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Botulism


Sickness caused by products contaminated with botulism sticks. The causative agent - anaerobic is widespread in nature, for a long time can be in the soil in the form of spores. It comes from the soil, from the intestines of farm animals, as well as some freshwater fish to various food products - vegetables, fruits, grain, meat, etc. Without access to oxygen, for example, during the conservation of products, botulism bacteria begin to multiply and secrete a toxin, which is the strongest bacterial poison. It is not destroyed by intestinal juice, and some of its types (type E toxin) even enhance its effect. Typically, the toxin accumulates in foods such as canned food, salted fish, sausage, ham, mushrooms, cooked in violation of technology, especially at home.
Symptoms and course:
The incubation period lasts from 2-3 hours to 1-2 days. The initial signs are general weakness, minor headache. Vomiting and diarrhea are not always, more often - persistent constipation, not amenable to the action of enemas and laxatives. With botulism, the nervous system is affected (impaired vision, swallowing, voice change). The patient sees all objects as if in a fog, double vision appears, the pupils are dilated, one wider than the other. Strabismus is often noted, ptosis is the omission of the upper eyelid of one of the eyes. Sometimes there is a lack of accommodation - the reaction of the pupils to the light. The patient has a dry mouth, his voice is weak, speech is slurred.
Body temperature is normal or slightly elevated (37.2-37.3 ± C), consciousness maintained. With increased intoxication associated with the germination of spores in the patient’s intestines, eye symptoms increase, swallowing disorders (paralysis of the soft palate) occur. Heart sounds become dull, the pulse, initially slowed down, begins to accelerate, blood pressure decreases. Death can occur with respiratory paralysis.
Recognition:
It is carried out on the basis of an anamnesis - the connection of a disease with the use of a certain food product and the development of similar phenomena in people who consumed the same product. In the early stages of the disease, it is necessary to distinguish between botulism and poisoning with poisonous mushrooms, methyl alcohol, atropine. A differential diagnosis should be made with a bulbar form of polio - according to eye symptoms and temperature data (poliomyelitis gives a significant increase in temperature). The diagnosis confirms the detection of exotoxins in the blood and urine.
Treatment:
First aid - saline laxative (for example, magnesia sulfate), peach or other vegetable oil for binding toxins, gastric lavage with a warm 5% sodium bicarbonate solution (drinking soda). And most importantly, the urgent administration of anti-botulinum serum. Therefore, all patients are subject to immediate hospitalization. In cases where it is possible to determine the type of bacterial toxin using a biological test, a special monoreceptor antitoxic serum is used, the action of which is directed against one specific type of exotoxin (e.g. type A or E). If this cannot be established, use a multivalent - a mixture of sera A, B and E.
Careful patient care is required, according to indications, respiratory equipment is used, measures are taken to maintain the physiological functions of the body. For swallowing disorders, they provide artificial nutrition through a tube or nutritional enemas. Of the medications, chloramphenicol (0.5 g 4-5 times a day for 5-6 days, as well as adenosyphosphoric acid (intramuscularly 1 ml of 1% solution once a day) has an auxiliary effect in the first 5 days of treatment. monitor the regularity of the stool.
Prevention:
Strict sanitary supervision of the food industry (catching fish - drying, smoking, canning, slaughtering cattle and processing meat).
Compliance with sanitary and hygienic requirements is mandatory for home canning. Remember that the spores of the anaerobic microbial botulism live in the soil, but multiply and secrete poison under conditions when there is no oxygen. The danger is canned mushrooms, not sufficiently cleared from the ground, where 1 spore, canned meat and fish from bloated cans can be preserved. Products with signs of poor quality are strictly prohibited: they have the smell of sharp cheese or rancid oil.