Header graphic for print
Marler Blog Providing Commentary on Food Poisoning Outbreaks & Litigation

A Food Poisoning Alphabet – GBS (Guillain Barre Syndrome), HUS (Hemolytic Uremic Syndrome), IBS (Irritable Bowel Syndrome) and RA (Reactive Arthritis)


The Centers for Disease Control and Prevention (CDC) estimates that 48 million-foodborne illness cases occur in the United States every year. At least 128,000 Americans are hospitalized, and 3,000 die after eating contaminated food.  Clearly, the vast majority of people become ill, but not seriously so.  However, those that do become ill can in rare situations become very ill.  Here are some of those complications:

Guillain-Barré (ghee-yan bah-ray) syndrome (GBS) is a disorder in which the body’s immune system attacks part of the peripheral nervous system. The peripheral nervous system includes the cranial nerves (except the optic [eye] nerve), the spinal nerves, and the autonomic nervous system that governs involuntary actions. The central nervous system is the spinal cord and brain.  GBS often occurs a few days or weeks after a person has had symptoms of a respiratory or gastrointestinal viral or bacterial infection; in fact, two-thirds of affected individuals have had a preceding infection. Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, and Mycoplasma pneumoniae are commonly identified antecedent pathogens, although C. jejuni is the most common pathogen that elicits GBS.

Post-diarrheal hemolytic uremic syndrome (D+HUS) is a severe, life-threatening complication that occurs in about 10 percent of those infected with E. coli O157:H7 or other Shiga toxin- (Stx-) producing E. coli. D+HUS was first described in 1955, but was not known to be secondary to E. coli infections until 1982. It is now recognized as the most common cause of acute kidney failure in infants and young children. Adolescents and adults are also susceptible, as are the elderly, who often succumb to the disease.

Irritable bowel syndrome (IBS) is one disorder in a spectrum of common functional gastrointestinal disorders. Symptoms of IBS can include constipation, diarrhea, alternating diarrhea and constipation, abdominal pain, urgency, bloating, straining at stools, and a sense of incomplete evacuation. The Rome III definition for IBS, which is widely accepted in the medical community, is recurrent abdominal pain or discomfort at least three days per month for at least three months, with at least two of the following symptoms also present: improvement of the pain or discomfort with defecation, a change in frequency of stools, or a change also in the form or appearance of stool.  The observation that the onset of IBS symptoms can be precipitated by gastrointestinal infection (like Salmonella) dates to the 1950s. Different studies have shown that 7-31% of individuals, who have experienced an episode of infectious gastroenteritis, whether bacterial or viral, may develop symptoms of IBS.

Reactive Arthritis (RA) refers to a group of arthritic diseases that includes a subset formally known as “Reiter’s Syndrome” The old term Reiter’s syndrome has fallen into disfavor. In recent medical literature Reiter’s Syndrome is simply referred to as Reactive Arthritis, which may or may not be accompanied by extraintestinal manifestations. Reactive Arthritis is the name used to describe an uncommon, but potentially debilitating group of symptoms that follows a gastrointestinal, genitourinary, or viral infection. The most common gastrointestinal bacteria involved are Salmonella, Campylobacter, Yersinia, Shigella, E. coli, and Vibrio. The most common genitourinary causes are sexually transmitted diseases such as Chlamydia and Gonorrhea. The most common viral causes are the common flu, HIV, and Parvovirus.