Botulinum enters the body through food consumption, open wounds, and even infant formula.
Botulinum is a powerful neurotoxin. When it enters the body, it binds tightly to the nerves, causing paralysis of the entire muscle. The characteristic feature of paralysis caused by botulinum is flaccid paralysis, bilaterally symmetrical, spreading from the head to the feet. Severe paralysis can cause respiratory failure, leading to death.
According to Dr. Nguyen Trung Nguyen, Director of the Poison Control Center, Bach Mai Hospital, the most common form of poisoning is through food , commonly known as food poisoning. Most cases of botulinum poisoning in recent times have occurred after eating contaminated foods, such as vegetarian pate (2020), pickled fish (March 2023), suspected of being caused by eating pork roll (May 2023 - cause not yet determined).
Meat, vegetables, fruits, and seafood that are packaged can all be contaminated with toxins. For example, in Thailand, there has been a case of botulism poisoning from eating canned bamboo shoots, while in China, there has been a case of poisoning after eating fermented beans.
Clostridium botulinum bacteria exist in the environment in the form of enveloped spores, can be mixed in many types of food ingredients and can withstand normal cooking temperatures.
Bacteria are anaerobic, meaning they can only grow in an environment lacking air, and cannot grow in an acidic (pH <4.6) or salty (salt concentration >5%) environment. Thus, processed foods containing a few bacterial spores due to unclean production processes, or being tightly packaged in bottles, jars, boxes, cans, or bags without enough acidity or saltiness, will create conditions for bacteria to grow and produce botulinum toxin.
Vietnam has also recorded cases of botulinum poisoning in breastfed babies (infants) , according to Dr. Nguyen. Two years ago, a baby was treated at the National Children's Hospital, with symptoms of paralysis that were mistaken for encephalitis. When investigating the epidemiology, doctors determined that the baby had botulinum poisoning, possibly caused by spores from the environment such as dust, dirty bottles, mixed in the milk the baby drank.
The digestive tract of children under 12 months old, especially in the first 6 months of life, is not yet fully developed and does not have enough beneficial bacteria to prevent harmful bacteria in the intestines. Children who are fed formula early, in an unclean environment, some spores get mixed into the milk and food of the child. At this time, in the child's digestive tract, the spores "bloom" and produce toxins, causing poisoning.
"More dangerously, many children with botulinum poisoning are easily confused with encephalitis, respiratory failure, and pneumonia because the symptoms are similar," said Dr. Nguyen, recommending breastfeeding. In cases where children must be fed formula, it is necessary to ensure a clean environment and sterile milk-making utensils.
Another form of botulinum toxin infection is through wounds. People with wounds from work accidents, traffic accidents, daily activities... when spores from the environment enter, they will develop and produce toxins. "There are as many cases of tetanus as there are cases of botulinum infection, because bacteria of the same family will act similarly," Dr. Nguyen compared.
Therefore, to prevent this type of poisoning, people need to follow the principles of first aid, cleaning, then treating and caring for the wound as directed by the doctor.
In addition, there is another form of botulinum poisoning caused by national security terrorism from biological weapons, but it is rare.
Botulinum antitoxin (BAT - Botulism Antitoxin Heptavalent), priced at 8,000 USD/bottle, is very rare in Vietnam. Photo: Provided by the hospital
Recently, there have been a series of botulinum poisoning cases. Most recently, five people in Thu Duc City were poisoned by botulinum after eating street-sold pork rolls and one person after eating fish sauce. This disease requires an antidote within 72 hours of poisoning. At this time, Vietnam only has two vials of BAT antidote left, which were given to three children. The remaining three people can only receive supportive treatment for symptoms. A week later, the person who ate fish sauce died before receiving the antidote sponsored by the World Health Organization (WHO); two people passed the "golden time" for antidote administration and were almost completely paralyzed.
Le Nga
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