Botulism

Botulism is a contagious disease caused by products infected with botulism organisms. Botulism agent is an anaerobic organism widespread in nature which lives in the ground in form of spores for a long time. It gets from the ground, from the intestinal tract of farm animals and from some kinds of river fish into various products – vegetables, fruits, grain, meat, etc. Without access of oxygen (for example, when product conservation) botulism organisms start to breed and to release toxin which can be a strongest bacterial poison.  Intestinal juice does not destroy it and some its types (type E toxin) even intensify its action. Usually toxin is accumulated in such products as tinned goods, wet fish, wurst, ham, mince prepared with violation of technological process, especially in home conditions.


Symptoms and course
Incubation period lasts from 2-3 hours up to 1-2 days. Primary symptoms: common weakness, insignificant headache. Vomit and diarrhea occur rarely, more often occur intractable constipations reluctant to enema and lapactic actions. Botulism affects nervous system (usually occur vision disorders, change of voice). Patient may see everything like in mist, he has enlarged pupils, moreover, one pupil larger than other. Often strabism and ptosis (the omission of superior eyelid of one eye) occur. Sometimes occurs the lack of accommodation  - the pupillary response to the light. Other symptoms are dry mouth, small voice, unarticulated speech.

Body temperature is normal or a little bit increased (37,2-37,3C), consciousness is kept. When occurs increase of intoxication connected with spore germination in intestinal tract of a patient, the eye symptoms may grow, appear swallowing disorders (falling of palate). Heart sounds become hollow, pulse is slow in the beginning and then it quickens, blood pressure is lowering. Death can come after respiratory paralysis occurred.

Recognition
Is based on making anamnesis – the connection of disease appearing with consumption of a particular product and progression of the same symptoms in people who were taken the same product. At early stages of the disease it is necessary to make difference between botulism and toxication with poisonous mushrooms, methyl alcohol, atropine. It is necessary to perform poliomyelitis  bulbar form differential diagnosis by using data about eyes symptoms and body temperature (poliomyelitis gives a significant temperature increase). The diagnosis confirms detection of ectotoxins in blood and urine.

Treatment
First aid is saline purge (for example, magnesium sulphate), vegetable oil to fix toxins, stomach lavage with 5% sodium hydrogencarbonate solution (cooking soda). And the most important thing is a immediate injection of antibotulinic serum. It is necessary to hospitalize patient. In cases when doctors with biological test find out type of organism toxin, they use a special antitoxin serum which acts against one particular exotoxin type (type A or type B). If it is impossible to do then they use multipartial mixture of different kinds of serum (type A, type B, type C).

Preventive Measures
Strict sanitary inspection of food industry should be performed, starting with fish capture, its drying, fuming, tinning and ending with butchering and meat processing.

It is necessary to meet sanitary requirements when you make home tinning. Remember that spores of anaerobic botulism organism live in the ground. They do breed and envenom in conditions when there is no oxygen. The dander is constituted in canned button mushrooms insufficiently cleaned from soil where can live spores, and also tinned meat and tinned fish from bloated tins. Products with signs of bad quality are strongly unpermitted: they usually smell like strong cheese or rank butter.