Ho Chi Minh City Experts say it is currently difficult to determine the exact cause of botulinum poisoning in 6 people, because the food samples they ate may no longer exist and were not the samples tested.
On the evening of May 25, two samples of pork roll taken by the Thu Duc City Health Department from the patient's home and the production facility both tested negative for botulinum toxin. The six patients have in common that they all live in Thu Duc, of which five ate pork roll sold on the street and one ate fish sauce before showing symptoms. Therefore, epidemiologically, these two foods are suspected of causing botulinum poisoning.
"The samples tested were from the same batch that the patients ate, taken from the production facility and the poisoned patient's home," said a representative of the Thu Duc City Health Department, but did not say whether the sample taken from the patient's home was the leftover food after eating.
So, the question is what caused the poisoning ? A representative of the Thu Duc City Health Department said they are continuing to investigate.
Regarding this issue, Dr. Huynh Van An, Head of the Department of Intensive Care and Anti-Poisoning, Gia Dinh People's Hospital, said that the patients are from the same locality and have the same clinical course, so to determine the cause, they will often consider the common point of eating pork roll. "However, determining the cause is currently very difficult because we have to review the sampling process, whether the test sample is the sample the patient ate or not," said Dr. An.
MSc. Dr. Doan Uyen Vy, Deputy Head of the Anti-Poison Unit, Cho Ray Hospital, said that if the tested sample is not the pork roll the patient ate, the test results will not reflect accurately.
"It is possible that the patient ate it all and the test sample was a new plant from the same place of production," Dr. Vy hypothesized, adding that it is also possible that there was no problem with the production process but that the storage and sale process caused the toxin to develop. She further explained that "the risk of poisoning depends on each individual in each specific situation," so some people get poisoned after eating it, but others do not.
Agreeing with the above two opinions, Ms. Pham Khanh Phong Lan, Head of the Ho Chi Minh City Food Safety Management Board, said that the way a case of botulinum poisoning occurs is unpredictable, because its spores always appear in the environment. Clusters of botulinum poisoning cases are not like mass food poisoning but belong to individual households.
Like the 6 cases in Thu Duc City, there were typical symptoms, tested positive for botulinum, but it is very difficult to conclude the exact cause, according to Ms. Lan. For example, the manufacturer may have processed it carefully but the problem arose during storage, expired or the product became slimy in anaerobic conditions, fell on sandy soil.
"We cannot know, it is all just a guess," said Ms. Lan, adding that even though the patients had something in common, namely eating pork roll, there was not enough basis to confirm the cause of poisoning from pork roll.
A child with botulinum poisoning is treated at Children's Hospital 2, May 2023. Photo: Provided by the hospital
Considering that botulinum poisoning can be a matter of "luck" and depends on the individual and the situation, experts advise people to be careful when eating and preparing food.
Keep the environment clean, avoid dust and dirt when processing 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 salt/100g 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 Celsius for 10 to 15 minutes to kill bacteria and limit poisoning.
From May 13 to now, 5 people in Thu Duc City have been poisoned by botulinum after eating street-sold pork rolls and one person after eating fish sauce. Of these, three children aged 10-14 were given antidotes and treated at Children's Hospital 2. Their condition is improving, and one child has been discharged. The remaining three patients only received supportive treatment because the country has run out of antidotes. The World Health Organization transferred 6 vials of medicine from Switzerland for treatment, however, one patient (who ate fish sauce) died before receiving the medicine, and the other two did not have time to use the medicine because the "golden" time had passed.
Botulinum is a very strong neurotoxin, produced by anaerobic bacteria - bacteria that prefer closed environments such as canned food, or food environments that do not meet the standards to inhibit bacterial growth.
Symptoms of poisoning include abdominal pain, muscle pain, fatigue, blurred or double vision, dry mouth, difficulty speaking, difficulty swallowing, drooping eyelids, and general muscle weakness. Finally, the patient has difficulty breathing or cannot breathe due to paralysis of the respiratory muscles. These signs appear slowly or quickly depending on the amount of botulinum ingested.
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