Botulism: causative agent, symptoms and first signs, diagnosis of the disease, treatment, prevention

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Botulism is the most severe, potentially dangerous infectious lesion, provoked by the penetration of botulinum toxin into the body, and leads to death.

For pathology are characterized by nervous systemic lesions, verbal and swallowing, visual disturbances and progressive inhibition of respiratory activity.

Characteristics of the pathogen and code for the ICD

Botulinum toxin is produced by a bacterial microorganism( botulinum clostridium), which is an anaerobic spore-forming rod.

When a bacterium enters an unfavorable environment, it takes on a spore-like form, in which it experiences all aggressive influences, because clostridia spores can remain viable for decades, being dried up. But when they enter a favorable environment, where there is no oxygen and the temperature conditions reach a 35-degree mark, they begin to vegetate.

Botulinum toxin is considered one of the strongest and deadly biological poisons.

Photo( picture) sticks botulism

If the bacteria boil for 5 minutes, they will die, at a temperature of 80 ° C they can hold for about half an hour. As for spore-like forms, they die only in an autoclave, and in boiling water can survive for more than 30 minutes.

Classification of

Botulinum infection is subdivided into several characteristic species according to the origin of the disease. There are such forms of botulism:

• Nutritional;
• Wound
• Respiratory;
• Child;
• Undefined type of botulism.

If the first forms are approximately comprehensible, then an undefined botulinum type is diagnosed when specialists can not figure out the exact origin of the infection and its etiological factors.

Etiology

Botulinum clostridia multiply rapidly and accumulate in the intestinal structures of fish, birds and animals, after which excrement is infiltrated into the open environment. When bacteria enter the soil, they enter a sporadic state in which they can stay for a fairly long time.

Bacteria from the ground fall on vegetables and other food products, but they are not dangerous yet. If the contaminated products fall into conditions where there is no oxygen, then they begin to develop, multiply and produce toxic substances. The pathogenesis of botulism may differ slightly depending on its variety.

Food

Food botulinum form is developed due to the ingestion of the rod, which was present on the consumed products.

What foods cause the disease?

Sometimes even the safest, it would seem, products can become a source of infection with botulinum bacillus. When toxin starts to develop, characteristic gas formation is observed, which is especially noticeable on canned vegetables on the swollen lid.

Botulism of food etiology may occur when using such products:

• Mushrooms. Statistics show that about half of cases of botulinum infection occur when consuming mushrooms harvested at home. The bacterium lives in the ground, and the fungi are hardest to clean from earth contamination. Therefore, the contents of the jars, which have a blister or blurred brine, can not be eaten categorically.
• Honey Yes, even such a useful product as honey can also become a source of infection. Most often, infection occurs in small, artificial children, who are fed with mixtures with the addition of honey. It happens that bees bring botulinum spores into honeycomb, and when they get into the children's body with honey, they begin to actively develop and release toxic substances.
• Fish. Fish can also suffer from contaminated water, and its habitat does not matter. Equally often there are both marine and freshwater varieties infected with botulynic spores. Usually, infection occurs due to a violation of cooking technologies. A characteristic feature of botulism in fish is the appearance of mucus and blurred vision.
• Jam. Occasionally, there are cases of botulism infection when using improperly prepared jam. This happens if raw materials were poorly washed( berries, fruits) or jam jars were contaminated. Evidence of a poor quality product will be a bank with an inflated lid. Neutralize a dangerous toxin can be by boiling jam though for 10 minutes.
• Canned cucumbers. Also a fairly common source of botulism, because cucumbers grow on beds that are generously fertilized with various organic substances. The soil itself can be infected with botulism, and if it is flavored with manure, the probability of infection increases many times.
• Sauerkraut. But sauerkraut, if it was prepared not for metal covers, botulism is practically not found. The fact is that an oxygen-free space is necessary for the development of the bacterium, when drinking any vegetables, barrels or simply glass jars with polyethylene caps are usually used, so they do not provide such tightness, i.e. do not create the necessary favorable environment for bacterial spores. Therefore, sauerkraut is not a potential source of infection by botulism.
• Jerky meat. Botulism may also occur in dried meat. And maybe a phenomenon that several people eat the same product, and only one of them will become infected. This is due to the nesting nature of the distribution of botulinum bacteria and their toxins.

Video will tell you how to avoid botulism in conservation:

Raneva

There is also a type of botulism, not related to the use of any blanks, dried or smoked products. This wounded botulinum form, which develops due to the defeat of blood with infected surfaces.

Also, the wound form of botulism is often found among addicts after heroin injections. For such botulism, a long incubation( about two weeks) is typical, only then the first symptomatology appears.

Child

A similar form of pathology occurs in small children up to 6 months of age. Infection usually occurs when violations of the sanitary standards of the baby's living or hygienic rules for its maintenance.

Infection occurs when a child eats with dirty hands, drags dirty toys into his mouth, etc. Also honey can become a source of child botulism, therefore, it is not recommended to use this product until one year old.

Respiratory

This botulinum form is very rare in patients. Under natural conditions, such a disease is practically not found. Usually, infection is possible with the use of biological weapons.

Epidemiology

Spore-shaped botulinum forms are found in soil, water, dust or silt. In any food that can be contaminated with earth or particles from the intestines of animals, it can cause infection. Most cases of infection are associated with canned products( fish, vegetable or meat, mushroom, etc.).

Immunity during infection is antibacterial type-specific and weak, so repeated infection is likely.

Susceptibility to botulinum toxins is the same for all layers of the population and does not depend on age or gender. Even a small amount of toxin can provoke a rapid development of the corresponding clinical picture of the disease.

Clinic

Characteristic clinical manifestations begin to occur only after the end of the incubation period, which in botulism can last a few hours, and can last up to several days, depending on the source of the disease and its form.

For example, with the wound variety, the first manifestations may occur one and a half to two weeks after the toxin or bacterium enters the wound.

By the duration of the incubation, one can judge the severity of botulinum infection, the shorter the incubation, the more dangerous the disease. Usually, in severe cases, it is no more than a day, most often the first symptomatology occurs within 3-12 hours.

First signs of the incubation period

Usually the primary botulinum symptomatology is short-term and nonspecific, indicating the development of infectious poisoning and acute inflammation of the gastrointestinal tract. Patients develop disorders such as:

1. Intensive epigastric pain;
2. Migraine attacks;
3. Diarrhea appears with a frequency of about 2-5 times a day;
4. May cause vomiting;
5. The patient feels a strong weakness, a pronounced malaise, quickly becomes tired;
6. One of the characteristic manifestations of botulism is sudden hyperthermia up to 40 ° C.

The main symptoms of botulism in adults and children

The general clinic of botulinum infection can have several characteristic forms: gastrointestinal, respiratory or ocular.

In the gastrointestinal form of development, the signs of botulism are similar to food intoxication. Patients develop a characteristic emetic reaction, diarrhea, dry mouth and abdominal pain. In the throat, as if there is a lump, the temperature rises slightly.

If botulism develops in a respiratory form, then the victim develops abnormalities of respiratory activity:

• Pulsation becomes more frequent;
• Bluish skin;
• The rhythm, frequency and rate of respiration changes;
• Appears clearly expressed shortness of breath.

In the eye version of the clinical picture, the symptoms begin with visual disturbances, the eyes appear as if a shroud is appearing, the midges appear, the outlines of surrounding objects lose their usual clarity, the farsightedness occurs when the patient clearly sees distant objects, but can not see the objects located nearhim.

When the disease reaches a peak, the initial symptoms are supplemented with general clinical manifestations.

• Swallowing disorders of appear, at first it is impossible to swallow solid food, then the patient can not swallow the liquid too, there is a lack of mobility of the tongue and tongue in the pharynx.
• There is a double vision in the eyes of , strabismus, heavier and lower eyelids, the look becomes wandering and can not focus on any one subject.
• There are also sound disturbances such as lack of speech abilities , hoarseness or nasal, a feeling of fullness of the mouth.
• The victim pales noticeably , his gait acquires uncertainty, the pulse becomes rapid, worsens muscle weakness, constipation and urinary problems.

In the final phase of the pathology, respiratory disorders predominate, in the chest area there is a feeling of constriction and contraction, the victim begins to talk with noticeable pauses to catch his breath. In such situations, pneumonia often develops, which only increases the development of respiratory failure.

Then there is a relaxation of skeletal muscles to a doughy state, the victims lose the ability to hold their heads, the slightest movements are given to them with difficulty. Soon there is paralysis and death.

Complications of

Against the backdrop of incorrect or somewhat belated treatment of botulism, complications may develop in patients:

1. Specific - they manifest themselves in neuromuscular lesions, myositis or arrhythmia;
2. Secondary complications of - here include pneumonia and sepsis, atelectasis lesions and tracheobronchitis, as well as pyelonephritis;
3. Post-therapeutic complications of - this group includes intestinal atrophy, hyperglycemic and hyperphosphatemic processes, serum pathology.

The most dangerous complication is acute respiratory failure, which often ends lethal.

Diagnosis

Diagnosis of botulism usually does not have any difficulties, because the clinical picture is quite pronounced.

Treatment of

If the first signs of botulinum infection occur, it is necessary to urgently call an ambulance, it is dangerous to postpone the call, because serum against botulism can help only in the first three days after the onset of intoxication.

Botulinum therapy, regardless of its severity, should be performed in the PIT of the infectious disease department.

First emergency medical service

While specialists have not arrived, it is necessary to give the patient first aid.

1. Rinse the stomach with a soda solution that creates the conditions for the successful destruction of botulinum toxins.
2. To carry out a siphon enema, for which a liter of soda solution is poured into the rectum through a special probe and a funnel( 10 teaspoons of baking soda are taken per liter of boiled water. For a full enema course, 10 liters of solution will be needed, i.e., 10 times per liter.)
3. After this, the patient needs to give an enterosorbent preparation such as Polysorb or white coal
4. If this is the case, then the patient is advised to give infusion with Haemodesum, trisol or lactosol, as well as a glucose solution with Furosemide

Vaccination

Specialists for the treatment of botulism usually use a special serum that is administered to the victim several times a day, depending on the degree of severity of the infectious process. Serial therapy lasts no more than 4 days

Also specific anti-botulinum therapy involves the use of a human immunoglobulin of a anti-botulinum type or homologous plasma.the patient recovers slowly enough, the salivary function and vision are restored first, returnsI have strength in muscle tissue, etc. Although botulism seriously affects the nervous system, with timely treatment, all negative consequences are usually cured without a trace.

This video will tell you about the measures to prevent and treat botulism:

Home Treatment

Treatment of botulinum intoxication at home is unacceptable. The best help to the victim will be called an ambulance and provide him with the first medical aid until the specialists arrive. Independent attempts to cure botulism can end very badly.

Prevention measures

Prophylactic anti-butulinic measures require strict adherence to the technology of preparation of canned billets, meat stew, etc.

It is also necessary to comply with sanitary and hygienic requirements: carefully wash and sterilize the dishes for rolling blanks, responsibly approach raw material selection, selecting only strong and unfertilized fruits. At what temperature does the toxin die?

Spore botulinum forms die only under autoclave conditions with 4-5 hours of boiling, and the vegetative form of the bacterium is killed by boiling for 5 minutes.

The timely predictions of the disease are quite favorable, although rehabilitation and recovery will take several months.

If with the first aid and specific treatment there was a delay, then the lethal outcome occurs in 60% of cases. The patient is dying from respiratory failure and inflammatory complications.