What are the symptoms of botulism? Treatment anddisease prevention

Update: October 2018

The topic of botulism infection becomes relevant in the summer and
autumn time. This is the time when people are often engaged in conservation.
products, namely canned food, most often, cause
diseases of botulism.

Everyone will be helpful to know the symptoms of botulism and their manifestation,
in what ways does the infection occur and how can you protect yourself and
close from this severe disease.

Botulism is a disease caused by ingestion.
botulinum toxin characterized by severe damage to the nervous
system.

Etiology of the disease

The causative agent is a bacterium – Clostridium botulinum. She is
very widespread in wildlife. Her disputes are in
soil where they fall from warm-blooded animal excrement
(wild and domestic animals, birds), as well as in the silt of lakes and seas from
fishes, mollusks. They are the natural reservoir for
Clostridium of this species. The pathogen is not dangerous to human health,
dangerous toxin produced by Clostridium botulinum. Disputes very
resistant to environmental factors, for example, they are not
die even when boiled for 5 hours. Ботулизм симптомы

The pathogen multiplies in an anaerobic environment (an environment in which
no oxygen), while botulinum toxin is released. He less
resistant to heat. When heated to 80 degrees Celsius toxin
partially decays. When boiling lasting 10-15
minutes botulinum toxin is destroyed completely. Botulinum
Toxin is one of the strongest poisons found in nature.
The toxin secreted by the causative agent of botulism is of three types – A, B
and E.

Most often, Clostridium botulinum can be found in
canned fruits, vegetables, mushrooms, salted and smoked fish
homemade ham. Of particular danger are
canned mushrooms, it is they who become statistics
наиболее частой причиной diseases of botulism.

It is characteristic that Clostridium botulinum spores are found in
contaminated product is not evenly distributed, but is concentrated in
certain sites. Therefore, from one bank or one and the same
smoked fish can be eaten by the whole family, and only one can get sick or
several people who will eat those canned food areas in
which were pathogen spores and botulinum toxin.

So what products can most often be sources
poisoning:

  • 50% of poisonings in Russia caused by mushroom canned food
  • further meat and fish products – smoked, dried,
    canned fish, ham
  • sometimes seasoning or garlic can be the cause of poisoning,
    filled with vegetable oil for preservation, but without acidification
  • poorly washed potatoes baked in foil

Pathogenesis of botulism

Botulinum токсин попадает с пищей в желудок человека, также
Clostridia themselves also enter, in the stomach they continue to multiply and
produce botulinum toxin. Hydrochloric acid produced in
human stomach does not destroy the toxin. The toxin is absorbed into the blood in
stomach and small intestine. Blood is transported around
the body, including the spinal cord and brain.
Botulinum токсин поражает черепные нервы, особой
motor neurons are sensitive to it
medulla oblongata and spinal cord, it causes severe
effects.

Symptoms of botulism – the clinical picture of the disease

The incubation period for botulism ranges from a few
hours to 5 days. The shorter it is, the harder the poisoning is. At the most
severe cases, the incubation period is not more than 24 hours. Symptoms
grow rapidly, others quickly join some manifestations,
the intensity of the symptoms is also increasing rapidly.

The first symptoms of botulism include the following: Botulism treatment

  • Sharp pain in the abdomen, having cramping
    character
  • Nausea, unrestrained vomiting.
  • Diarrhea, stools becoming frequent and runny, no strangers.
    no impurities in it.

These are early manifestations of botulism, many of them are associated with the usual
food poisoning (see symptoms of food poisoning) and not
turn to the doctor, relying on their own strength, thereby only
worsen their condition and prognosis.

These symptoms last for about a day, then bloating appears.
stomach, feeling of “rastiraniya” in the stomach, diarrhea is replaced by constipation.
Such manifestations are caused by the development of intestinal paresis. Are amazed
motor neurons responsible for intestinal peristalsis. Respectively,
this leads to the fact that the peristalsis disappears, the passage through
the intestine is absent, it accumulates gases, fecal masses.

Neurological symptoms appear following
gastrointestinal. Among them:

  • Double eyes, mist before eyes, impossibility
    consider small details, difficult to read, this is due to
    accommodation paralysis
  • Among the neurological symptoms are also omission of one or two
    upper eyelids, dilated pupils, sluggish reaction of the pupils to light or
    its absence, strabismus, nystagmus, poor convergence.
  • The patient is lethargic, his headaches are diffuse
    nature, dizziness, weakness, like rule raising
    no temperature.
  • Separately worth noting muscle weakness, it manifests itself
    in almost all muscle groups.
  • The face becomes a mask, there is no facial expression, the patient
    can not stick out the tongue.
  • Among the first, motor neurons that innervate
    occipital muscles, what causes their paralysis, the head hangs down and for
    keeping her in the usual position, the patient has to hold her
    by hands.
  • The weakness of the intercostal muscles causes breathing problems, breathing
    becomes superficial. Gradually, there is a weakness in
    limbs.

An important diagnostic sign is that with such
severe movement disorders, sensitivity completely
persists.

There are also other symptoms of poisoning, botulism manifests
dry mouth, the mucous membrane of the mouth is dry,
bright red. In the epiglottic space occurs
the accumulation of clear mucus, which over time becomes
whitish color. The voice changes, it becomes muffled,
the patient is worried about the feeling of “coma” in the throat.

Also, there is a violation of the cardiovascular system,
upon auscultation of the heart, a muffled tone is detected. because of
respiratory impairment, hypoxia develops
oxygen in the blood). Появление respiratory недостаточности является
bad prognostic sign, as this is the main reason
death in people with botulism.

Botulism in childhood

Baby botulism occurs in children up to 6-12 months. Is different
it is from food botulism, discussed earlier, the fact that the body
a child does not get botulinum toxin, and Clostridium spores
botulinum. They freely reproduce in the intestines of the child and excrete
it has a toxin. In adults and older children in
intestine and stomach have certain protective mechanisms,
which do not allow Clostridium botulinum to multiply, but in small
there are no children.

Signs of botulism in children:

  • constipation, constant crying
  • loss of appetite, as a result, weight loss
  • loss or lack of ability to hold the head

The most likely way of infection with honey infected
Clostridium botulinum. Some parents like to experiment.
with the nutrition of children or dip the pacifier in honey. To do this categorically
due to the risk of infecting a child, and it can also cause
severe allergic reaction.

Wound botulism

It is extremely rare. In this case, the causative agent of botulism
reproduces in a wound under anaerobic conditions. Clinical manifestations
the same as with food botulism, only they begin
appear after 2 weeks from the moment of infection. Rana
botulism is associated with injecting drugs.

Diagnostic methods

With botulism routine laboratory tests do not give any
specific data. With differential diagnosis with other
neuroinfection helps lumbar puncture and the study of cerebrospinal fluid.
Liquor with botulism does not change.

A special method is used to diagnose the disease.
also helps determine which serum to use effectively
for the treatment of botulism in a particular patient.

The patient takes blood, then it is centrifuged.
The resulting serum is administered to three mice, mixing
antiobotulinic serum of three types – A, B, E,
respectively.

Since a patient can have only one of three types of toxin,
then two mice will die within 4 days, and one will survive, the one
which was introduced antitoxin against that type of botulinum
toxin that is present in the patient’s blood.

Botulism treatment

  • Gastric lavage with sodium bicarbonate using
    nasogastric tube – performed to remove leftovers
    food that caused the disease, and with it part of the dispute
    Clostridium botulinum and botulinum toxin.
  • Siphon enemas with sodium bicarbonate to remove residues
    toxin.
  • Introduction of antitoxic sera A, B, E. After receiving
    these studies in mice, enter only the serum, which
    is needed.
  • Detoxification – injected infusion-water-salt
    solutions.
  • Antibiotics, to which Clostridium is sensitive
    botulinum.
  • Hyperbaric oxygenation – allows to reduce
    hypoxia.

Disease prevention

  • When home canning must comply with all rules.
    hygiene.
  • Remember that any canned food, hermetically sealed, is potentially
    dangerous. This is especially true of mushrooms, as they are very difficult
    completely clear of soil particles, where the spores are
    Clostridium botulinum.
  • Before using such canned food, it is necessary to subject
    boiling the contents of the jar for 15–20 minutes to
    botulinum toxin collapsed.
  • Products that cannot be exposed to such effects
    must be stored at temperatures below +10 degrees
    Celsius.

Forecast

If treatment is started in time, the prognosis for botulism
favorable. The recovery period lasts for several months.
Without the use of modern and specialized treatment methods,
mortality rate of about 60%. Death comes as a result respiratory
insufficiency or complications of an inflammatory nature.

Автор: Ревус Олеся Григорьевна врач-невролог

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