Doctors say that packaging food in nylon bags or vacuuming easily creates an anaerobic environment that produces botulinum toxin, causing food poisoning.
On May 28, Dr. Nguyen Trung Nguyen, Director of the Poison Control Center, Bach Mai Hospital, said that food poisoning caused by botulinum toxin is a classic type of poisoning in medical literature but in reality it does not occur often. Epidemiological factors and typical manifestations of the disease are often difficult to exploit, so definitive diagnosis is very difficult.
Bach Mai and many other medical facilities have not officially recorded any cases of this type of poisoning. However, in 2020, when a cluster of poisoning cases due to eating vegetarian pate was discovered, doctors have since learned about and paid attention to this type of disease.
Most recently, five people in Thu Duc City were poisoned by botulinum after eating street-sold pork sausage and one person after eating fish sauce. This disease requires an antidote within 72 hours of poisoning. Unfortunately, Vietnam only has two vials of BAT antidote left, which were given to three children. The remaining three people could 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 the antidote and were almost completely paralyzed.
Two months earlier, 10 people in Quang Nam were poisoned after eating pickled carp, one of whom died during his initial hospitalization. At that time, Cho Ray had 5 vials of antidote left, which were sent to save the lives.
Botulinum is one of the most potent toxins known to man, produced by the anaerobic bacterium C. botulinum. The lethal dose in humans is recorded in medical literature as 1 mcg. Under normal conditions, this bacterium cannot survive, but it can adapt and create spores, which are the shells that the bacteria use to hibernate. When exposed to an anaerobic environment (without air), C. botulinum will reactivate, breaking the spore shell to produce a toxin called botulinum. Thus, the possibility of you being infected with this bacterium is everywhere, at all times.
Why are poisoning cases increasing?
Explaining why many cases of botulinum poisoning have been discovered recently, Dr. Le Quoc Hung, Head of the Department of Tropical Diseases at Cho Ray Hospital, said that in the past, cases of this type of poisoning still existed, but today, medical diagnosis is better, so more cases are detected than before. Paraclinical tests, epidemiological and clinical investigations, and bacterial isolation and culture are increasingly modern and developed, making diagnosis easier.
Doctors also believe that changes in eating and food preparation habits compared to traditional ones can cause more poisoning. For example, Dr. Nguyen said that in the past, ham was wrapped in airy banana leaves, but now it is replaced by nylon bags, tightly wrapped, and vacuum-sealed for long-term preservation, unintentionally creating an anaerobic environment that produces toxins. Dr. Doan Uyen Vy, Deputy Head of the Anti-Poison Unit, Cho Ray Hospital, said that improper storage and preservation of food can easily lead to poisoning. In the past, people prepared fresh food and used it within the day, with little risk of poisoning. Nowadays, in modern life, there are many ready-to-eat foods sold, and food stored for a long time in the refrigerator. If the processing and preservation are not safe, the risk of poisoning is very high.
Dr. Vy said that the poisoning depends on each individual in each specific situation. "Anyone and at any time can be infected with botulinum toxin, which occurs when eating or drinking, through open wounds," Ms. Vy said. Depending on the strength of the toxin, the patient will have a long or short recovery time.
Given that the possibility of botulinum poisoning can be "lucky" depending on the individual and the situation, experts recommend that people be careful when eating and preparing food. Keep the environment clean, avoid dust and dirt when preparing fresh food. Do not seal food if you do not have good knowledge and techniques. Another measure is to create acidity or salinity above 5%, 5g of salt/100g of food so that bacteria do not have an environment to grow.
When using food, you need to carefully check the expiration date. The characteristic of bacteria that cause poisoning, including botulinum, is to produce gas and distort the food. Therefore, if you notice that the food no longer has its natural flavor, the container is swollen and deformed, you should not eat it even if it is still within the expiration date. All food should be cooked at 100 degrees for 10 to 15 minutes to limit poisoning.
Eat cooked food and drink boiled water. If food must be sealed, it should not be left for long because the longer it is sealed, the more bacteria will grow and cause poisoning, Dr. Nguyen advised.
A doctor examines one of three children with botulinum poisoning. Photo: Provided by the hospital
National Reserve of Rare Drugs
The important issue is that the medical sector needs timely emergency equipment, especially antidotes. Early detoxification within 48 to 72 hours from the onset of symptoms can help patients escape paralysis and avoid needing a ventilator. Or, if a patient starts on a ventilator 1-2 days after poisoning and is given medication, they can recover and be weaned off the ventilator in an average of 5-7 days.
Dr. Hung said that with the development of urbanization and science and technology, people are exposed to more toxic sources, not just botulinum. Therefore, it is necessary to stockpile treatment drugs, including rare drugs.
"With readily available medicine, patients' health returns to normal quickly, with fewer complications, less pressure on doctors, and less burden on society," said Dr. Hung.
Sharing the same view, Ms. Pham Khanh Phong Lan, Head of the Ho Chi Minh City Food Safety Department, also stated that rare drugs such as BAT and antivenom serum for snake bites, if only ordered by treatment facilities, would be very difficult and the quantity would be very small because the drugs have a short shelf life, are expensive, and are difficult to preserve. Not to mention, buying drugs is also very difficult because companies sell in small quantities, with little profit.
Therefore, according to Ms. Lan, the optimal way to ensure treatment is to have a national reserve of rare drugs. The Ministry of Health should plan for 6 months or a year of drugs, then negotiate prices, purchase and store them in the two major cities of Hanoi and Ho Chi Minh City for immediate transfer when needed.
"Buying it is something you have to accept. If you don't use it for a whole year, you have to feel lucky that no one got poisoned. It's better to lose money like that," said Ms. Lan.
On the morning of May 27, the Ministry of Health announced that it is urgently establishing 3-6 centers to reserve rare drugs. The number of drugs in the reserve list will be about 15-20 types. Botulism Antitoxin Heptavalent (BAT), used to detoxify botulinum, is also on this list.
Le Nga - My Y
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