Health officials in the US state of Arizona said on Tuesday there are now 24 reported cases of a rare paralyzing disease known as Guillain-Barré Syndrome (GBS) affecting people on both sides of the border between the US and Mexico. They urge people travelling to or living in the area affected to be extra careful about personal hygiene and practise good handwashing habits, as contaminated food or water could be a source of infection.

The area affected is Yuma County in the far west of Arizona in the US, and just over the border in San Luis Rio Colorado, in the state of Sonora in northern Mexico. So far 7 people are known to be affected on the US side and 17 on the Mexican side.

This latest report is 8 cases more than that of a week earlier, on 18 July, when the Arizona Department of Health Services issued a statement about how a cluster of cases of GBS, which normally occurs in about 1 in 100,000 people, was emerging in a small geographical area along the US-Mexican border.

GBS is an acute disease of the peripheral nervous system that causes inflammation in the nerves of the arms and legs. It starts as tingling and numbness in the fingers and sudden muscle weakness, and leads to paralysis, loss of sensation, and sometimes pain in the arms and legs. It can eventually cause respiratory problems, and rarely, death.

The nerves become damaged because the person's own immune system attacks them. Scientists are not sure what triggers the immune system to behave like this, except that in about two-thirds of cases, the symptoms appear a few days or weeks after being sick with diarrhea or respiratory illness. It is not transmitted from person to person.

The symptoms can last for weeks, or even months. Most people make a full recovery, but some have permanent nerve damage. In rare cases, some people have died, usually because of respiratory failure.

A foodborne disease epidemiologist with Arizona's Health Services, Joli Weiss, told Reuters news agency that it was very unusual to have so many cases in a small area and they were very concerned about it.

Weiss said health authorities in Arizona were working closely with counterparts in Mexico to locate the source of the outbreak. It could be a bacteria that has contaminated water or food. She said they were looking at the travel histories of the people affected, what food they had been eating and if they had attended any large gatherings at the same time.

Shoana Anderson, Office Chief of Infectious Disease at the Arizona Department of Health Services, said in a statement last week they suspect Campylobacter bacteria as a potential cause, but hadn't confirmed it yet in these cases.

Health officials from Sonora have carried out outreach and education to people living in the San Luis Rio Colorado area. Officials from Arizona's health department have asked doctors and hospitals to be extra alert for signs of GBS and swiftly contact their local health office about any potential cases.

GBS can't be passed from person to person. The Arizona health department advises people either travelling to or living in the areas affected to practise good handwashing habits. Always wash hands after using the bathroom, and also before eating. Wash hands before and also while preparing and cooking food, they urge.

For more information on GBS, see the GBS CIDP Foundation International website.

Sources: Reuters, Arizona Department of Health Services, CDC.

: Catharine Paddock, PhD

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