Botulism - a very serious disease from the group of poisoning.Called by the toxin Cl.botulinum (from the Latin botulus -. sausage).This is a life-threatening form of bacterial food poisoning "sausage poison", which, unlike conventional forms of food poisoning affects the central nervous system.The venom heat-resistant.Effective neuroparalytic;kurarepodobnymi - mainly in the synapses of motor nerves.Poisoning most often develops after eating fish and meat products, especially sausages, ham, canned mushrooms home canning (pickling), after less consumption of dairy and vegetable products.
symptoms typically appear in the range of 18 to 36 hours after ingestion of contaminated food, and sometimes within a few days (up to 8 days).In 10 percent of cases, the disease is fatal, mostly due to respiratory failure.
most severe form of the disease occurs in people who are experiencing symptoms less than 24 hours;they have the highest mortality rate.Those who survived the first few days, usually recover completel
• Botulism is caused by eating food contaminated with the bacterium Clostridium botulinum, generating a deadly poison botulinum, which interferes with the transmission of signals between nerve cells.Botulism most commonly transmitted through cooked food is not up to the end, or foods with low acid content.
• In rare cases, the disease occurs when an open wound infected with spores of the bacteria.
to the clinical picture of botulism is characterized by a triad:
1) symmetric bilateral neurological symptoms (blurred vision, swallowing and muscle paresis);
2) defeat of the gastrointestinal tract with the change hypermotor function on inhibition of intestinal peristalsis, the stagnation of its contents and persistent constipation;
3) the development of acute respiratory failure.
• Dry mouth and sore throat.
• Fog and double vision, the appearance of the veil before the eyes, blurred contours of objects.
• Stopped dilated pupils, respond poorly or do not respond to light.Diplopia.Bilateral ptosis.
• Difficulty in swallowing and breathing.Paralysis of the soft palate, and later - the muscles of the pharynx and esophagus.Upsets breathing.Attacks of suffocation, cyanosis.Sometimes it comes asphyxia.
• speech disorders.The voice becomes hoarse.
• Abdominal cramps, diarrhea, nausea, vomiting.Diarrhea or severe constipation.Sometimes a sharp flatulence paresis with bowel, bladder.
• Weakness in the hands and feet, headache, staggering gait, followed by paralysis.
body temperature increased.Initially, there is bradycardia, then the pulse quickens.Cardiac activity falls.Dyspnea.
• necessary medical history and physical examination.
• Blood, stool, stomach contents, as well as the suspect product can be tested for the presence of bacteria and botulinum, but the final diagnosis is based on symptoms.
• To identify other violations can be carried electromyogram, showing the transmission of electrical impulses along the nerves.
differentiate needs from mushroom poisoning, methanol, atropine and hyoscyamine.Exclude as diphtheria, polio, encephalitis.
precise diagnosis - by examining the food, feces and vomit in the presence of the toxin and Clostridium.The biological sample to guinea pig.
• Immediately call the "ambulance";needed first aid and hospitalization.
• If from the time of receiving the contaminated food has passed only a few hours, induce vomiting
• If possible, try to freeze part of the food suspected to be analyzed.
• Your doctor will prescribe an antitoxin that will help save lives, but it can cause a pronounced unpleasant side effects.When a doctor is almost certain of the diagnosis, the antitoxin to provide laboratory confirmation of diagnosis.
• Patients are often given penicillin, but its use is controversial because the issue does not create the presence of the bacteria itself.
• The patient can put an enema or to give drugs that cause the release of the intestine to help the body get rid of toxins.
• mechanical ventilation can be used in case of severe breathing difficulties.
• Seek help if you feel any symptoms of botulism .
1. Prehospital conduct resuscitation.Rinse the stomach.
immediate hospitalization.In the House have ready the equipment for endotracheal intubation or tracheostomy, apparatus for ventilation.
2. Intramuscular enter 100-150 ml anti-botulinus polyvalent serum.Simultaneously enter toxoid.
If no improvement occurs in 5-10 hours, repeat administration of serum (500 ml).
In severe cases the serum administered intravenously and intralyumbalno.
previously injected under the skin for the prevention of anaphylactic shock 1 ml of serum.In trying to enter a substitute nonspecific serum at the same doses.Have ready a set of drugs to combat anaphylactic shock!
3. Gastric lavage through a tube with plenty of water (10-12 liters per session) with a suspension of activated charcoal - 2 tablespoons per 1 liter of water, 0.2% tannin solution or 0.1% solution of potassium permanganate.
4. Saline laxatives - 30 g magnesium sulfate or sodium sulfate in 200 ml of water to enter through the probe after lavage.
5. Cleaning or siphon enema.
6. If severe pain - subcutaneously with 1 ml of 0.1% solution of atropine.
7. 2.4 ml subcutaneously or sulfokamfokain kordiamina, 1 ml of a 10% solution of caffeine.
8. In severe cases, toxic-infectious shock enter intramuscularly 125 mg hydrocortisone, and intravenous drip infusion as part of 30-60 mg of prednisone, metipred.
9. Bleed.Exchange transfusion.
10. Intravenously 500-1000 ml of isotonic sodium chloride solution and 500-1000 ml of 5% glucose infusion followed by forcing diuresis by the intravenous administration of 80-120 mg of Lasix or 80-100 grams of mannitol.
Poliglyukin (500-1000 ml), gemodez (400 ml) intravenously.
11. Heavy drinking alkaline water, such borzhoma.Dining with a probe.
12. In the struggle with paralysis of the respiratory center: subcutaneously 1 ml of a 1% solution of lobeline or tsititona, oxygen, carbogen;controlled breathing ventilator.
Vitamin B1 (1-2 ml of a 5% solution) subcutaneously, intramuscularly or intravenously in cocktails of 5% glucose solution (400-500 ml), heart (0.5 ml of a 0.05% solution of strophanthin) and vascular (15-2 mL kordiamina) means.In the absence of spontaneous breathing - Emergency tracheal intubation (or tracheotomy);Hardware mechanical ventilation with oxygen.
13. Permanent monitoring of the condition of the patient, the breath (hardware mechanical ventilation).
• Never eat any food drops from bulging tin (this is a sign that there developed bacteria), from banks, which flows, or if the food has an unusual color and smell.
• Do not give honey to children under one year.Infected honey is often the cause infant botulism, but does not cause disease in older children and adults.
• wary of following the diet, which is most often contaminated: a home-cooked canned fruits and vegetables (especially green beans), fish, not fully cooked sausage and other pork products, smoked meat, meat withblood and milk products.
• Keep products are not more than an hour before or after cooking.Carefully freeze all leftovers products (large pieces of food pre-divide into smaller).