How dangerous is botulinum poisoning?

More worryingly, treating these poisoning cases is challenging because the specific antidote is difficult to obtain and very expensive.

Previously, in late August 2020, Bach Mai Hospital also treated several patients with botulinum toxin poisoning due to eating canned vegetarian pate. Dr. Nguyen Trung Nguyen, Director of the Poison Control Center (Bach Mai Hospital), who directly treated those patients, stated that botulinum toxin poisoning is a classic type of poisoning but does not occur frequently. Epidemiological factors and characteristic symptoms are often difficult to ascertain, making diagnosis and identification very challenging. Furthermore, botulinum toxin is an extremely potent neurotoxin; after patients consume unsafe food containing botulinum, the toxin is absorbed into the body, binds tightly to nerves, and causes paralysis of all muscles. Symptoms of poisoning appear approximately 12-36 hours after consumption, with the patient beginning to experience paralysis starting from the head, face, and neck (difficulty swallowing, sore throat, difficulty speaking, hoarseness, inability to open eyes), spreading to both arms and legs, followed by paralysis of the respiratory muscles (wheezing, phlegm buildup in the throat, difficulty breathing), causing respiratory failure and easily leading to death.

Diagnosing and treating botulinum poisoning is difficult because it is a unique type of poisoning that occurs infrequently. The symptoms are similar to those of many other diseases, such as tetrodotoxin poisoning (from pufferfish and blue-ringed octopus), polyneuropathy, and myasthenia gravis, making misdiagnosis easy. According to Dr. Nguyen Trung Nguyen, canned foods are most likely to cause botulinum poisoning. In addition, all other types of food, such as vegetables, fruits, and seafood, are still at risk of botulinum contamination if they are properly preserved, sealed, and not handled with food safety in mind. Foods processed and packaged manually, produced on a small scale, by households, or under substandard production conditions pose an even higher risk of poisoning.

Mr. Nguyen Hung Long, Deputy Director of the Food Safety Department ( Ministry of Health ), stated that botulinum toxin is the most dangerous and potent toxin, with a lethal dose ranging from 1.3 mcg to 2.1 mcg/kg. Furthermore, botulinum poisoning is not a frequent occurrence, so very few companies produce and supply antidotes, leading to a scarcity of supply. These drugs are difficult to obtain and expensive (approximately $8,000 per vial). If the drug expires when no poisoning occurs, it must be discarded. However, if a severe poisoning or major incident involving many people occurs and there is no antidote available, it poses a significant danger. Therefore, a national reserve policy for these rare and specialized drugs is necessary.

To prevent botulinum poisoning, the Food Safety Administration recommends that consumers only use food products and ingredients with clear origins and sources. Absolutely avoid using canned products that have expired, are swollen, dented, deformed, rusty, damaged, or have unusual changes in smell, taste, or color. Do not self-package food and store it for extended periods without freezing. For traditionally packaged or sealed fermented foods (such as pickled cucumbers, bamboo shoots, and eggplant), ensure they retain their sour and salty properties. Do not eat food that has lost its sourness. Homemade dishes should be stored in a very cool environment and not left at room temperature for too long. When preparing food, prioritize eating freshly cooked food, as botulinum toxin is broken down at 100°C for 15 minutes.

DIEP CHAU

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