The main thing about botulism - what is this disease than to treat it, and why Ukraine has no antitoxic serum against botulism.
Botulism is a serious infectious disease, which in Ukraine in recent weeks, three men have died and suffered already 70. At the moment it is recorded of botulism in Kyiv and Kyiv region in Sumy, Poltava, Vinnitsa, Kherson, Zaporizhia, Lviv, Rivne regions. The cause of an outbreak of botulism in Ukraine - poor quality dried fish.
Botulism died, one resident of Kiev, Sumy and Odessa. Before the disease ate store bought dried fish.
In Ukraine botulism was recorded earlier, but the outbreak this year are extremely dangerous because of the serum against the disease no 2014 it has ceased to supply from Russia.
Reporter understood in the causes, symptoms and how to treat the deadly botulism.
What is botulism
Botulism – severe toxicoinfection a disease that occurs when human poisoning by toxins of botulism bacteria, is characterized by lesions of the Central and autonomic nervous systems.
The causative agent - Clostridium botulinum, it constantly exists in the soil and forms spores that are extremely resistant to chemical and physical factors. Exciter stand boiling for 5 hours and killed only at a temperature of +120° in 30 minutes.
Bacteria of botulism contains one of the strongest in nature toxins – botulinum toxin. A lethal dose for a human is 0.3 mg.
Once in the digestive tract, botulinum toxin is absorbed into the bloodstream and spreads throughout the body, settling in parts of the nervous system. Internal enzymes of the toxin is not destroyed.
The infection of humans with botulism is possible when consumption of products of animal and vegetable origin. For example, contaminated with Clostridium fruits and vegetables, canned products, sausages, hams, smoked fish.
Infection of adult humans is usually through the digestive tract, mucous membranes of the respiratory tract, rarely through intact skin and lungs.
Person-to-person infection is not transmitted. A sick person can be dangerous only by reason of selection in the environment of the botulism bacteria from feces and vomit.
Outbreak of botulism in Ukraine and 2017
The first cases of botulism in 2017 recorded in may in Kiev three people, one of whom later died. Later botulism ill another resident of the capital. Shortly botulism found in Kherson (1 case), Vinnickoy (2), Sumy (1 fatal case), Poltava (1 fatal case), Odessa and Zaporizhzhya regions (with 10 cases).
In the Lviv region seized 89 kilograms of dangerous fish, which is related to the cases of botulism in other regions. However, in the Lviv region of cases not yet recorded.
The deadly fish, which contracted Kiev, produced in the town of Svitlovodsk, Kirovohrad region, the sender of the product is there the LLC “Chudo-Yudo”. Poisoned products were purchased in “Caravan”, “Auchan” and the “Megastore”. After consumption of this fish and people sick with botulism. May 29 in Kiev introduced a temporary ban on the sale of fish products. And the doctors asked people to refrain from using the compromised stockfish production company, Merkulov A.V.
In the village of Gradizhsk, Poltava region SBU exposed a strong network of poaching brigades who supplied the fish that has infected at least two people. They caught and processed the fish in dirty barns, garages, and even on the street. Seasoned it with harmful chemical additives. Products transported across Ukraine.
According to doctors, the situation of botulism within the seasonal norm, but abnormal is the lack of serum in the country - and it’s killing infected people.
In public hospitals there’s no cure – this drug is not registered in Ukraine, thus, hospitals have no right to use it. Until 2014, Ukraine was was serum from the botulism company Microgen (Russia), production of which is located in Ufa.
In 2014, over the validity of the certificate on the state registration in Ukraine in the sera of types A, b and E and still not received the documents for re-registration. The Ministry of health claim that has repeatedly appealed to manufacturers with a request to initiate registration of their products in Ukraine, but to no avail.
Saving drug you can buy only the illegal - on the Internet the price of whey is from 1900 to 5000 UAH, depending on the manufacturer. But doctors have the right to refuse the use of serum, since it is not registered. After all, if the patient eventually dies, it’s on the doctor who used the drug documents.
The health Ministry said that the only way is buy the drug through international organizations. Such a mechanism would allow to purchase non-registered drugs. But even such purchases will be possible only after changes in the law on state budget for 2017.
The Ministry of health appealed to the embassies and international organizations with a request to supply Ukraine with serum against botulism as humanitarian aid, but no answer was received.
The symptoms of botulism
Botulism is deadly toxic disease, its severe form can lead to death. The first symptoms may appear a few hours after consumption of contaminated foods, and through 10 days.
The symptomatology develops from the top down. First, problems with vision (people began to see double vision, could not read the fine print, there is dryness of the eyes). Then muscle weakness, loss of reflexes, trouble breathing, nausea, vomiting, abdominal pain. You may receive loose stools, thirst, swallowing disorder, can change the timbre of the voice. Among other symptoms - severe headache, dizziness, insomnia, General weakness, fever, heaviness in the chest.
The result of botulism is paralysis of the muscles of the internal organs and musculoskeletal system that may lead to death.
The treatment of the disease
At the first symptoms of poisoning should immediately seek medical care. Intensive treatment of botulism include:
- gastric lavage to remove residual toxin;
- intestinal dialysis (5% soda solution);
- weenie antitoxic serum, which in Ukraine is not (type a, C, E is entered by ME 10 000 and the 5 000 ME);
- the introduction of infusion media for the purpose of detoxification, correction of water-electrolyte and protein violations;
- antibacterial therapy;
- hyperbaric oxygenation;
- treatment of complications.
The serum is administered intramuscularly for 1-4 days. Given that in the intestine the spores of the botulinum toxin may develop into vegetative forms, to eliminate them using antibiotics. In disorders of the respiratory patients are administered lung ventilation.
With regard to antibiotic therapy in botulism, if not disturbed swallowing function, prescribe chloramphenicol 0.5 g 4 times a day for 5 days or ampicillin 0.75-1 g per day for 7 days.
If after therapy, again there is the necessity of treatment with antibiotics, take the antibiotics which the patient received in the first days, you should not. We must remember that antibiotics can cause intestinal dysbiosis with all the complications.
Also, doctors prescribe chelators (polifepan, use adsorbents, microcrystalline cellulose). Daily intravenous should be administered 400 ml lactitol and diuretics (furosemide, lasix 20-40 mg).
Patients prescribed means of metabolic support, such as glucose-potassium-magnesium mixture, Riboxin, ATP, vitamins (b group).
Glucocorticoids are used as pulse therapy, warning of allergic reactions to the introduction of the antitoxic serum for the treatment of serum sickness.
Folk remedies for the treatment
Folk remedies can be applied only during the recovery period after illness, when, thanks to the actions of physicians, removed the threat to life and you just need to get rid of the effects of poisoning. Given this, the recipes of traditional medicine can only apply after discharge from the hospital:
1. A decoction of cinnamon – a means to accelerate recovery. 1 teaspoon ground cinnamon pour 200 ml of just boiled water. Then, again bringing the composition to a boil, boil for 3 minutes. In the process of cooking is constantly in the way. Atadev, to take such means in the form of heat 200 ml in the morning and evening during the rehabilitation period.
2. Medication on the basis of black chokeberry. Three teaspoons of dried berries, pour 300 MLG of boiling water, to insist in a thermos 6 hours. Then strain off, divide into 2 portions. Take morning and evening 1 portion. This auxiliary treatment is done for the entire recovery period after the botulism.
3. Cranberry juice is a tool for cleaning the body of toxins. Take 1 Cup of fresh or frozen berries, pour 6 cups of water. Bring to boil and boil 10 minutes. Further berries to mash these again and boil the composition for 5 minutes. Cool slightly, drain and drink throughout the day. To drink the juice not less than 10 days after the disease.
4. Dog rose drink. Three tablespoons crushed hips, pour three cups of boiling water and nastavte in a thermos 6 hours. Atadev, the drug to drink 1 glass morning, afternoon and evening. Duration of therapy – a minimum of two weeks.
5. Raspberry. Four teaspoons dried raspberries pour 500 ml boiling water. Then insist in a thermos 3 hours. Separated drink take 120 milliliters four times per day in the form of heat.
Prevention of botulism
Since the cause of botulism is the consumption of poorly cooked and spoiled food, especially in the prevention of this disease is consumption of foods prepared with canning. For the destruction of a botulinum toxin before eating canned food, it is advisable to heat to 100 ° C for 30 minutes.
It is impossible to eat meat and canned fish, if the iron Bank is inflated or deformed.
It is not recommended to buy fish, meat products and preservation in places of spontaneous trade and “with hands”.
To prevent anyone who used along with patients with botulism infected food, injected serum of type A, b, E (against the most dangerous to humans types of clostridia), and watching them for 10-12 days.
