BOTULISM

Etiology

Clostridium botulinumfound in soil and marine sediments

worldwideFruits, vegetables, seafood The most powerful poison known

Contamination: open wounds or ingestion of inappropriately canned or preserved foods

Incubation:8-36 hours

Epidemiology

The profession-the cooksThe sex: femalesThe age: the youngThe source:95% cases- inadequately cooked

food home-made, especially meatIncreased susceptibility: alcohol -

consumption

Simptoms

Onset (4-24 hours) with neural damage: troubles of vision(fotofobia,diplopia, ptosis,nistagmus), difficulty swallowing and speaking

Agravation(1-6 weeks):peripheral nerve paralysis muscarinic type manifestation disorders of muscular activity signs of respiratory failure coma-like statusPeculiarities:NO fever, diarrhea or loss of consciousness

Diagnosis

Clostridium botulinum -home-canned vegetables, honey, corn syrup, smoked or raw fish, and cured pork and ham

Laboratory confirmation is done by demonstrating the presence of toxin in serum, stool, or food, or by culturing C. botulinum from stool, a wound or food

Differential DiagnosisADULTSGuillain-Barre syndromeCerebrovascular accident (CVA)Bacterial and/or chemical food poisoningTick paralysisChemical intoxication (e.g., carbon monoxide)Mushroom poisoningPoliomyelitisPsychiatric illnessMiastenia gravis

Differential Diagnosis

CHILDRENS

SepsisMeningitisElectrolyte-mineral imbalanceReye’s syndromeCongential myopathyWerdnig-Hoffman diseaseLeigh disease

Treatment

Medical emergency General:clear the digestive system(to induce

vomiting,enema,acetilcolin i.v.,hydration)Specific:the antitoxin-in the first 24 h -10%

mortality, no antitoxin-46% mortalitySupportive measures:Breathing assistance Rehabilitation

Prophylaxis:

It can be used as a biological weaponOnly for the laboratory-technicians or in the

army2004-vaccine