How to detect and treat botulinum poisoning?

Botulinum poisoning is usually diagnosed through analysis of stool and vomit samples and treated with antitoxin, antibiotics, or a ventilator.

Botulinum is a powerful neurotoxin that can cause paralysis, respiratory failure, or death in infected people at doses as low as 0.004 μg/kg. The most famous recent botulinum fatality is that of American student Otto Warmbier, who was paralyzed while in North Korea and later died in his home country.

Initial symptoms include fatigue, weakness, and severe dizziness. Later, patients often experience blurred vision, dry mouth, difficulty swallowing, and difficulty speaking. Some cases experience vomiting, diarrhea, constipation, and bloating.

If not treated promptly, the disease can progress to muscle weakness, arms. Next, the respiratory organs and lower body are affected. People with botulinum poisoning do not have fever or loss of consciousness.

Symptoms usually appear within 12 to 36 hours (minimum and maximum range from 4 hours to 8 days) after exposure to contaminated food. The rate of poisoning is low, but the risk of death after infection is quite high if not treated promptly and appropriately. The mortality rate after poisoning is 5-10%.

To diagnose botulism poisoning , the doctor will check for signs of muscle weakness or paralysis, such as drooping eyelids and slurred speech. The patient will also be asked to list the foods they have eaten over the past week.

In cases of infant botulism, usually due to exposure to toxins after eating honey, constipation and sluggishness are present.

Analysis of blood, stool, or vomit can also help diagnose botulism poisoning. However, these tests often take days and are not as high a priority as a physical examination.

In some cases, patients are prescribed an electrocardiogram, magnetic resonance imaging to check for signs of stroke, and a lumbar puncture to help differentiate it from a syndrome with similar symptoms, Guillain-Barre.

For botulinum poisoning, doctors will treat by draining the digestive system, causing the patient to vomit or urinate repeatedly. In cases of poisoning from an open wound, doctors may surgically remove infected tissue, depending on the severity.

One of the main treatments for people diagnosed early is antitoxin injections, which reduce the risk of complications. The drug binds to toxins still circulating in the blood, keeping them from "running" into the nervous system.

This treatment cannot completely repair the initial damage caused by botulinum. However, nerves have the ability to regenerate themselves. Many patients recover completely, while others may need months of treatment.

In Vietnam, Bach Mai Hospital has proposed to purchase an antidote from Thailand to treat a couple with botulinum poisoning. The drug, called Botulism Antitoxin Heptavalent , is supported by the Ministry of Health and the World Health Organization (WHO) to bring it to Vietnam as quickly as possible for timely treatment.

What is special about Botulinum antitoxin?

Doctor Nguyen Trung Nguyen, Director of the Poison Control Center, said that this drug is called Botulism antitoxin heptavalent (BAT), produced in Canada, and is used to detoxify botulinum.

According to the US Food and Drug Administration, BAT is a mixture of antibodies designated A, B, C, D, E, F, G that specifically treat the respective forms of botulinum toxin.

In terms of mechanism, BAT will provide a passive immune response to the body, through the antibodies it possesses. Specifically, when injected into humans, these antibodies will bind tightly to free botulinum, making them no longer able to interact with nerve cell receptors.

Thanks to this mechanism, BAT helps to significantly reduce paralysis and muscle weakness in patients with botulinum poisoning. Patients who are detoxified will have a reduced risk of severe complications requiring mechanical ventilation.

For newborns, doctors around the world often use a special type of antitoxin, called globulin.

One of the drugs used to treat botulinum poisoning. (Photo: AP).

In some cases, antibiotics are prescribed. However, this method is not recommended for all types of botulinum poisoning because they can speed up the process of toxin dissemination.

If you have difficulty breathing, you may need to use a ventilator for several weeks until the effects of the poison wear off. This can take weeks or even months.

After detoxification, some patients need rehabilitation to improve speech, swallowing, and other affected organs.

To prevent botulism poisoning, people need to follow the principle of "eating cooked food and drinking boiled water". Some products sterilized by heat in industrial and commercial chains (including vacuum-packed or smoked items) may not be hygienic enough and have not completely destroyed bacterial spores.

WHO has proposed the Five Keys to Food Safety: keep clean, cook thoroughly, separate raw and cooked foods, store food at the correct temperature, and use safe water and ingredients.

According to WHO, cases of mass poisoning with botulinum are rare, but they are public health emergencies that require rapid recognition to identify the source of the infection. The patient's prognosis depends significantly on early diagnosis and appropriate treatment.

Although botulism poisoning can cause severe and long-lasting symptoms, most people recover completely. Early treatment reduces the risk of death or permanent disability.