting neurological complications, according to the WHO. However, some people continue to experience weakness.
GBS can be life-threatening, with a small proportion of patients dying due to complications such as paralysis of the respiratory muscles, blood infections, pulmonary embolism, or cardiac arrest.
How is GBS diagnosed?
By matching the patients’ symptoms with the disease.
However, the symptoms of GBS overlap with other diseases, so tests are needed to support a GBS diagnosis.
A lumbar puncture might be ordered, where a small amount of fluid is collected from the spinal canal in the lower back.
This fluid is tested for a change consistent with GBS.
Another test is electromyography, where thin-needle electrodes are inserted in the muscles to monitor nerve activity.
How is it treated?
GBS does not have a cure, but treatments can be used to alleviate its symptoms.
For instance, if a patient is having difficulty breathing, they are put on a ventilator. If a patient is experiencing muscle weakness, rehabilitation exercises can help.
Since GBS is an autoimmune disease, immunotherapy is used to manage early symptoms.
This includes plasma exchange, which removes antibodies from the blood. These treatments are most effective when started within a couple of weeks after symptoms develop.
Because GBS is a life-threatening disease, patients are hospitalised and monitored for complications.
Are other diseases in Gaza leading to paralysis?
While GBS is not the only disease spreading in Gaza that causes paralysis.
Gaza has recently seen a surge in acute flaccid paralysis (AFP), a condition that leads to muscle weakness or paralysis.
“The Ministry of Health warns of a dangerous increase in cases of acute flaccid paralysis and Guillain-Barre syndrome among children in the Gaza Strip, as a result of atypical infections and worsening acute malnutrition,” the Palestinian Health Ministry in Gaza said in a press release on its Telegram channel on August 4.
“Medical examinations have revealed the presence of intestinal viruses other than polio, confirming the existence of a fertile environment for the uncontrolled spread of infectious diseases,” said the press release.
The poliovirus, which had been eradicated from Gaza for 25 years, also causes paralysis.
It reappeared in Gaza 11 months after the start of Israel’s war on the enclave.
It is caused by a type of enterovirus and primarily affects children below five years of age.
No medicines in Gaza as it grapples with famine
Gaza is dealing with a man-made famine imposed by Israel, as well as a severe lack of medication as a result of the Israeli blockade.
The Integrated Food Security Phase Classification (IPC) recently determined that Gaza is facing a level 5 catastrophe, where “starvation, death, destitution and extremely critical acute malnutrition are evident”.
In mid-March, Israel imposed a total blockade on essential supplies, including food, water, medication and fuel. The blockade is officially lifted, but the entry of supplies is extremely limited and haphazard.
Hospitals in Gaza are overwhelmed, the United Nations reported on August 13.
Dr Rik Peeperkorn, WHO representative for the occupied West Bank and the Gaza Strip, said less than half of Gaza’s hospitals and 38 percent of its primary healthcare centres are partially operational or functioning only at minimal levels.
The UN also said bed occupancy in major hospitals is far beyond capacity.
Al-Shifa Hospital in Gaza City is operating at 250 percent, Nasser Medical Complex in Khan Younis at 180 percent, al-Rantisi Children’s Hospital in Gaza City at 210 percent and al-Ahli Arab Hospital in the south of Gaza City at more than 300 percent.
