Causes of botulism in humans. The first signs of botulism. Manifestations of the disease and consequences. The most characteristic clinical signs in humans

What is botulism
What Causes Botulism
Symptoms of Botulism
Diagnosis of Botulism
Botulism Treatment
Prevention of Botulism

What is botulism

Botulism- an acute toxic-infectious disease associated with the consumption of foods containing Clostridium botulinum toxin and the pathogens themselves. The development of paresis and paralysis of the muscles is characteristic in connection with the blockade of the release of acetylcholine by the toxin in the nerve synapses.

Brief historical information
Under the names allantiasis (from gr. allantiksa - sausage), ichthyosis (from gr. ichtis - fish), the disease has been known since the 18th century, when cases of poisoning by fish and black pudding were recorded. The term "botulism" (from Latin botulus - sausage) was introduced by the Belgian bacteriologist E. Van Ermengem (1896), who isolated the pathogen from the intestines of a deceased patient. At the same time, as early as the 9th-10th centuries in Byzantium, and somewhat later in Germany, cases of illness associated with the use of black pudding were observed. In 1818, a nerve disease associated with eating smoked fish was described in Russia.

What Causes Botulism

Pathogen is a motile Gram-positive, strictly anaerobic, spore-forming bacterium Clostridium botulinum. In smears, it looks like sticks with rounded ends, arranged in random clusters or small chains. Under unfavorable conditions, it forms subterminal and terminal spores, in the form of which it persists in the environment. When dried, spores can remain viable for decades. There are 8 known botulism serovars - A, B, Ca2beta, D, E, F, G, however, in human pathology, serovars A, B, E and F dominate.

Optimum growth of clostridia and toxin formation occur under anaerobic conditions at a temperature of 35 °C. Vegetative forms of bacteria die at 80 °C within 30 minutes, and at boiling - within 5 minutes. Spores withstand boiling for more than 30 minutes and are destroyed only by autoclaving. The toxin (botulinum toxin) is rapidly destroyed by boiling, is resistant to pepsin and trypsin, withstands high concentrations (up to 18%) of table salt, and is not destroyed in products containing various spices. The presence of botulinum toxin in food products does not change their organoleptic properties. Botulinum toxin is one of the most powerful biological poisons. There may be cases of poisoning of people and animals with several toxins produced by bacteria of various serovars at once.

Epidemiology
Reservoir and sources of infection- soil, wild and synanthropic animals, waterfowl, fish and humans. The causative agent of botulism lives in the intestines of cows, horses, pigs, rabbits, rats, minks, chickens, wild waterfowl and many other representatives of the animal world. In this case, the carriage of pathogens usually does not cause visible harm to animals. A sick person does not pose an epidemiological danger to others. Bacteria are excreted from the body of infected animals (or humans) with feces and enter the soil, water, livestock feed, etc. Pollution of various elements of the external environment can also be caused by the decomposition of the corpses of rodents and birds that died from botulism.

Transfer mechanism- fecal-oral. The main cause of the disease is the consumption of home canned food, most often vegetables and mushrooms, as well as sausages, ham, smoked and salted fish contaminated with clostridia. Almost all food products contaminated with soil or intestinal contents of animals, birds, fish, may contain spores of botulism pathogens. However, the disease can only occur when eating foods stored under anaerobic conditions (canned food prepared at home). Wound botulism and botulism of newborns are much less common, which occurs in the latter when clostridium enters the intestine and produces a toxin. With injuries in crushed, necrotic tissues, deprived of oxygen access, conditions are created that are close to anaerobic, under which spores germinate and botulinum toxin accumulates. The toxin is well absorbed not only from the mucous membrane of the gastrointestinal tract, but also from the mucous membranes of the eyes and upper respiratory tract, which is a great danger if the toxin aerosol is used as a biological weapon.

Natural susceptibility of people high. Due to the fact that the toxin realizes activity in minimal doses, significant antitoxic immune reactions do not develop and antitoxic immunity is not produced.

Main epidemiological signs. Botulism is registered as sporadic and group diseases; often cases are familial as a result of eating contaminated home-cooked foods. They account for about 38% of all cases of the disease. Botulism is not characterized by a strictly pronounced seasonality. It should be noted that botulism due to the consumption of industrially produced food products has practically disappeared. In Ukraine, diseases associated with the use of home-cooked mushrooms, smoked or dried fish are more often recorded, in European countries - meat and sausage products, in the USA - canned beans. The relationship between the typical structure of pathogens and the nature of transmission factors has been determined. Infection after eating canned food from the meat of warm-blooded animals (stew, hams, sausages, etc.) is most often caused by bacteria of type B, from fish - by bacteria of types E and F, canned products of plant origin (pickled mushrooms, vegetables, fruits, etc.) - bacteria of types A and B. Local and national characteristics, traditions and customs in nutrition and methods of food preservation determine the unequal distribution of one or another type of pathogen in different territories. Clinical and epidemiological features of diseases caused by bacteria of different types are also expressed. The causative agent of type B causes intoxications with relatively low mortality and foci, which are distinguished by an extended incubation period, late hospitalization and the start of specific treatment. At the same time, type E bacteria cause lesions with a very high lethality (30% or more), with a predominance of severe clinical forms. In recent years, there has been a tendency towards an increase in morbidity, mortality and the number of outbreaks, which is due to the increasing pace and spontaneity of canning various types of products at home. Most often, the disease is registered among people 20-25 years old.

Pathogenesis (what happens?) during Botulism

In the vast majority of cases, human infection occurs when the toxin enters the gastrointestinal tract with food, but other ways of infection are possible (wound botulism, neonatal botulism). The good absorption of the toxin determines its highest concentration in the blood already on the first day, however, doses of the toxin that did not have time to contact the nervous tissue are completely eliminated from the body with urine by the 3-4th day. The pathogenetic mechanisms of the development of intoxication are still not clear enough. It is known that botulinum toxin reversibly disrupts carbohydrate metabolism in nerve cells, which ensures their energy regime. This disrupts the synthesis of choline acetyltransferase, which activates the formation of acetylcholine. As a result, the neuromuscular impulse weakens or disappears, reversible (in case of recovery) paresis or paralysis develop.

Botulinum toxin has an effect on the parasympathetic nervous system, inhibiting its activity, which is manifested by mydriasis, dry mucous membranes and constipation.

Many researchers classify botulism not as intoxication, but as a toxic infection, attaching importance to the pathogen. In particular, a rare long incubation period (up to 10 days) is explained by the germination of pathogen spores in the gastrointestinal tract, followed by the release of exotoxin by vegetative forms. In addition, the possibility of the development of vegetative forms from spores in purulent foci or "pockets" during injuries (wound botulism) has been established. These mechanisms maintain the concentration of the toxin in the patient's body for a long time, which should be taken into account when conducting serum therapy.

Symptoms of Botulism

Incubation period of botulism. In most cases, it is short and is 4-6 hours. However, in rare cases, it can be extended up to 7-10 days. This makes it necessary to monitor the health status of all persons who have eaten the product that caused the first case of the disease for 10 days.

Initial period. Symptoms of the disease can be vague, similar to a number of other diseases, which makes early diagnosis difficult. According to the nature of the main clinical manifestations of botulism in the initial period, the following options can be conditionally distinguished.
gastroenteric variant. There are pains in the epigastric region of a cramping nature, single or double vomiting of food eaten, loosening of the stool are possible. The disease resembles manifestations of food poisoning. Along with this, it should be borne in mind that with botulism there is no pronounced increase in body temperature and a strong dryness of the mucous membranes of the oral cavity develops, which cannot be explained by a slight loss of fluid. A common symptom during this period is difficulty in passing food through the esophagus (“lump in the throat”).
"Eye" option. It is manifested by visual disturbances - the appearance of fog, a grid, "flies" before the eyes, the clarity of the contours of objects is lost. In some cases, "acute farsightedness" develops, corrected by plus lenses.
A variant of acute respiratory failure. The most dangerous variant of botulism with lightning-fast development of acute respiratory failure (shortness of breath, cyanosis, tachycardia, pathological types of breathing). The death of the patient can develop in 3-4 hours.

The outbreak of illness. The clinical manifestations of botulism are quite characteristic and differ in a combination of a number of syndromes. With the development of the ophthalmoplegic syndrome, bilateral blepharoptosis, persistent mydriasis, diplopia, eyeball movement disorders (more often converging strobism), and vertical nystagmus can be observed. At the same time, the patient develops a syndrome of swallowing disorders, which is expressed in the difficulty of swallowing first solid and then liquid food (when you try to drink water, it pours out of the patient through the nose). The latter is due to paresis of the swallowing muscles. When examining the oral cavity, attention is drawn to the violation or, in more severe cases, the complete absence of mobility of the soft palate and tongue. There is no pharyngeal reflex, tongue movements are limited.

Phonation disturbances are characteristic, successively passing 4 stages. Initially, hoarseness of the voice or a decrease in its timbre appear, due to dryness of the mucous membrane of the vocal cords. In the future, dysarthria develops, explained by a violation of the mobility of the tongue (“porridge in the mouth”), followed by a nasal voice (paresis or paralysis of the palatine curtain), and finally complete aphonia occurs, the cause of which is paresis of the vocal cords. The patient does not have a cough push, which leads to an asthma attack when mucus or liquid enters the larynx.

In some cases, but not always, violations of innervation from the side of the facial nerve of the muscles of mimic muscles are detected: facial distortion, impossibility of teeth grin, etc.
At the height of the disease, patients complain of severe muscle weakness; their gait becomes unsteady ("drunk" gait). From the first hours of the disease, a pronounced dryness of the mucous membranes of the oral cavity is typical. Constipation associated with intestinal paresis develops. Body temperature remains normal and only occasionally rises to subfebrile numbers. Tachycardia is characteristic, in some cases a slight arterial hypertension is noted. Consciousness and hearing are completely preserved. Violations from the sensitive sphere do not happen.

Complications of botulism
With botulism, the fatal development of pneumonia is observed, primarily due to a decrease in the volume of external respiration in patients. However, the preventive prescription of antibiotics for botulism does not prevent the onset of this complication.

The most formidable complications, often leading to death, are respiratory disorders that can occur during any period of botulism. In the initial stage, they are distinguished by an increase in breathing up to 40 per minute, motor restlessness of the patient, retraction of the intercostal spaces, paralysis of the diaphragm, and involvement of the shoulder muscles in the breathing process. Already at this stage, it is necessary to transfer the patient to a ventilator.

With the introduction of heterogeneous anti-botulinum serum, anaphylactic shock may develop, and at a later date (on the 10-12th day after its use) - serum sickness.

Recently, there have been a number of reports of a fairly common occurrence of myocarditis as a complication of botulism. Its course in clinical manifestations and prognosis are similar to myocarditis in diphtheria.

Diagnosis of Botulism

Differential Diagnosis
Botulism should be distinguished from food poisoning, poisoning with henbane and poisonous mushrooms, bulbar form of poliomyelitis, diphtheria, stem encephalitis.

Of particular importance is the differential diagnosis of the disease in its initial period. With botulism, dyspeptic phenomena are possible (gastroenteric variant of the disease), but there is no pronounced increase in body temperature; characterized by severe dry mouth, often noted difficulty in swallowing ("lump in the throat"). In other variants of the initial period of botulism, visual disturbances (“eye variant”) or acute respiratory failure develop rapidly at normal body temperature. At the height of the disease, significant muscle weakness, severe dryness of the mucous membranes of the oral cavity, and constipation are characteristic. Patients simultaneously develop manifestations of the ophthalmoplegic syndrome, swallowing disorders, successive phonation disorders (hoarseness - dysarthria - nasality - aphonia); in some cases, pathology of the facial nerve is detected. Violations from the sensitive sphere do not happen.

Laboratory diagnostics
Currently, there are no laboratory tests that allow the identification of botulinum toxin in human biological media in the early stages of the disease. The goals of bacteriological studies are the detection and identification of the toxin; isolation of the pathogen is carried out at the second stage. To do this, put a biological sample on laboratory animals (white mice, guinea pigs). A batch of 5 animals is selected for the experiment. The first is infected only with the test material, the rest - with the test material with the introduction of 2 ml of 200 AU antitoxic serum of types A, B, C and E. In the presence of a toxin in the material, the animal that received the antiserum that neutralized the toxin of the corresponding type survives. For express indication of toxins, RPHA is put with an antibody diagnosticum (erythrocytes sensitized with antitoxins of the corresponding types).

Modern promising methods are based on the indication of antigens in ELISA, RIA or PCR.

Isolation of the pathogen does not give grounds for confirming the diagnosis, since spores of C. botulinum may germinate, which can be found in the intestines of a large number of healthy people.

Botulism Treatment

Due to the threat to life, hospitalization of patients is necessary in all cases, even if botulism is suspected. Patients are referred to any hospital where there is equipment for mechanical ventilation.

Therapeutic measures begin with gastric lavage with a thick probe; during the procedure, it is necessary to make sure that the inserted probe is in the stomach, given the fact that in the absence of a pharyngeal reflex, the probe can be inserted into the respiratory tract. Gastric lavage is advisable to carry out in the first 1-2 days of illness, when contaminated food can still remain in the stomach.

To neutralize the toxin on the territory of Ukraine, polyvalent antibotulinum sera are used in a single initial dose of type A - 10,000 IU, type B - 5000 IU, type E - 10,000 IU, sometimes type C - 10,000 IU. Serum is administered intravenously or intramuscularly after preliminary desensitization (Bezredka method). When administering serum intravenously, it must first be mixed with 250 ml of saline, heated to 37 ° C. In most cases, a single administration of the above doses of serum is sufficient. If 12-24 hours after the end of its administration, the patient develops neuroparalytic disorders, the administration of serum should be repeated at the initial dose.

The use of human antibotulinum plasma has a fairly good clinical effect, but its use is difficult due to the short shelf life (4-6 months). There is evidence of the efficacy of human botulinum immunoglobulin.

Simultaneously with the introduction of anti-botulinum serum, massive detoxification therapy is carried out, including intravenous drip infusion solutions. It is desirable to use compounds based on polyvinylpyrrolidone (hemodez, rheopolyglucin, etc.), which adsorb freely circulating botulinum toxin well and excrete it through the kidneys with urine.

Due to the fact that the patient cannot swallow, he is fed through a thin probe. Food should be not only complete, but also necessarily liquid, passed through the probe. It is undesirable to leave the probe until the next feeding, since with dry mucous membranes, the rapid development of bedsores is possible.

Given the toxic-infectious nature of the disease and the possibility of developing vegetative forms of the pathogen from spores in the gastrointestinal tract, the patient is prescribed antibiotics. The drug of choice is levomycetin at a daily dose of 2.5 g for a course of 5 days.

The complex of treatment of patients includes the appointment of a 3% solution of adenosine triphosphoric acid (ATP) and cocarboxylase. There are reports of a fairly good therapeutic effect of hyperbaric oxygen therapy. With the development of pneumonia, antibiotic therapy is carried out according to generally accepted schemes. At the first signs of the onset of respiratory disorders, the patient should be transferred to a ventilator. After the disappearance of signs of intoxication, for a faster recovery of the neuromuscular apparatus, it is possible to use physiotherapeutic procedures.

Prevention of Botulism

Epidemiological surveillance basically similar to that in intestinal infections, includes bacteriological control of food raw materials used in the preparation of meat, fish and vegetable canned food, monitoring compliance with their sterilization regimen. The sale of canned food in the distribution network, their appearance (bombing) and the timing of implementation are subject to systematic control. The incidence analysis is carried out taking into account the type of pathogen and the type of food product. There remains a need to improve methods of laboratory control of food products and diagnosis of the disease.

Prevention of botulism is based on strict observance of sanitary and technological rules of food preservation. Meat and fish can only be preserved fresh. Vegetables and fruits must be thoroughly washed before canning to remove soil particles. It is also unacceptable to preserve overripe fruits. It is necessary to strictly observe the guarantee sterilization regime. Sterilization should be carried out in autoclaves, since high pressure and high temperature (120 ° C) destroy not only bacterial cells and toxin, but also spores. At home, plant products can be prepared for the future only by pickling or salting with the addition of a sufficient amount of acid and salt, and always in a container open to air. Of great importance is the prevention of botulism in the distribution network. The most important point is compliance with the storage conditions for perishable products. Spoiled (with bombing) and expired canned food should not be allowed into the trading network. An important role is played by explanatory work among the population about the danger of botulism and the rules for preserving food at home.

Activities in the epidemic focus
Hospitalization of the patient is carried out according to clinical indications. It is recommended to discharge patients from the hospital no earlier than 7-10 days after clinical recovery. If cases of the disease are detected, suspicious products are subject to seizure and laboratory examination, and the persons who used them are subject to medical observation for 10-12 days. It is advisable to give them intramuscular anti-botulinum serum containing 2000 IU to toxins A, B and E, as well as the appointment of enterosorbents. Active immunization has not found wide application.

Which Doctors Should You See If You Have Botulism

Infectionist

Promotions and special offers

medical news

07.05.2019

The incidence of meningococcal infection in the Russian Federation in 2018 (compared to 2017) increased by 10% (1). One of the most common ways to prevent infectious diseases is vaccination. Modern conjugate vaccines are aimed at preventing the occurrence of meningococcal disease and meningococcal meningitis in children (even very young children), adolescents and adults.

25.04.2019

A long weekend is coming, and many Russians will go on vacation outside the city. It will not be superfluous to know how to protect yourself from tick bites. The temperature regime in May contributes to the activation of dangerous insects ...

18.02.2019

In Russia, over the past month there has been an outbreak of measles. There is more than a threefold increase compared to the period of a year ago. Most recently, a Moscow hostel turned out to be the focus of infection ...

Medical Articles

Almost 5% of all malignant tumors are sarcomas. They are characterized by high aggressiveness, rapid hematogenous spread and a tendency to relapse after treatment. Some sarcomas develop for years without showing anything ...

Viruses not only hover in the air, but can also get on handrails, seats and other surfaces, while maintaining their activity. Therefore, when traveling or in public places, it is advisable not only to exclude communication with other people, but also to avoid ...

Returning good vision and saying goodbye to glasses and contact lenses forever is the dream of many people. Now it can be made a reality quickly and safely. New opportunities for laser vision correction are opened by a completely non-contact Femto-LASIK technique.

Cosmetic preparations designed to care for our skin and hair may not actually be as safe as we think.

In many regions of the country, mushrooms are often called the “third bread” (after the bread itself and potatoes), so these gifts of the forest are loved and popular.

But sometimes when cooking some dishes with them, there is a serious danger of "getting" a deadly toxic-infectious disease - botulism, because of the fear of which many housewives tend to refuse to cook mushroom food at all. But, if you have complete information about the disease, botulism in mushrooms will not become a real threat to the health and life of true lovers of these natural gifts.

Botulism - what is it

The causative agents of the disease - botulinum sticks (Clostridium Botulinum) are initially found in the soil, and since mushrooms grow on it, there is a very high risk of collecting and bringing home particles of contaminated land along with the "trophy".

Once in the human body, the bacteria begin to develop either rapidly (signs of botulism appear after 6 hours), or gradually (on the 3rd day). In any case, there is not a minute to lose, because the symptoms of the disease increase very quickly and with a high rate of deterioration.

How to identify botulism? In fact, its signs are very characteristic, and even a non-physician may well understand that pathogenic botulinum bacilli have raged in the body:

legs are “wadded” (or hurt);
dizziness/headache;
stomach ache;
nausea, vomiting;
diarrhea, later turning into constipation;
vision problems (double vision or blurred vision);
ptosis (violation of the blinking reflex with drooping of the upper eyelid);
dilated pupils, dry eyes;
difficulty speaking, weakness of the voice;
a feeling of tightness in the throat with a violation of the swallowing reflex;
dryness in the nose;
unsteady (shaky) gait;
muscle weakness;
progressive paralysis, "capturing" the peripheral and then the central nervous system;
paralysis of the lungs leading to death.

The symptoms are really terrible, but the disease can be caught at the beginning of its development. However, such poisoning is quite difficult to treat in time.

The bacteria themselves are not dangerous. The main threat is the poison botulinum toxin produced by them.

Why mushrooms can be dangerous

As already mentioned, mushrooms grow directly on the ground. And if the gifts of the forest are collected in an infected place, sticks with soil will certainly be delivered home. Naturally, mushrooms must be washed before cooking, but if lamellar russula, volushki or milk mushrooms can still be somehow cleaned with a jet of water, then spongy boletus, boletus or butter mushrooms are almost impossible even for several times.

And if microscopic particles of earth infected with botulism spores remain in the fungus, the risk of poisoning increases significantly.

But the risk is not guaranteed, so it is obviously wrong to assume that fungal infectious botulism necessarily "traps" every mushroom picker. It is never and under no circumstances possible to get poisoned if the gifts of the forest are prepared as follows:

boiled and fried;
boiled, frozen and then fried;
dried and boiled.

The reason why botulism will not develop in mushrooms prepared in this way is the access of oxygen, in which the spores are in an inactive state. That is, in fact, there are no favorable conditions for the normal functioning of the sticks.

Conditions ideal for the development of botulism spores

Unfortunately, the spores and bacteria of botulism are very resistant to external factors. They are not afraid of ultraviolet radiation, lack of humidity and heat. In an inactive state, they survive in the soil at any time of the year and under different weather conditions. But how does botulism develop in blanks, and why does the bacteria “wake up”?

How to understand if mushrooms are infected

Infected blanks do not differ from normal ones either in appearance, smell, or taste, so it is almost impossible to understand whether botulism develops in mushrooms or not. This answer could have been limited, if some signs, noticing which the bank can and should be immediately thrown away:

Bombing. If the lid on the glass jar is swollen, this can also be a sign of the active life of bacteria that cause poisoning. Sometimes it even comes to the spontaneous opening of the lids under the pressure of accumulated toxins inside the jar.
Cloudy marinade or brine. If the transparency of the liquid is lost, the bacteria have already poisoned the contents.
Air bubbles. If small bubbles are seen rising from the bottom of a hermetically sealed jar to its top, such blanks can no longer be eaten.
Mold. Mold itself is not a sign of botulism, but it is formed in conservation that has not undergone enough heat treatment (and this is one of the prerequisites for the development of botulism bacteria).

Additional reasons for the ejection of blanks may be a foreign smell or a strange taste of mushrooms. But these reasons, like the signs listed above, are not direct evidence that there really is botulism in the bank.

As already mentioned, mushrooms poisoned with a botulinum stick cannot be distinguished from normal ones. All that can be done is to take the product to the laboratory for analysis, but this, unfortunately, is rarely practiced.

And all suspicious signs can also be due to the activity of completely different bacteria, which also provoke mushroom poisoning, but here we are not talking about the disease in question. Although other microorganisms are not alien to good neighbors with the botulinum bacillus, therefore, by throwing away suspicious preservation, you can simultaneously save yourself and loved ones not only from botulism, but also from poisoning of a different etiology.

How to avoid poisoning

How to avoid botulism is vital information, the neglect of which can end very scary. Only the strictest observance of certain rules when harvesting mushrooms will not allow spores to become active and make the product dangerous:

In the forest, try to cut the mushrooms not at the very base, but a little higher. This will capture a much smaller amount of potentially contaminated soil.
Peel mushrooms on the day of returning from the forest, without postponing for tomorrow. After that, thoroughly rinse everything several times (preferably with running water).
Boil the mushrooms for 30-40 minutes.
Sterilize jars where salted or pickled mushrooms will be placed. Covers are subjected to the same treatment.
Don't roll up the banks! To close them, use either polyethylene lids or sheets of parchment. This will ensure the access of oxygen inside the container and will not allow the bacteria to “come to life”, therefore, botulism in mushrooms will not develop.
When salting, withstand milk mushrooms and waves in "breathing" wooden tubs under oppression (number of days - according to the recipe). Salt should not be small, the contents of the tub must be periodically mixed in order to “pass” oxygen inside. If there is not enough salt (less than 18% relative to the mass of the workpiece), botulism in salted mushrooms will develop more likely.
Botulism in pickled mushrooms will not be so likely if the proportion of vinegar and salt is strictly observed. It is these components that partially neutralize the activity of bacteria (in salted mushrooms, the role of the neutralizer falls only on salt).
On each closed jar, make a note indicating the production time so that the workpiece is not stored for more than a year.
Store the finished preservation below 6 °C (refrigerator or cellar).

Before using canned mushrooms, subject them to heat treatment (boil);
In no case should you buy mushroom preparations from strangers, whose integrity is unknown or clearly in doubt.

Finally, especially ardent mushroom lovers would like to advise additionally: if you are not sure that the snacks will be prepared safely, it is better not to risk it.

There is always a choice: mushrooms can be harvested in different ways (freeze, dry), and from them you can already create no less original dishes. And if the soul lies precisely in pickles and pickled snacks, it is better to buy industrial products in the store, because when it comes to botulism, it is advisable to use all the ways to avoid it.

The term "botulism" comes from a Latin word meaning "sausage". Such an interesting comparison of an infectious disease with an alimentary product arose because in 1822 sausages were considered the cause of infection.

This was explained by the fact that they allegedly contain a dangerous fatty acid. But only in 1897 was a true causal relationship established, revealing why the disease develops when eating sausages. This sensational discovery was made by Ermengen, who isolated a bacterial toxin.

Botulism, what is it?

Botulism is an acute infection in which pathological processes in the body are associated with the exotoxin of botulinum clostridia. Paralysis of skeletal and smooth muscles are considered typical clinical manifestations.

The latter is localized in the internal organs. Its paralysis can lead to the development of acute pulmonary insufficiency, with the involvement of the respiratory muscles in the pathological process.

Botulism is thought to be a neurotoxin produced by Clostridium. It causes damage to the nervous system, which leads to paralysis. Currently, 8 serological types of this toxin are known, and in the antigenic ratio they are completely different.

This means that the formation of antibodies to one type of toxin does not protect against others. Currently, botulinum toxin is recognized as the most powerful biological poison. Its toxicity is compared with sarin, which it exceeds by 20-100 thousand times.

Under adverse conditions, the causative agents of botulism form spores that allow them to remain viable for a long time. These "protective" forms are widely distributed in soil, water, rotting plants and animal carcasses. However, they do not cause disease.

The most common way that botulism poisoning occurs is by eating unsuitable canned food, especially home-cooked food. This is due to the incredible resistance of spores to environmental factors:

they withstand boiling for 5 hours;
salt concentration up to 18% does not kill them;
in an acidic environment (pH over 4.7), they remain viable;
do not die even with severe freezing (up to -190 ° C);
direct ultraviolet rays are indifferent to them.

However, the clinical symptoms of botulism can only be caused by a toxin that is secreted by vegetative forms (spores do not form it). The danger arises when the spores germinate and the pathogen multiplies under suitable conditions.

The latter include:

lack of oxygen;
sufficient temperature conditions;
a certain level of acidity of the environment;
the presence of other microbes, etc.

In order for the disease to develop, all these factors must be present - only their combined action leads to the formation of botulinum toxin. For this reason, botulism is not a common pathology.

In most cases, botulinum toxin is present in the preservation, which is the source of infection. When eating fresh food, poisoning is impossible, even if it contains spores. They are not toxin-producing.

Sources and methods of entry of bacterial toxin into the body can be different. On this basis, four main forms of the disease are distinguished:

Food, developing when the toxin enters the food in which it is already contained.
Wound - the toxin is formed in anoxic conditions of a wound infected with clostridia.
Infantile, which can only develop in children under 12 months of age as a result of the absorption into the bloodstream of a toxin formed in the intestine due to the germination of spores.
Botulism in children older than 12 months and adults (there are a few reports of this variant in the literature), which is also associated with the formation of toxins in the intestine.

Foodborne botulism is the most common form. Infection most often occurs through the use of products such as:

canned food, especially home-cooked;
smoked meats;
dried products;
fish products;
canned mushrooms.

The main condition when a disease can occur is eating only those products that were stored without oxygen (or with a slight supply of it) and which were not pre-treated thermally (at the proper temperature for a certain time).

So, at home it is not possible to achieve the death of disputes, because. it is not possible to create a high pressure and temperature of 120 ° C. At the same time, there are no signs of botulism in the preservation - the dishes do not have an unpleasant odor, they look normal outwardly, so it is impossible to calculate the infected products organoleptically.

The first signs of botulism, the incubation period

The first clinical signs of botulism appear after an incubation period that lasts from 6 hours to 10 days. Its average duration is from 18 to 36 hours.

The onset of the disease can be either acute or gradual. The severity of symptoms also varies. In some cases, they can be mild, while in others they can be significantly pronounced. In most cases, patients are engaged in self-diagnosis, referring to various specialists - depending on what hurts. However, this approach only leads to a delay in time.

The common features of botulism that distinguish it from other diseases are:

lack of fever (for acute infections, fever is almost always characteristic);
symmetrical development of neurological symptoms;
lack of depression and loss of consciousness, except in cases of acute respiratory failure;
no sensory disturbances.

The first suspicious signs of botulism are:

dry mouth;
difficulty seeing closely spaced objects;
Difficulties in reading regular font, which was previously easily perceived;
a grid appears before the eyes;
doubling of the objects in question (see photo).

In some patients, this stops the progression of clinical symptoms, and the person recovers. As a rule, he does not seek medical help and these cases of the disease remain unrecorded. With a more severe course, the initial symptoms worsen and new signs of the disease appear. These include:

changes in the voice - it becomes rough and hoarse;
speech becomes unclear and slurred with a characteristic French pronance;
there is a lump in the throat;
choking;
insufficient formation of saliva, which further aggravates the manifestations of dysphagia;
severe muscle weakness (a person does not want to do anything because of muscle weakness);
constipation associated with paralysis of the intestinal muscles;
difficulty urinating, etc.

Neurological symptoms of botulism are dominant. In some cases, there may be an increase in body temperature. This is due to the presence of other bacteria in food, which can additionally provoke gastrointestinal syndrome. It shows up:

nausea and vomiting;
diarrhea
pain in the abdomen.

However, these signs are not specific to botulism. They can either be present or absent, so they are not taken into account in the diagnosis. These symptoms may appear before neurological disorders or already against their background.

Damage to the nervous system is characterized by a number of symptoms:

symmetry of disorders;
descending weakness, which in severe cases turns into paralysis;
involvement of the muscles of the trunk and neck, arms and legs.

Severe intoxication leads to severe ophthalmic manifestations and bulbar paralysis. During this period, the risk of aspiration of food, saliva and water increases, which leads to the development of aspiration syndrome, manifested by purulent tracheobronchitis and pneumonia.

A patient with botulism has a characteristic appearance:

adynamic;
masking of a face that is devoid of facial expressions;
bilateral drooping of the eyelids (sometimes can be unilateral);
dilated pupils, which practically do not react to light;
floating look;
strabismus;
dryness of the oral mucosa;
inactivity and unsteadiness of gait;
breathing is rapid and weakened;
pallor of the skin associated with a drop in pressure;
bloating due to intestinal paresis.

In the general clinical analysis of blood, deviations from the norm are minimal. However, monocytosis is a characteristic hematological finding. An increase in the number of leukocytes and neutrophils, as well as an acceleration of ESR, are suspicious of purulent inflammation.

Diagnosis of botulism

The final diagnosis is based on clinical data and the results of an epidemiological investigation. The presence of neurological disorders can lead to diagnostic errors when botulism is mistaken for a disease of the nervous system. At the same time, the doctor takes into account the signs that exclude botulinum toxin poisoning. These include:

the presence of tension in the occipital muscles;
sharp pains in the head;
pathological signs in the cerebrospinal fluid;
paralysis of central origin;
sensory disturbances;
convulsions;
loss of consciousness;
mental disorders.

In difficult cases, laboratory diagnosis may be required. It includes the detection of botulinum toxin in the blood, vomit, as well as in foods that may have caused poisoning. for this disease is currently under development.

Treatment of botulism is carried out without delay, because. respiratory resuscitation may be necessary. The main therapeutic areas for this bacterial poisoning are:

1) Gastric lavage if no more than 72 hours have passed since the moment the contaminated food entered the body. At the first stage, it is carried out with boiled water, and at the second - with the addition of soda, which neutralizes the toxin.

Gastric lavage should not be performed if there is paresis of the pharyngeal and laryngeal muscles, because. the contents of the stomach can enter the respiratory tract.

2) Introduction antitoxic antibotulinum serum. You should not hesitate, because. serum can only neutralize the toxin that circulates in the blood until it has contacted the nerve endings.

Before the introduction of toxoid, a skin test is required, because. there may be cases of allergic intolerance. If the test is positive, then the serum can be administered only for health reasons.

3) Application equine immunoglobulin is a promising therapeutic area. It can also be used for preventive purposes, developments in this direction continue.

4) Symptomatic therapy– desensitization, vitamins, detoxification, artificial pulmonary ventilation, antibiotics, etc. The choice of one or another method (means) depends on the specific clinical symptoms.

Complications of the disease

Direct complications of botulism are:

pneumonia of aspiration origin;
areas of collapse of the lung (atelectasis);
purulent tracheobronchitis;
sialadenitis, purulent form (inflammation of the salivary glands).

The addition of a secondary bacterial infection, which significantly aggravates the course of the disease, is observed with the use of invasive methods of treatment. Thus, the risk of purulent processes increases with tracheal intubation, tracheostomy, artificial pulmonary ventilation and bladder catheterization.

Drug therapy may be complicated by the development of serum sickness. It develops in children approximately 8-10 days after the introduction of anti-botulinum serum. Its main mechanism is immune. Symptoms of serum sickness usually appear when clinical neurological symptoms regress.

Prevention of botulism

Prevention of botulism is based on strict observance of the rules for the manufacture and storage of canned food, as well as meat and fish semi-finished products.

It should be remembered that the use of home canned food is especially dangerous, in which the spores that have fallen can not die. Therefore, to avoid infection, it is recommended to boil homemade canned food for 15 minutes before eating.

This will completely neutralize the botulinum toxins. Persons who have consumed unknown products must be under medical supervision for 12 days to detect the very first signs of illness.

When making canned food at home, it is recommended to adhere to the following rules:

canned food should not be made from greens, meat, mushrooms and fish;
vegetables that do not contain natural acid (green peas, cucumbers) require its artificial introduction (therefore, vinegar or citric acid is added);
do not preserve spoiled vegetables and fruits that have been lying for a long time;
procure only pure processed raw materials;
carefully process jars and lids, observing the temperature regime;
optimal storage temperature from 3 to 6°С;
timely reject bombed canned food.

The introduction of the vaccine (specific prophylaxis) is indicated only for those persons who can come into contact with botulinum toxin. To create a strong immunity, three vaccinations are necessary.

Bacterial infection with anaerobic microorganisms Clostridium botulinum is classified as foodborne infectious poisoning, since the main way they enter the body is through food (various canned food, dried fish, smoked artisanal meat).

Botulinum toxin, produced by activated spores of bacteria, is the strongest organic nerve agent that does not have a clear taste, color, smell, or other recognition factors, and therefore is especially dangerous for humans.

During the years of the Cold War, the theory of using Clostridium botulism spores (as well as tetanus bacteria) as a biological weapon was seriously developed in the United States. The idea of biological destruction of the enemies of the Yankees was abandoned, but the strategic secret stock of "sleeping" microorganisms, perhaps somewhere, awaits its X-Hour. But not everything is so bad - today botulinum toxins have been put on guard of health in the beauty industry: Botox injections return the graceful young features of the facial oval to old women who want to shine at 35 at the age of 70.

How does botulism manifest itself in humans? Distinctive signs of poisoning are spastic pain in the abdomen, vomiting, muscle weakness, flatulence with constipation.

Then there may be a split in the eyes and a sensation of a lump in the throat that interferes with swallowing. Signs of botulism disease can appear after only a couple of hours, and after 24 hours (up to 5 days) after eating spoiled foods containing poison.

In order to prevent the active reproduction of pathogenic bacterial flora and the penetration of botulinum toxins into the blood, it is important to immediately carry out a plentiful lavage of the stomach cavity, take an antidote recommended by the doctor. A mild form of botulism does not cause much harm to the digestive organs and nervous system, the treatment is quick and painless. The recovery period after severe intoxication botulism takes a year or even more.

How and why poisoning occurs

As long as the bacteria and spores of Clostridium botulinum live in the environment (soil, silt, water), they are not dangerous to humans.

As soon as they enter the body with food (together with earth, silt, sand), they quickly become active. This usually occurs with insufficient heat treatment in the depths of the layers of the pulp of dried fish, meat, stew, as well as fruits, vegetables, mushrooms, canned without the addition of acid.
In the process of vital activity, pathogenic Clostridia of botulism begin to produce the strongest poison (botulinum), which destroys blood cells and the nervous system. There is a disconnection of neuromuscular connections, a person may stop breathing and refuse the heart.

The minimum amount of botulinum toxin that can accumulate in a can of stew, canned fish or salted mushrooms in less than 1 month is enough to poison everyone who just tastes the products - the rate of formation of the toxin is so high.

How to recognize jars with botulism? Visually, this is almost impossible. If in canned food of industrial production swollen lids, mixed friable consistency of the product become a criterion for assessing the good quality of the product, then it is difficult to notice damage in home-made preparations - the appearance of the container may remain unchanged.

Clostridia botulinume are invisible without a microscope, imperceptible to the taste, except for the bitterness from the toxins in the canning oil.

Danger of household and industrial products

How can you get botulism? It is important to determine the highest likely risk of poisoning, where it can most often develop:

The rating for the threat of infection is headed by canned mushrooms (without the addition of vinegar) at home. Provoking factors are dishonest washing of forest gifts, lack of heat treatment (clostridia spores from the soil get into conservation, begin active life, quickly producing botulinum).
The second place in food poisoning with botulinum toxins belongs to canned vegetables, fruits, on which bacteria could get from the soil, and also those with low natural acidity. Information about the rapid death of spores of Clostridium botulism during home sterilization is greatly exaggerated - the boiling point is not enough, even with heat treatment for more than 1 hour.
The botulism stick is very stable, withstands 4 hours of domestic boiling. To destroy the spores, you need an autoclave with a temperature of 120 degrees or more.
Fruits and berries growing on trees cannot cause botulism in humans, provided that they are removed from the tree and did not come into contact with the soil during collection, transportation, storage. Berries located close to the ground (blueberries, blueberries, strawberries) should be harvested with caution.
Violation of sanitary rules for processing, trade in products from dirty trays of spontaneous markets near shops and from land near railway stations is a direct path to the development of a pandemic in any locality. That is why the police kick out old women with jars of compotes and mushrooms: so that the population does not become infected with botulism, disinteria, and so on, and not because law enforcement officers want to improve the improvement of the territory.
No less often (than mushrooms) poisonings are registered when using smoked, dried fish (meat products), as well as semi-finished products and canned food made from these products at home or in handicraft shops.
Unfortunately, there are cases of infection with botulism through honey. Rod spores get into bee products with plant pollen.
Botulism can develop when pathogenic microorganisms enter wounds of a person received in an accident, a fight, or other cases of falling to the ground.

Is there an antidote that prevents the rapid activity of botulism in humans in the body, and how to avoid poisoning?

According to medical journals, Maryland scientists have created an antidote for botulism. This is a specific plant protein that can recognize, attract and block botulinum toxins, as a result of which there is no damage to the central nervous system, paralysis does not occur. The infected suffer a mild degree of poisoning without negative consequences.

For canning at home, it is imperative to use acetic acid, it causes the partial destruction of the protein neurotoxin. Banks for blanks must be disinfected with a solution of baking soda before sterilization.

Food must be stored at low temperatures to prevent the growth and reproduction of bacteria.

How to distinguish botulism by symptoms of poisoning

Before the first signs of poisoning with botulinum toxins appear, in some cases it takes 2 hours, in others - more than 2 days. It is believed that the shorter the incubation period, the more difficult the course of the disease.

Initial symptoms of the disease

In the first phase of bacterial development, there is a so-called nested infection, when among the mass of the product there are areas clear of toxins, therefore, slight but dangerous poisoning can occur.

Sickness and causes of death

After a day or two of infection, the onset and intensification of neurological symptoms are noted:

increased sensation of muscle weakness;
increased dryness of the mucous membranes of the mouth and skin;
pupils dilate, vision is impaired - the reaction to light weakens;
development of paralysis of striated muscles begins;
followed by paralysis of the muscles of the larynx (aphonia);
then the paralysis of the muscles of the neck, chewing, hands, and further progresses.

As a result, without medical intervention, with a complete failure of the functioning of the muscle group, death occurs from asphyxia due to paralysis of the respiratory system. This can happen both on the third and tenth day after the poison has entered the saliva, stomach, blood, depending on the dose of botulinum toxin received and the state of the body.

The cause of death is frivolity in relation to food poisoning: unwillingness to figure out why intoxication occurs, what it can cause, untimely access to a doctor.

Comparison of signs of botulism and other food poisoning

Meanwhile, the differences by which it is easy to recognize botulism in comparison with other food poisoning are the following main symptoms:

no fever occurs
consciousness is not lost
the pulse can be either slow or normal,
intoxication increases without loss of sensitivity,
there is a presence of respiratory failure due to paresis,
neurological pathologies increase symmetrically,
there is constipation due to paresis of the gastrointestinal tract (diarrhea in botulism can only be caused by concomitant infection with other bacteria).

The pathogenesis of botulism: the progression of toxicoinfection of botulism in adults is accompanied to a greater extent by signs of neurological disorders of the central nervous system, while the gastrointestinal symptoms of the disease remain of secondary importance.

Complications of toxic infection of botulism

The consequences of poisoning often become diseases of the respiratory tract (bronchitis, pneumonia, pleurisy), which is due to paresis of the muscular frame of the nasopharynx, trachea, and bronchi.

Respiratory failure after botulism is accompanied by shortness of breath, asthma attacks, a lack of oxygen is formed, which leads to cardiac pathologies: a decrease in pressure, tachycardia, fainting, loss of consciousness.

A complication of botulism is a decrease in salivation, which provokes the growth of staphylococcal and streptococcal pathogenic flora, causing inflammation of the parotid glands (mumps).

Help for botulism, provided in a timely manner, predisposes to the disappearance of organ obstructions, the cure of heart diseases that have arisen against the background of poisoning. If vision is partially affected during intoxication, its recovery occurs quite quickly as the toxin is removed from the blood.

Preventive safety conditions

How not to get botulism? Today, the botulism bacterium is practically not found in industrial foodstuffs. Toxin poisoning arises from the consumption of products of individual entrepreneurs, who attract cheap, and therefore terribly lazy, labor to the manufacture of canned meat and fish preserves.

But you can get poisoned not only with smoked meat or dried fish. Black and red caviar from fish caught in the nets of poachers is a very common source of infection with botulism bacteria, ending in terrible consequences: disability from blindness or death.

Prevention of botulism is to eliminate the factors that cause the possibility of infection. In order not to get sick with botulism, you need to follow simple rules:

in the forest - cut off the legs of mushrooms high from the ground, but rather collect only hats;
in the garden - put a film under a low creeping berry;
thoroughly wash the crop, while changing the water 3-4 times;
vinegar for pickles and pickles should be added to a jar filled with food and brine, and not boiled in advance;
all dishes should shine with a brilliance of perfect cleanliness;
re-screw caps should not be used;
it is unacceptable to reduce the process of sterilization of canned food;
avoid buying expired goods;
do not buy canned products, dried corned beef, mushrooms, jam from spontaneous markets, near stations and shops, as botulism caused by spores from the ground is very dangerous.

If, after some time after processing the products, turbidity and bubbles form in the jar, you should never use conservation. Feel free to throw in the trash products with swollen lids, even if their surface is skewed by a few millimeters.

In products spoiled by other foodborne infections, the likelihood of the presence of botulinum toxins increases many times over.

How to protect yourself from botulism? Every year, SES and Rosnadzor publish warning-memos on websites: what kind of disease is botulism and its prevention, but the symptoms of botulism and their manifestation at the initial stage are almost indistinguishable from other food poisoning, so people prefer not to go to doctors.

If problems with weakness in the muscles begin, double vision, a lump is felt in the throat - urgently call an ambulance, as these are the first symptoms of botulism.

Online Tests

Drug addiction test (questions: 12)
Whether it's prescription drugs, illegal drugs, or over the counter drugs, once you become addicted, your life begins to spiral downhill and you drag those who love you with you...

Botulism

What is Botulism -

Brief historical information

Under the names allantiasis (from gr. allantiksa - sausage), ichthyosis (from gr. ichtis - fish), the disease has been known since the 18th century, when cases of poisoning by fish and black pudding were recorded. The term "botulism" (from Latin botulus - sausage) was introduced by the Belgian bacteriologist E. Van Ermengem (1896), who isolated the pathogen from the intestines of a deceased patient. At the same time, as early as the 9th-10th centuries in Byzantium, and somewhat later in Germany, cases of illness associated with the use of black pudding were observed. In 1818, a nerve disease associated with eating smoked fish was described in Russia.

What provokes / Causes of Botulism:

Epidemiology

Reservoir and sources of infection- soil, wild and synanthropic animals, waterfowl, fish and humans. The causative agent of botulism lives in the intestines of cows, horses, pigs, rabbits, rats, minks, chickens, wild waterfowl and many other representatives of the animal world. In this case, the carriage of pathogens usually does not cause visible harm to animals. A sick person does not pose an epidemiological danger to others. Bacteria are excreted from the body of infected animals (or humans) with feces and enter the soil, water, livestock feed, etc. Pollution of various elements of the external environment can also be caused by the decomposition of the corpses of rodents and birds that died from botulism.

Pathogenesis (what happens?) during Botulism:

Botulinum toxin has an effect on the parasympathetic nervous system, inhibiting its activity, which is manifested by mydriasis, dry mucous membranes and constipation.

Symptoms of Botulism:

Incubation period of botulism

In most cases, it is short and is 4-6 hours. However, in rare cases, it can be extended up to 7-10 days. This makes it necessary to monitor the health status of all persons who have eaten the product that caused the first case of the disease for 10 days.

Initial period

Symptoms of the disease can be vague, similar to a number of other diseases, which makes early diagnosis difficult. According to the nature of the main clinical manifestations of botulism in the initial period, the following options can be conditionally distinguished.

gastroenteric variant. There are pains in the epigastric region of a cramping nature, single or double vomiting of food eaten, loosening of the stool are possible. The disease resembles manifestations of food poisoning. Along with this, it should be borne in mind that with botulism there is no pronounced increase in body temperature and a strong dryness of the mucous membranes of the oral cavity develops, which cannot be explained by a slight loss of fluid. A common symptom during this period is difficulty in passing food through the esophagus (“lump in the throat”).
"Eye" option. It is manifested by visual disturbances - the appearance of fog, a grid, "flies" before the eyes, the clarity of the contours of objects is lost. In some cases, "acute farsightedness" develops, corrected by plus lenses.
A variant of acute respiratory failure. The most dangerous variant of botulism with lightning-fast development of acute respiratory failure (shortness of breath, cyanosis, tachycardia, pathological types of breathing). The death of the patient can develop in 3-4 hours.

The height of the disease

The clinical manifestations of botulism are quite characteristic and differ in a combination of a number of syndromes. With the development of the ophthalmoplegic syndrome, bilateral blepharoptosis, persistent mydriasis, diplopia, eyeball movement disorders (more often converging strobism), and vertical nystagmus can be observed. At the same time, the patient develops a syndrome of swallowing disorders, which is expressed in the difficulty of swallowing first solid and then liquid food (when you try to drink water, it pours out of the patient through the nose). The latter is due to paresis of the swallowing muscles. When examining the oral cavity, attention is drawn to the violation or, in more severe cases, the complete absence of mobility of the soft palate and tongue. There is no pharyngeal reflex, tongue movements are limited.

In some cases, but not always, violations of innervation from the side of the facial nerve of the muscles of mimic muscles are detected: facial distortion, impossibility of teeth grin, etc.

At the height of the disease, patients complain of severe muscle weakness; their gait becomes unsteady ("drunk" gait). From the first hours of the disease, a pronounced dryness of the mucous membranes of the oral cavity is typical. Constipation associated with intestinal paresis develops. Body temperature remains normal and only occasionally rises to subfebrile numbers. Tachycardia is characteristic, in some cases a slight arterial hypertension is noted. Consciousness and hearing are completely preserved. Violations from the sensitive sphere do not happen.

Complications of botulism

With botulism, the fatal development of pneumonia is observed, primarily due to a decrease in the volume of external respiration in patients. However, the preventive prescription of antibiotics for botulism does not prevent the onset of this complication.

With the introduction of heterogeneous anti-botulinum serum, anaphylactic shock may develop, and at a later date (on the 10-12th day after its use) - serum sickness.

Diagnosis of Botulism:

Differential Diagnosis

Botulism should be distinguished from food poisoning, poisoning with henbane and poisonous mushrooms, bulbar form of poliomyelitis, diphtheria, stem encephalitis.

Laboratory diagnostics

Currently, there are no laboratory tests that allow the identification of botulinum toxin in human biological media in the early stages of the disease. The goals of bacteriological studies are the detection and identification of the toxin; isolation of the pathogen is carried out at the second stage. To do this, put a biological sample on laboratory animals (white mice, guinea pigs). A batch of 5 animals is selected for the experiment. The first is infected only with the test material, the rest - with the test material with the introduction of 2 ml of 200 AU antitoxic serum of types A, B, C and E. In the presence of a toxin in the material, the animal that received the antiserum that neutralized the toxin of the corresponding type survives. For express indication of toxins, RPHA is put with an antibody diagnosticum (erythrocytes sensitized with antitoxins of the corresponding types).

Modern promising methods are based on the indication of antigens in ELISA, RIA or PCR.

Isolation of the pathogen does not give grounds for confirming the diagnosis, since spores of C. botulinum may germinate, which can be found in the intestines of a large number of healthy people.

Botulism treatment:

Due to life threatening hospitalization of patients is necessary in all cases even if botulism is suspected. Patients are referred to any hospital where there is equipment for mechanical ventilation.

Treatment starts with gastric lavage with a thick tube; during the procedure, it is necessary to make sure that the inserted probe is in the stomach, given the fact that in the absence of a pharyngeal reflex, the probe can be inserted into the respiratory tract. Gastric lavage is advisable to carry out in the first 1-2 days of illness, when contaminated food can still remain in the stomach.

To neutralize the toxin on the territory of Ukraine, they use polyvalent antibotulinum sera in a single initial dose of type A - 10,000 ME, type B - 5000 ME, type E - 10,000 ME, sometimes type C - 10,000 ME. Serum is administered intravenously or intramuscularly after preliminary desensitization (Bezredka method). When administering serum intravenously, it must first be mixed with 250 ml of saline, heated to 37 ° C. In most cases, a single administration of the above doses of serum is sufficient. If 12-24 hours after the end of its administration, the patient develops neuroparalytic disorders, the administration of serum should be repeated at the initial dose.

A fairly good clinical effect is exerted by Application of human botulinum plasma However, its use is difficult due to the short shelf life (4-6 months). There is evidence of the efficacy of human botulinum immunoglobulin.

Simultaneously with the introduction of anti-botulinum serum, massive detoxification therapy, including intravenous drip infusion solutions. It is desirable to use compounds based on polyvinylpyrrolidone (hemodez, rheopolyglucin, etc.), which adsorb freely circulating botulinum toxin well and excrete it through the kidneys with urine.

Given the toxic-infectious nature of the disease and the possibility of developing vegetative forms of the pathogen from spores located in the gastrointestinal tract, the patient is prescribed antibiotics. The drug of choice is levomycetin at a daily dose of 2.5 g for a course of 5 days.

Prevention of Botulism:

Activities in the epidemic focus. Hospitalization of the patient is carried out according to clinical indications. It is recommended to discharge patients from the hospital no earlier than 7-10 days after clinical recovery. If cases of the disease are detected, suspicious products are subject to seizure and laboratory examination, and the persons who used them are subject to medical observation for 10-12 days. It is advisable to give them intramuscular anti-botulinum serum containing 2000 IU to toxins A, B and E, as well as the appointment of enterosorbents. Active immunization has not found wide application.

Which doctors should you contact if you have Botulism:

Are you worried about something? Do you want to know more detailed information about Botulism, its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can book an appointment with a doctor– clinic Eurolaboratory always at your service! The best doctors will examine you, study the external signs and help identify the disease by symptoms, advise you and provide the necessary assistance and make a diagnosis. you also can call a doctor at home. Clinic Eurolaboratory open for you around the clock.

How to contact the clinic:
Phone of our clinic in Kyiv: (+38 044) 206-20-00 (multichannel). The secretary of the clinic will select a convenient day and hour for you to visit the doctor. Our coordinates and directions are indicated. Look in more detail about all the services of the clinic on her.

(+38 044) 206-20-00

If you have previously performed any research, be sure to take their results to a consultation with a doctor. If the studies have not been completed, we will do everything necessary in our clinic or with our colleagues in other clinics.

You? You need to be very careful about your overall health. People don't pay enough attention disease symptoms and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called disease symptoms. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to several times a year be examined by a doctor not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the body as a whole.

If you want to ask a doctor a question, use the online consultation section, perhaps you will find answers to your questions there and read self care tips. If you are interested in reviews about clinics and doctors, try to find the information you need in the section. Also register on the medical portal Eurolaboratory to be constantly up to date with the latest news and information updates on the site, which will be automatically sent to you by mail.