Contents
What is botulism
The term “botulism” doctors call acute food poisoning. This means that it is not the bacteria themselves that get into the products that are dangerous, but the botulinum toxin they secrete – when it enters the human body, it leads to severe symptoms, even death.
With botulism, nerve fibers are damaged, which are blocked due to the toxin and cannot conduct impulses to the tissues. This leads to muscle paralysis, including the vital respiratory muscles and even the heart.
Causes of botulism in adults
The main reason for the development of this dangerous disease is improperly cooked food, in particular preservation, in which bacteria have multiplied. And as a result, dangerous botulinum toxin turned out to be in food.
The causative agent of botulism
Botulinum toxin is secreted by specific bacteria – clostridia (Clostridium botulinum). They are anaerobic organisms, that is, they develop without air access. In an unfavorable environment, they can be in a spore state for a long time, including in a dried form. But as soon as they get into the optimal environment – a warm place without access to oxygen (for example, a recently rolled up can of food), they germinate and multiply, releasing the toxin along the way.
When boiled, bacteria die within 5 minutes. When heated to 80 ° C, they can withstand half an hour. Therefore, it is important to sterilize canned food properly. Spores can only be destroyed in an autoclave.
The isolated botulinum toxin itself can be easily destroyed by boiling, but in cold brine, canned food or food with spices, it retains its properties. Moreover, the presence of botulinum toxin does not change the taste of products. This, along with mushroom poisons, is the most poisonous biological compound.
What foods cause botulism in adults
The source of these bacteria in nature is the soil, as well as some wild birds and animals, such as rodents. These microbes do not harm them, they come out with feces and spread through the soil. If spores land on manure gardens, they can contaminate food.
Food is usually the source of the toxin. The most dangerous in terms of botulinum toxin poisoning:
- homemade canned vegetables;
- garlic and onion in oil, sauces;
- mushroom blanks (salted, pickled mushrooms);
- salty fish;
- homemade meat products.
There should be no air access for reproduction of clostridia, therefore hermetically sealed jars are the most dangerous.
Symptoms of botulism in adults
The toxin enters the digestive tract with food and is absorbed into the bloodstream, affecting the nerves. Usually, botulinum toxin poisonings have the character of outbreaks within the family or community that consumed home-made canned food.
The disease develops quickly – usually within a few hours after eating dangerous food, the first symptoms appear. At the very beginning, non-specific manifestations are possible, by which it is not immediately possible to determine that this is botulism.
Doctors share the gastroenterological picture, eye manifestations, as well as the form with the development of acute respiratory failure.
If this is a gastroenterological form, it proceeds like a food poisoning, but in a severe form. There are pains in the abdomen, severe nausea, which provokes vomiting and diarrhea. But against the background of relatively moderate digestive symptoms, severe dryness of the skin without dehydration occurs, as well as swallowing disorders with a feeling of a strong lump in the throat, choking, swallowing and speech disorders.
If this is an ophthalmic form of botulism, visual disturbances occur in the initial period. Patients experience clouding of the eyes, flickering of dots or flies, loss of clarity of vision, a decrease in its sharpness, double vision. Severe farsightedness may occur.
The most dangerous of the variants of botulism is with a disorder of respiratory functions. Shortness of breath arises and sharply increases, pronounced cyanosis (cyanosis) of the skin is formed, the heart rhythm is disturbed. If measures are not taken to resuscitate the patient, death may occur within a few hours.
At the height of the disease, the manifestations of botulism are quite typical and vivid. There are paresis (partial paralysis) or complete paralysis of muscles in different parts of the body, a symmetrical lesion of the pupils (they are dilated in both eyes), strabismus is formed, the eyes converge to the bridge of the nose, the eyelids droop, and nystagmus occurs (trembling of the eyeball).
Due to damage to the muscles in the pharynx, swallowing disorder (dysphagia) occurs. Initially, it is difficult to swallow only solid foods; as the disease progresses, it is difficult to swallow even liquids.
Speech disorders go through successive stages. First, the timbre of the voice suffers, hoarseness is formed due to the dryness of the ligaments. Then, with paresis of the tongue, dysarthria or blurred speech is formed, nasal voice is typical, and then its complete loss. The cough reflex also suffers, so patients may suffocate when taking liquids or mucus accumulation.
Botulinum toxin affects the muscles of the face, provoking asymmetry of tone and facial expressions, instability of gait appears, and constipation begins due to intestinal damage. Also possible rapid pulse, increased pressure, arrhythmias.
Treatment of botulism in adults
It is necessary to treat patients with botulism in a hospital, under the strict supervision of doctors. Some people require urgent resuscitation. The treatment will be long.
Diagnostics
If botulism is suspected, an urgent consultation with a neurologist is necessary.
Specific tests for the detection of botulism at an early stage have not been developed. The diagnosis can be determined by the symptoms and an indication of the group nature or association with the use of canned food.
The main way to diagnose botulism is to detect botulinum toxin. For this, a study of blood serum, feces, stomach contents, food products is carried out. Botulinum toxin can be isolated in laboratory samples with animals.
Modern treatments
If botulism is suspected, patients are referred to the intensive care unit. This is necessary in order to timely connect the patient to mechanical ventilation in case of damage to the respiratory muscles.
The first thing that is carried out upon admission to the hospital is gastric lavage and enemas in order to remove as much as possible the toxin that has not yet been absorbed.
That part of the botulinum toxin that is in the blood can be neutralized by a single injection of anti-botulinum serum. If this is not enough, after a day the administration is repeated under strict control of tolerance.
Additional therapy is carried out according to the severity of the condition. If respiratory failure develops, a transfer to artificial lung ventilation is necessary, which can last for several months. Feed patients with dysphagia through a probe so that there is no aspiration of solutions.
Prevention of botulism in adults at home
The basis of prevention is the use of only high-quality products prepared with strict adherence to technology. It is important to refuse suspicious canned food, buying them from the hands of private traders in the market.
Popular questions and answers
We discussed with infectious disease doctor Tatyana Kovaleva the problem of botulism development, possible complications, principles of recovery.