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Botulism


Zabolsvanie caused, products contaminated with botulism sticks. Pathogen - anaerobe widely distributed in nature, a long time may be in the form of spores in the soil. It falls from the soil of farm animal intestines, and also some fresh-water fishes various foods - vegetables, fruits, grains, meat, etc. Without oxygen, for example, when konservirovapii products botulism bacteria begin to multiply and produce toxins, which is the strongest bacterial poison. He does not break the intestinal juice, and some of its types (toxin type E) even enhances its effect. Typically, the toxin accumulates in foods such as canned food, salted fish, sausage, ham, mushrooms, cooked in violation of the technology, especially in the home.
Symptoms and over:
The incubation period lasts from 2-3 hours to 1-2 days. Initial symptoms - weakness, a slight headache. Vomiting and diarrhea are not always, more often - persistent constipation, are not amenable to the action of enemas and laxatives. When botulism affects the nervous system (blurred vision, swallowing, voice changes). The patient sees all things as if in a fog, there is double vision, dilated pupils, with one wider than the other. Often there is strabismus, ptosis - drooping of the upper eyelid of one eye. Sometimes there is a lack of accommodation - the reaction of pupils to light. The patient experiences a dry mouth, his voice weak and slurred speech.
The body temperature is normal or slightly increased (37,2-37,3 ± C), consciousness is stored. With increasing toxicity associated with the germination of spores in the intestine of the patient, eye symptoms are increasing, there are swallowing disorders (paralysis of the soft palate). Heart sounds become deaf, pulse, slow at first, begins to accelerate, blood pressure decreases. Death may occur with symptoms of respiratory paralysis.
Recognition:
It carried out on the basis of history - diseases due to the consumption of certain foods and the development of similar phenomena in individuals who consumed the same product. In the early stages of the disease it is necessary to distinguish between a botulism poisoning and poisonous mushrooms, methyl alcohol, atropine. It is necessary to carry out differential diagnosis with the bulbar form of polio - in eye symptoms and temperature data (polio gives znachitelnoepovyshenie temperature). Diagnosis is confirmed by detection of exotoxins in blood and urine.
Treatment:
First Aid - saline laxative (eg, magnesium sulfate), peach or other vegetable oil to bind the toxins, gastric lavage with warm 5% sodium gidrokarboiata (baking soda). And most importantly - the introduction of an urgent protivobotulinicheskoy serum. Therefore, all patients are subject to immediate hospitalization. In cases when using a biological sample fails vyyasnittip toxin bacteria used monoretseptornuyu specific antitoxic serum, the effect of which is directed against a single specific type exotoxin (eg. A or E). If it can not be installed, use polyvalent - a mixture of sera A, B and E.
Careful patient care, respiratory equipment is used according to indications, carry out activities to maintain the physiological functions of the body. When swallowing disorders - perform artificial tube feeding or nutritional enema. From medicines has auxiliary action chloramphenicol (0.5 g 4-5 times a day for 5-6 days, and adenoziptrifosfornaya acid (intramuscularly 1 ml of a 1% solution in 1 time daily) in the first 5 days of treatment. It is important to monitor the regularity of the chair.
Prevention:
Strict sanitary supervision for the food industry (fish catch - it dried, smoked, canning, slaughtering and meat processing).
Implementation of the hygiene requirements necessary and when home canning. Remember that disputes anaerobic microbe of botulism live in the soil, and multiply and secrete a poison in an environment where there is no oxygen. Hazards include canned mushrooms, insufficiently treated from the ground where spores may persist 1, meat and canned fish from the swollen cans. It is strictly forbidden foods with signs of poor quality: they have a sharp smell of rancid cheese or butter.