SGGP
In recent days, Cho Ray Hospital, Gia Dinh People’s Hospital, and Ho Chi Minh City Tropical Diseases Hospital have consulted and discovered 3 more cases of botulinum poisoning. Previously, the city also recorded 3 cases of this type of poisoning.
Use of unsafe food
Dr. Le Quoc Hung, Head of the Department of Tropical Diseases, Cho Ray Hospital, said that 3 cases of botulinum poisoning are being treated at 3 hospitals: Nhan Dan Gia Dinh, Ho Chi Minh City Tropical Diseases and Cho Ray.
On May 13, two brothers (18-year-old and 26-year-old male) ate bread with pork roll from a street vendor and one person (45-year-old) ate a type of fish sauce that had been stored for a long time. Both had symptoms of digestive disorders, fatigue, headaches, dizziness, and diarrhea. On May 15, their condition worsened, with muscle weakness and difficulty swallowing.
Of these, the 18-year-old patient had an early progression and muscle weakness so he was admitted to the Ho Chi Minh City Hospital for Tropical Diseases; the 45-year-old patient was also admitted to Gia Dinh People's Hospital in the afternoon of the same day; the 26-year-old patient had a less severe condition so he went to Cho Ray Hospital on his own.
After consultation, the doctors diagnosed all 3 patients with botulinum poisoning. Currently, 2 patients (18 years old and 45 years old) have only 1/5 of their muscle strength; the 26-year-old patient can move and breathe on his own, and has not required a ventilator yet, but his condition is getting worse.
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Doctors at Children's Hospital 2, Ho Chi Minh City, examine a child with botulinum poisoning. |
Previously, Children's Hospital 2 also treated 3 children (living in Thu Duc City) who were poisoned by botulinum after eating bread with pork sausage from a street vendor. Cho Ray Hospital contacted the Northern Mountainous Region General Hospital of Quang Nam to transfer the last 2 vials of botulinum antitoxin (named Botulism Antitoxin Heptavalen - BAT) to treat the children on May 16. By the afternoon of May 20, all 3 children had shown initial improvements in muscle recovery.
The whole country is running out of antidote
The southern region is currently out of BAT, while our country usually does not stock this drug or only has a few bottles in the whole country. In 2020, many people who suffered botulinum poisoning from eating Minh Chay pate were also saved thanks to this drug.
Dr. Nguyen Tri Thuc, Director of Cho Ray Hospital, informed: Up to now, this rare drug BAT worth thousands of USD has been purchased by Cho Ray Hospital as a reserve. On May 16, immediately after using 2 bottles of BAT transferred from Quang Nam to save 3 children who were poisoned, the whole country was considered to have no more antidote for botulinum toxin. On May 17, we urgently sent an official dispatch to the Ministry of Health asking for permission to purchase more BAT and are waiting for instructions.
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Botulinum poisoning patients are treated at Cho Ray Hospital |
According to Dr. Le Quoc Hung, when using the antidote for BAT early, within 48-72 hours, the patient can escape paralysis and not need a ventilator. In the absence of the antidote for BAT, only supportive treatment can help stabilize the patient.
Supportive treatment is mainly nutrition and mechanical ventilation because the disease is caused by botulinum toxins that damage the nervous system, leading to muscle paralysis, making it impossible to breathe and leading to death.
“In the past, without ventilator support for invasive respiratory support, patients could easily die. But with ventilator support, treatment is now easier, but the results are not as good as when using medication,” Dr. Le Quoc Hung shared.
According to world medical literature, without an antidote, the average time a patient is on a ventilator must last 3-6 months and during the ventilator process, many complications occur such as secondary respiratory infections, malnutrition, complete paralysis, etc.
The possibility of botulinum infection is always lurking.
Regarding this issue, SGGP Newspaper reporters had a quick conversation with Dr. Le Quoc Hung (photo).
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* REPORTER: Sir, recently the number of cases diagnosed with botulinum poisoning has shown signs of increasing, is that unusual?
* Dr. LE QUOC HUNG: The number of patients with botulinum poisoning each year may not be increasing suddenly, but rather due to the development of the diagnostic capabilities of our country's medical sector, detecting more cases.
* What causes botulinum poisoning, sir?
* Botulinum bacteria live in anaerobic environments. In normal environments, this bacteria does not grow due to high oxygen levels, so it automatically adapts and creates spores (bacteria create a shell for itself so that it can hibernate, not work and not die). When it exists in an environment without air, it will reactivate. It will break the spore shell, producing toxins. At that time, we can be infected with this type of bacteria anywhere, anytime.
* How should food be processed and preserved to prevent botulinum poisoning?
* When processing fresh food, buying food to process at home or processing bottled or jarred food, the first thing to do is to do it in a clean environment. Do not seal it if you do not have good techniques. For people, a preventive measure is to use acidity or salinity above 5% (5g salt/100g food) because bacteria cannot grow in a salty environment.
In addition, when using food, you must check the expiration date. Not only botulinum but also other bacteria can cause poisoning. When reactivated, bacteria will produce gas, causing food containers to dent. If the food container is bulging and deformed, you should not eat it even if it is still within the expiration date.
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