Botulinum poisoning cases are increasing, and the antidote has run out.

SGGP 21/05/2023 05:59

In recent days, Cho Ray Hospital, Gia Dinh People's Hospital, and Ho Chi Minh City Tropical Diseases Hospital have held consultations and discovered three more cases of botulinum poisoning. Previously, the city had also recorded three cases of this type of poisoning.

Consuming unsafe food

According to Dr. Le Quoc Hung, Head of the Department of Tropical Diseases at Cho Ray Hospital, three cases of botulinum poisoning are currently being treated at three hospitals: Gia Dinh People's Hospital, Ho Chi Minh City Tropical Diseases Hospital, and Cho Ray Hospital.

On May 13th, two brothers (18 and 26 years old) ate bread with Vietnamese sausage from a street vendor, and a 45-year-old man ate a type of fermented fish sauce that had been left for a long time. Both experienced symptoms of digestive disorders, fatigue, headache, dizziness, and diarrhea. By May 15th, their condition worsened, with muscle weakness and difficulty swallowing.

Of these, the 18-year-old patient experienced early deterioration and muscle weakness, leading to admission to the Ho Chi Minh City Hospital for Tropical Diseases; the 45-year-old patient was also admitted to Gia Dinh People's Hospital that same afternoon; and the 26-year-old patient, whose condition was milder, went to Cho Ray Hospital on their own.

After consultation, the doctors diagnosed all three patients with botulinum poisoning. Currently, two patients (18 and 45 years old) have only 1/5 of their muscle strength; the 26-year-old patient can move, breathe on their own, and does not yet require a ventilator, but their condition is deteriorating.

Doctors at Children's Hospital 2 in Ho Chi Minh City examine a child with botulinum poisoning.

Previously, Children's Hospital 2 also treated three children (from Thu Duc City) who suffered botulinum poisoning after eating bread with Vietnamese sausage from a street vendor. Cho Ray Hospital contacted the Northern Quang Nam Regional General Hospital to transfer the last two vials of botulinum antitoxin (Botulism Antitoxin Heptavalen - BAT) to treat the children on May 16th. By the afternoon of May 20th, all three children had shown initial improvements in muscle strength recovery.

The entire country is running out of antidotes.

The southern region has run out of BAT (Bacterial Antiseptic) medication, while Vietnam typically doesn't stock this drug, or only has a few vials nationwide. In 2020, many people who suffered botulinum poisoning from eating Minh Chay pâté were saved thanks to this medication.

Dr. Nguyen Tri Thuc, Director of Cho Ray Hospital, stated: "Until now, Cho Ray Hospital has kept the rare BAT antidote, worth thousands of USD, in reserve. On May 16th, immediately after using two vials of BAT transferred from Quang Nam to save three children suffering from botulinum toxin poisoning, the entire country considered itself to have run out of botulinum toxin antidotes. On May 17th, we urgently sent a letter to the Ministry of Health requesting permission to purchase more BAT and are awaiting instructions."

Patients with botulinum poisoning are being treated at Cho Ray Hospital.

According to Dr. Le Quoc Hung, with early administration of the BAT antidote, patients can recover from paralysis and no longer require mechanical ventilation within 48-72 hours. In the absence of the BAT antidote, only supportive treatment can stabilize the patient.

Supportive treatment primarily involves feeding and mechanical ventilation because the botulinum toxin damages the nervous system, leading to muscle paralysis, which in turn prevents breathing and can be fatal.

"Previously, without ventilator support for invasive respiratory support, patients were very likely to die. But with ventilator support, treatment is now easier, although the results are not as good as when using medication," shared Dr. Le Quoc Hung.

According to world medical literature, without an antidote, the average duration of mechanical ventilation for patients must be 3-6 months, and during this time, many complications can occur, such as secondary respiratory infections, malnutrition, and complete paralysis.

The risk of botulinum infection is always present.

Regarding this issue, a reporter from SGGP newspaper had a quick interview with Dr. Le Quoc Hung (pictured).

* REPORTER: Sir, there has been a recent increase in the number of cases diagnosed with botulinum poisoning. Is that unusual?

* Dr. Le Quoc Hung: The annual increase in the number of botulinum poisoning patients may not be a sudden spike, but rather due to the development of diagnostic capabilities in our country's healthcare system, leading to the detection of more cases.

* What causes botulinum poisoning, sir?

* Botulinum bacteria live in anaerobic environments. In normal environments, these bacteria do not grow because of the high oxygen levels, so they automatically adapt and create spores (bacteria create a protective shell for themselves to hibernate, remain inactive, and not die). When they survive in an environment without air, they reactivate. They break through the spore shell, producing toxins. At that point, we can become infected with this type of bacteria anywhere, anytime.

* How should food be processed and preserved to prevent botulinum poisoning?

* When preparing fresh food, buying groceries to cook at home, or preparing bottled or jarred food, the first thing to do is to do it in a clean environment. Do not seal food tightly unless you have the proper technique. For the general public, a preventative measure is to use food with an acidity or salinity level above 5% (5g salt/100g food) because bacteria cannot thrive in a salty environment.

In addition, when using food, you must check the expiration date. Not only botulinum but other types of bacteria can also cause food poisoning. When bacteria reactivate, they produce gas, causing food containers to warp. If a food container is swollen and deformed, it should not be eaten even if it is still within the expiration date.

Source: https://www.sggp.org.vn/ca-ngo-doc-botulinum-tang-thuoc-giai-het-post690517.html