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Botulism: symptoms, diagnosis, treatment

Botulism Botulism is a serious and potentially fatal infectious disease, which, fortunately, is not so common. The basis for the development of pathological symptoms of this disease is the effect on the human body of one of the most powerful toxins, botulinum toxin, among all known toxins.

How does the infection occur?

Pathogen of botulism is a microorganism of clostridium( Clostridium botullini), which is widely distributed in the environment.Its spores persist for decades in soil, in mud and water, and vegetative forms live in the intestines of some animals and fish.In itself, the causative agent of botulism for humans is not dangerous( it does not take root in the digestive tract of a healthy person).But the toxin, synthesized by clostridia in the process of vital activity, blocks the nervous functions of the human body and causes paralysis of the muscles, including those providing respiration, so without medical assistance a person can die from acute respiratory failure.

Depending on the pathways of infection, several forms of botulism are distinguished:

  • Forms of botulism Food botulism.In the human intestine, clostridia can not multiply and produce poison, so botulism most often develops when it enters the gastrointestinal tract of a ready-made toxin contained in food.
  • Newborn botulism.In infants up to six months of age, the immunological barrier of the intestine is still immature, so botulism spores can grow into vegetative forms, which subsequently begin to release botulinum toxin.Infection of young children, scientists associated with the use of honey( it can be part of nutrient mixtures), in which spores of bacteria enter bees.
  • Wound botulism.Infection with clostridia occurs when the wound is in the ground, dust, which contains spores.If, at the same time, oxygen-free conditions are created in the wound, the microorganism passes into the vegetative form and begins to release the toxin.

It is possible to infect botulism with an aerosol route, which is carried out by inhalation of aerosols with botulinum toxin.In natural conditions, this can not happen, but deliberately - it is quite real( for example, for terrorist purposes).

Another not completely standard way of getting botulinum toxin into the human body is "injections of beauty" or "botox"( the introduction of solutions containing a dangerous poison in a minimal concentration, to the face to reduce wrinkles).

Woman Receiving Plastic Surgery Treatment in Her Lip With a Syringe Well, from human to human, botulism is not transmitted.Outbreaks of this disease are explained by the use of several people at the same time by the same infected food.

Potentially hazardous products

Any food product can become a source of dangerous botulinum toxin if spores or vegetative forms of clostridia of botulism enter it and conditions favorable for isolating the poison are created.These conditions include lack of air access and a temperature of 28-35 degrees.In addition, microorganisms may die before the toxicity begins, if the correct thermal treatment of the product is carried out. Therefore, only the following potentially dangerous products can be:

  • Canned mushrooms of domestic production.Of the mushrooms, it is hardest to wash the remains of earth and sand.In addition, at home it is very difficult to achieve a disastrous temperature for the spores( above 100 degrees), this can only be done in an autoclave.
  • Vegetable, meat, canned fish, homemade sausages.Especially the risk is raised if the products are stored incorrectly( optimally - up to 10 degrees).Lightly salted and dried fish.
  • .

Potentially hazardous products Canned industrial production in terms of infection with botulism is almost not dangerous, because when they are made use special autoclaves, which allow to heat the raw material at a temperature of 120 degrees.

Symptoms of botulism

The first symptoms of botulism appear 12-36 hours after the penetration of botulinum toxin into the body.And everything starts as usual poisoning: with vomiting, nausea, short diarrhea.As the disease progresses, these gastrointestinal disorders are replaced by flatulence and constipation. In addition, by the end of the first day of the disease, there are the most revealing neurological signs of botulism:

  • Visual disturbance( fog, "mesh" before the eyes, doubling, significant reduction in visual acuity, the patient seems to be blind).
  • Dry mouth.
  • Change the Voice Voice.
  • Muscle weakness.

There may also be difficulty swallowing, speech impairment.If the toxin continues to act, weakness develops in the muscles of the neck, hands, there are problems with breathing( due to paralysis of the respiratory muscles).

Vpid-clostridia-rod-anaerobic-bacterium_and_31 The severity of the described symptoms and accordingly the severity of the disease varies depending on the amount of toxin that has entered the body, as well as the health status of the person as a whole.Therefore, the clinical picture of botulism may differ for different patients.

Important : if after some time after consuming potentially dangerous products( in Russia it is more often canned mushrooms, stews and pates rolled in cans, salted fish) symptoms of poisoning appear without increasing the body temperature and at the same time ariseEven the slightest problems with eyesight, the mouth becomes very dry, the voice becomes a nasal, it is necessary to seek medical help.

As for rare forms of botulism, they manifest themselves as follows:

  • In pediatric botulism, children develop persistent constipation, choking with milk, lethargy and weakness, changing the character of crying and losing the ability to hold the head.
  • In wound botulism, neurological symptoms develop, as in food botulism, but they appear later( sometimes even a few weeks after infection).
  • Aerogenic botulism is also manifested as food, but without gastrointestinal disorders.

Recovery in botulism occurs after 3-4 weeks, with a gradual complete regression of all symptoms, including neurological ones. However, it is possible to develop a number of complications:

  • aspiration pneumonia( when a person can not swallow, food and water enter the lungs, which causes inflammation);
  • of myositis;
  • lesions of the nervous nodes of the heart, which subsequently provokes arrhythmia.

Antitoxic immunity after the transferred botulism is not formed, so you can get sick again.

Diagnosis of botulism

Diagnosis of botulism Diagnosis in the classical course of botulism doctors put easily - according to the characteristic clinical symptoms, the appearance of which has a direct connection with the use of dangerous products from the point of view of infection with botulism.To confirm the diagnosis, laboratory tests are performed( detection of botulinum toxin in the blood serum of the patient and bacteriological examination of samples of suspicious products, feces, vomit).

Botulism treatment

Botulism treatment includes several directions:

  • Removal of toxin residues from the body.To do this, wash the stomach, conduct intestinal dialysis( washing the intestine) with an alkaline solution, inject intravenously solutions for detoxification and give the patient enterosorbents.
  • Neutralization of circulating poison in the blood by administering to the patient the required dose of antitoxic serum( a test for the tolerability of the drug is preliminary performed).Treatment of botulism
  • Elimination of pathological changes in the body.The tactics of action depend on the presence of specific symptoms.If the patient can not breathe on his own, it is connected to an artificial lung ventilation device, so-called metabolic support preparations( mixtures of electrolytes, ATP, riboxin, vitamins, etc.) are introduced to correct metabolic disorders.If an allergic reaction to an antitoxic serum occurs, glucocorticoids are used.To treat and prevent possible inflammatory processes, antibiotics are prescribed.

Important: in most cases, doctors manage to save patients only due to the timely introduction of antitoxic serum( it must be introduced in the first 72 hours).

Self-treatment with botulism is unacceptable! If symptoms of poisoning occur before the ambulance arrives, you can try to rinse the stomach with the patient, but if swallowing is disturbed, the procedure of gastric lavage or sorbent intake may result in the person simply choking or choking.

    Conservation requires cleanliness of raw materials, cans, lids and used water( it must be boiled).
  • The best way to prepare products for the winter is to use methods that do not require sealing the cans tightly.
  • Pasteurize canned food for at least half an hour.
  • Store ready cans preferably at a temperature of no higher than 8 degrees.
  • Marinades are best prepared using standard, proven recipes.
  • Meat carcasses should be cleaned well from the ground and make sure that the intestinal contents do not get on the meat.
  • Fish must be gutted and rinsed thoroughly with running water.
  • Prepared fish carcases should be well salted, and also observe a temperature regime of not more than 8 degrees during salting and storage.
  • It is unacceptable to buy canned goods at home.
  • Blown banks must be disposed of, since the bombing is a clear sign that something is wrong with conservation.This product should not be eaten.However, normal-looking banks of home preparations can not be called safe.
  • All canned meat and home-made sausages should be heat treated before use so that the toxin, even if formed, is destroyed.
  • Canned mushrooms are also recommended to be boiled for 30 minutes before use, for this purpose it is possible to place a can of conservation into a pot of boiling water and to sustain the required time on the fire, then cool it.

As for prophylaxis in the focus of botulism, all people who, together with the patient, used dangerous food, are administered a preventive dose of antitoxic serum.

I also want to pay attention to such a popular method of prevention of botulism, as drinking alcohol.Quite often it happens that people at the table eat together, but only one gets sick, who drank the least alcohol.There are no scientific data confirming such an effect of alcohol, and selective damage to the disease is due to the fact that the toxin in the product was placed locally( for example, in one fungus that was not well cleared from the ground before conservation).In addition, after consuming strong drinks, the emerging symptoms of botulism can be attributed to alcohol intoxication, and valuable time will be lost. Therefore, one should never use alcohol as a means of preventing poisoning.

Zubkova Olga Sergeevna, medical reviewer, epidemiologist-doctor

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