Guillain-Barré syndrome, a rare paralyzing disease erupting in Gaza due to contaminated food and water

The outbreak of a rare disease that paralyzes the body and can be fatal is worrying the exhausted medical teams in the Gaza Strip. Guillain-Barré syndrome (GBS), which is caused by a viral or bacterial infection, causes the immune system to attack the body, weakening muscles and progressively paralyzing different parts of the body. The World Health Organization (WHO) has detected 85 cases in the enclave since June. Three of these patients have died, according to the Hamas-run Gaza Ministry of Health.

The WHO acknowledges that the cause of the disease “is not fully understood,” but it is being linked to contaminated food or the consumption of untreated water. In Gaza, Israeli bombs have destroyed water and sanitation networks, creating an unhealthy ecosystem in the same territory where obtaining water for drinking, cooking, cleaning, or washing is a daily challenge, forcing the use of wastewater.

Now, specialists warn that the disease will spread as long as Israel persists with its attacks and humanitarian blockade, which prevents the contamination and shortages on the ground from being addressed. In most cases, GBS allows for a subsequent recovery, often after a period of care in an intensive care unit (ICU). The disease has no official cure, but there are effective treatments. According to the WHO, the main one is not available in the Gaza Strip.

The outbreak marks the spread of yet another infectious disease in the 23 months of fighting in the enclave, after Gazan hospitals also detected outbreaks of polio, cholera, hepatitis A, and scabies. Before the current Israeli offensive, cases of this crippling disease could be counted on the fingers of one hand.

Symptoms and consequences

Diarrhea is the first symptom of infection. Within a few days, the disease makes it difficult to move the legs and later blocks the muscles that help the body breathe. This impairment can be fatal. The spread of paralysis can also affect heart rate or speech.

The emergence of GBS also increases the burden on Gazan hospitals. When the disease progresses and the body experiences difficulty breathing, the patient requires nasal intubation. The main medical centers in the enclave have doubled or tripled their initial capacity and are already overwhelmed by the massive influx of dead and wounded. Many centers treat patients on the floor or in hallways. According to the WHO, 30% of cases require intensive care, and 5% of those affected can die from complications arising from GBS even when they have access to the best medical conditions and infrastructure. Circumstances that do not exist in Gaza.

The most vulnerable populations to the disease are infants, children with pre-existing conditions, the elderly, and people with disabilities. All of them, as an emergency room doctor at Al Shifa Hospital in Gaza lamented in a recent Amnesty International special report, are particularly affected by the simultaneous lack of food, medicine, clean water, and hygiene, an ecosystem that can be lethal when combined with the perpetual state of fear and anxiety caused by the Israeli offensive.

The doctor warns that the spread of this condition is occurring in a population weakened by malnutrition. Wounds, he says, are taking longer than normal to heal, which increases hospital stays. The doctor quoted by Amnesty also denounced the “intertwined, multi-layered destruction,” where a hospital like Al Shifa, which has been invaded and destroyed from within twice by Israeli soldiers in this war, must face the consequences of famine, constant bombing, and the mass displacement of civilians to overcrowded and unsanitary areas.

“First it was his legs,” says Nujood Abu Ghalibeh, sitting in the hospital bed where her son Waleed is confined. “Then he lost the ability to speak, and then he couldn’t swallow,” she explains in a video released by the WHO on Friday. Later, she recalls, her son had difficulty blinking. He kept his eyes open and shed tears.

After 17 days in intensive care, Waleed has regained the ability to breathe and some movement in his legs, but he cannot stand, eat, or swallow. He is fed through a tube in his nose, breathes through a tube in his neck, and they are considering installing another one in his abdomen. “The thing I want most is for my son to talk, breathe, drink, and love life,” says his mother.

On August 4, the Gaza Ministry of Health confirmed the first three deaths from the disease. In a statement, the Ministry warned of a “dangerous increase in cases of acute flaccid paralysis and GBS among children in Gaza, resulting from atypical infections and worsening acute malnutrition.” Analyses conducted so far, medical authorities said, confirmed “the existence of an environment conducive to the uncontrolled spread of infectious diseases.” The three announced deaths, they concluded, “are a warning of a potential infectious disaster.”

“Since the start of the war, Israel has systematically destroyed the water and wastewater treatment system in Gaza,” Palestinian-British doctor Ghassan Abu-Sitta, from Beirut, denounced in several messages exchanged with EL PAÍS. This doctor, who serves as rector of the University of Glasgow, has worked in the Strip during the current war and during almost all the conflicts that have led Israel to take military action in the enclave in the 21st century. He also recalled that “Israel already bombed the wastewater treatment plants in October and November 2023,” at the start of the offensive, and that the occupying troops have also broken the pipes that carry wastewater.

At the same time, the destruction of Palestinian homes has forced citizens to live in overcrowded and unsanitary conditions. And the famine has exacerbated their weakness, making them immunocompromised. “People who suffer from famine have lower immunity,” Abu-Sitta explains, “and all of this has created a social, physical, and biological ecosystem in which this syndrome has erupted.”

Prime Minister Benjamin Netanyahu, a fugitive from international justice since 2024 after the International Criminal Court issued an arrest warrant for him for possible war crimes and crimes against humanity in Gaza, announced on March 1 a total embargo on food and all basic supplies entering the Strip. The decision, which violated international humanitarian law, constitutes collective punishment for more than two million unarmed civilians.

The medieval siege lasted two and a half months. Since mid-May, Israel has allowed the intermittent and trickle-down entry of some food products and basic supplies. In any case, the easing of the blockade and the entry of goods in quantities that the UN defines as negligible have not prevented the territory’s slide toward famine, declared last week by the UN in parts of the Strip.

After months of shortages, the consequences of the humanitarian blockade have multiplied in recent weeks. This period has seen virtually all of the GBS cases and most of the 303 deaths recorded due to starvation. The vast majority of them, 238, occurred in less than two months: since the beginning of July.

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