Shigella and Guillain-Barré syndrome: Reconsidering an overlooked link

Guillain-Barré Syndrome (GBS) is a rare autoimmune neurological disorder, mostly associated with preceding gastrointestinal or respiratory infections. Various bacterial and viral pathogens have been associated with GBS; Campylobacter jejuni being a well-established bacterial trigger. A few case reports and an outbreak of GBS wayback in 1976 also indicated an association of Shigella and GBS. Although Shigella primarily causes bacillary dysentery; however, it has been linked with neurological complications, including peripheral neuropathy. Shigella's substantial global burden, high endemicity in low- and middle-income countries (LMICs) with known neuroinvasive potential prompted us to explore its possible role in GBS outbreaks. This perspective discusses the recent GBS outbreak in India, the possible role of Shigella in GBS, and surveillance gaps for GBS in LMICs for rapid diagnosis and treatment.