Botulism - an acute infectious disease caused by poisoning with botulinum toxin, enter the body due to the use of a variety of foods that contain the botulism toxin and is characterized by severe lesions of the autonomic and central nervous systems
Causesoccurrence of botulism
botulism bacteria anaerobes, ie,may exist only in places with lack of air.The place in which constantly live spores of botulism, is the soil.It is because of this they then fall into the water, for food products, vegetables, fruits, and ultimately into the gut of animals (fish, birds, invertebrates, mammals) or human.Botulism bacteria are widely distributed in nature in two forms - in the spore and vegetative.The vegetative form of the bacteria are killed within 30 minutes at a temperature of 80 degrees and in five minutes - by boiling.The spores (spore forms) is extremely resistant to chemical and physical agents, as they can withstand a five-hour boiling and killed only 30 minutes at a temperature of 120
One of the features of botulism is that the lack of warming at from vegetative forms often can form dormant spores, "germinating only after six months.These spores are very resistant to direct ultraviolet radiation, desiccation and freezing.In anaerobic (airless), or conditions close to them (animal meat, canned), spores are activated and begin to produce toxins that are 375,000 times stronger than the venom of a rattlesnake.
In normal conditions, the external environment, botulinum toxin can persist up to one year, but in canned foods - for many years.They are not destroyed by digestive enzymes are stable in acid medium, can easily withstand a very high concentration of salt (about 18%).But when boiled for fifteen - twenty minutes, or under the influence of alkalis, toxins quite quickly decompose and lose their toxic properties.Also be aware that the presence of botulinum toxin in food, does not affect their taste.
Source of outbreak of botulism - the contents of the intestines of domestic and wild animals, shellfish, fish, birds, seas and lakes silt soil.
most often develop botulism after eating a variety of canned foods (fish, mushroom, meat, vegetable), salted and smoked fish (and other smoked meat), sausages and ham.The most dangerous are products made at home, as well as those who for some - any reason have been contaminated soil.
When wound botulism toxin formation occurs in the necrotic tissue and in botulism in infants - in the gut.Botulinum toxin can be selectively affects cholinergic parts of the nervous system, resulting in nerve synapses stops release of acetylcholine and there is muscle paralysis
symptoms and for botulism
incubation period of botulism can range from a few hours to two - five days (in severe usually do notmore than 24 hours).It was noted that the shorter the incubation period, they will be more severe course of the disease.
Typically, botulism begins suddenly.Appears expressed general weakness, dizziness, headache, much worse overall health, body temperature within normal range or slightly elevated.The stomach starts cramping sharp pains, diarrhea, nausea, vomiting.One day, these displays are replaced by pretty dry mouth, bloating and constipation.Then, after a relatively short period of time, there are visual disturbances: patients can not read, seen very indistinctly, may experience double vision objects.As a result of incomplete paralysis (paresis) of facial muscles, wrinkles and nasolabial folds are smoothed, there is drooping eyelids.With further progression of the disease, there is hoarseness (the voice can do the abyss) and disturbed swallowing.It is a formidable feature that indicates an unfavorable course of the disease, a breathing disorder.Patients feel chest tightness, shortness of breath, breathing becomes shallow, may be present pain in the chest, develops paresis of the respiratory muscles (the cough reflex disappears).In severe cases, due to respiratory distress may occur death
diagnosis of botulism
diagnosis of botulism set, based on data from medical history, laboratory and clinical research.Of great importance is early diagnosis of the disease, based on the presence of typical clinical features: As a general rule no febrile reaction, acute onset of symptoms of intoxication, the total absence or very weakly expressed diarrheal syndrome in the future nausea (rarely vomiting), constipation, oftalmoplegichesky syndromeskeletal muscle weakness, respiratory disorders, skin pallor, hemodynamic disorders.
epidemiological history plays an important role in the diagnosis of botulism: mass disease in humans who ate one time the same food (canned mushrooms, vegetables, meat, home-made juices, dried fish, smoked meats, canned goods).
Laboratory diagnosis of botulism is to study the remains of food, feces, gastric lavage, vomit and blood.The definition in the material presence of botulinum toxin occurs by means of a biological method.
necessary to carry out differential diagnosis with stem encephalitis, rabies, polio with other foodborne diseases and intoxications of different etiology;poisoning poisonous mushrooms, methyl alcohol, belladonna, atropine
Treatment of botulism
All, without exception, patients at the slightest suspicion of botulism should be immediately hospitalized in the infectious hospital for acute specific treatment aimed at preventing possible serious complications.The primary objectives are to provide emergency treatment of cardio - vascular and respiratory systems of the body, as well as the neutralization of binding and the subsequent elimination of toxins from the body.In the case of attachment of muscle paralysis or paresis of the larynx and pharynx, respiratory failure is greatly enhanced when botulism.This contributes to a serious deterioration in airway management, as well as the development of atelectasis and aspiration pneumonia.Therefore, even in the prehospital should undertake urgent measures such as gastric lavage, initially boiled water, then 2% p-rum sodium bicarbonate;give the patient a saline laxative (500 ml of water, 30 g magnesium sulfate), and then chelators (Enterodez, Polyphepanum etc.);to do a cleansing enema with polifepanom or 2-4% of p-rum sodium bicarbonate;assign frequent excessive drinking with the introduction of a diuretic (hydrochlorothiazide, Lasix and so on.).
In severe cases, detoxification is necessary to conduct an infusion therapy with forcing diuresis, introducing guanidine hydrochloride 20-35 mg / kg / day.In acute respiratory distress performed artificial respiration.When respiratory paralysis, the patient is transferred to a ventilator.In order to neutralize the botulinum toxin used medical protivobotulinicheskie monovalent serum.Since the digestive tract, the debate can be transformed into vegetative forms, shown holding antibiotic therapy: drugs tetracycline and chloramphenicol.
Even if the timely provision of qualified medical assistance in the recovery of patients with botulism passes slowly.Residual effects after paralysis may occur even for one - two months
Warning Before use, thorough inspection of canned food, mandatory withdrawal "bombazhnyh" (inflated) cans.Before use, you need to warm up (100 * C - 30 min.) Home-cooked mushrooms, meat and canned vegetables.
After sampling for laboratory testing, the products have served the cause of the infection, you need to remove and destroy.Flatware, which is in contact with contaminated food and linen contaminated secretions patients undergoing thorough disinfection.People who use the products cause disease, shows the introduction of compulsory protivobotulinicheskoy serum followed medical supervision for at least ten days.