How dangerous is botulinum poisoning?

More worryingly, treatment of these poisoning cases is difficult because specific antidotes are difficult to buy and very expensive.

Previously, at the end of August 2020, Bach Mai Hospital also received and treated a number of patients infected with botulinum toxin due to eating canned vegetarian pate. As the person directly treating those patients, Dr. Nguyen Trung Nguyen, Director of the Poison Control Center (Bach Mai Hospital) said that botulinum toxin poisoning is a classic type of poisoning but does not occur often. Epidemiological factors and typical manifestations of the disease are often difficult to exploit, making diagnosis and identification very difficult. Moreover, botulinum toxin is an extremely strong neurotoxin, so after the patient eats unsafe food containing botulinum, this toxin is absorbed into the body, attaches to the nerves, and causes paralysis of all muscles. Symptoms of poisoning are that after eating about 12-36 hours, the patient begins to show symptoms of paralysis from the head, face, neck (difficulty swallowing, sore throat, difficulty speaking, hoarseness, unable to open eyes), spreading to the arms and legs, then paralysis of the respiratory muscles (wheezing, phlegm in the throat, difficulty breathing) causing respiratory failure, easily leading to death.

Diagnosing and treating patients with botulinum poisoning is very difficult because this is a special type of poisoning that occurs infrequently. The symptoms of poisoning are similar to many other diseases such as tetrodotoxin poisoning (puffer fish, blue-ringed octopus), polyradiculoneuritis, myasthenia gravis, so it is easy to confuse. According to Dr. Nguyen Trung Nguyen, canned foods are most at risk of botulinum poisoning. In addition, all other types of food such as vegetables, tubers, fruits, seafood... are still at risk of being contaminated with botulinum bacteria if they are incubated, sealed and do not ensure food safety. Processed foods, hand-packaged foods, small-scale production, households or unsecured production conditions have an even higher risk of poisoning.

Mr. Nguyen Hung Long, Deputy Director of the Department of Food Safety ( Ministry of Health ), said that botulinum toxin is the most dangerous and most toxic toxin, with a lethal dose of 1.3mcg to 2.1mcg/kg. On the other hand, botulinum poisoning is a type of poisoning that does not occur often, so very few companies produce and supply antidotes, leading to a very limited supply. These drugs are difficult to buy and expensive (about 8,000 USD/bottle). When there is no poisoning and the drugs expire, they must be discarded. When there is a serious poisoning or a major incident with many people affected, there is no medicine, which is very dangerous, so there needs to be a national reserve policy for these rare and special drugs.

To prevent botulinum poisoning, the Food Safety Department recommends that consumers only use food products and food ingredients with clear origins and sources, and absolutely do not use canned products that have expired, are swollen, flattened, deformed, rusted, are no longer intact, or have unusual flavors or colors. Do not self-package foods and leave them for a long time in non-frozen conditions. For fermented foods, packaged or covered in the traditional way (such as pickles, bamboo shoots, pickled eggplants, etc.), they must be sour and salty. When the food is no longer sour, it should not be eaten. For dishes made at home, they should be stored in a deep-freeze environment and should not be left in the natural environment for too long. When preparing, prioritize eating freshly cooked foods because botulinum toxin will decompose at 100°C for 15 minutes.

DIEP CHAU

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