From the double vision to muscle paralysis: here’s what happens to the body during a intoxication from botulism and which treatments allow you to avoid fatal consequences.
Botulism is rare but extremely dangerous food intoxication, caused by botulinum toxin produced by the bacterium Clostridium botulinum: infinitesimal quantities, measurable in nanograms, are sufficient to cause serious and potentially lethal damage. In August, in Italy they occurred Serious outbreaks of food botulism -LEl the probable consumption of sandwiches with sausage and broccoli by a food truck in Calabria and avocado pulp during a festival in Sardinia. At the moment the balance is two dead, a 52 -year -old man and a 38 woman, seven patients hospitalized in intensive care and a child in critical conditions transferred to the Gemelli Policlinico from Sardinia. Unlike other food poisonings, botulism does not cause fever or inflammatory symptoms, but acts directly on the nervous systempreventing the transmission of impulses from nerves to muscles. This block causes a progressive paralysis which, if not treated, can lead to respiratory failure.
The end “botulism” comes from Latin Botulus (sausage)precisely because since the most remote times it has been associated with the preparation and consumption of homemade sausages: the Clostridium Botulinum is able to produce a neuro-toxin which is considered the most powerful poison existing in nature and so far known. One gram can kill more than 14,000 people by ingestion and a tiny quantity is enough to be lethal. It is considered a bacteriological weapon that could be used by terrorist organizationsand it is good to know that sterilizing, undermine and boil everything is not enough: in the domestic environment it is impossible to make the jars reach the right temperatures to cancel the risks. Historically, the rural areas of southern Italy are those in which more cases occur, because they are the regions where we tend to prepare home preserves, and the impact in our country is among the highest in Europe.
“It is a rare disease: in Italy there are about 40 cases the year of botulinum poisoning, a stable number for some time and in most cases due to contamination of home preserves” explains the prof. Carlo Alessandro Locatelli, Director of the Antiviolene Center Maugeri Pavia . “The cases that emerged in these days belong to two different clusters. In the first event in Sardinia, responsible food was identified and it is an industrial sauce. The Ministry has already issued the alerts of the case through the procedures that in Italy are very efficient. For the second event in Calabria, analysis are still underway even if all patients have a food consumed in a public exercise in common. The foods are contaminated by the toxin that the Clostridium Botulinum produces in particular conditions “.
THE Symptoms of botulism They generally appear between the twelve and thirty -six hours from the ingestion of the contaminated food, but sometimes they can occur even after a few days. In the initial phase, generic symptoms such as nausea, vomiting and abdominal pain. Then follow disorders concerning the vision, with the appearance of Double vision, clowning and difficulty in focusing. The pupils can be dilated and slowly react to light. Almost simultaneously they can appear dryness of the mouth, Difficulty speaking and swallowingwith a faint or nasal voice. The muscle weakness, initially located with face and neck, then extends to the shoulders, chest and limbs. For this progression it is also called the 4D disease: Diplopia, disartria, dysphonia, dysphagia.
There botulinum toxin blocks the release of acetylcholine, an indispensable neurotransmitter for muscle contraction. Without this signal, the muscles remain inactive and relax completely, giving rise to one flaccid paralysis. If the process involves respiratory muscles, the risk of respiratory failure It becomes very high and requires immediate assisted ventilation. “Botulinum toxin is not seen and often does not alter the flavor of foods” continues Locatelli. “The antidote is effective in the initial phase of the intoxication, when the toxin is still circulating. While the toxin is subsequently binds to the nerves e Recovery is difficult and very slow. Prevention is therefore fundamental: accurate sterilization, respect for the guidelines of the Ministry of Health and never give honey or home preserves to children under the year “ . Botulism treatment is a medical emergency. At the suspicious diagnosis, the patient is hospitalized immediately. The treatment provides for the administration of Botulinum antitoxinwhich neutralizes the toxin still free in the circle. However, it does not act on the one already linked to the nerves, which is why timeliness is decisive. In severe cases, respiratory support is needed through mechanical ventilation, together with hydration, assisted nutrition and rehabilitation. Recovery can take months, since nerve endings must regenerate. There Botus prevention It is based on correct food conservation practices. It is essential to sterilize the homemade preserves – even if not even this practice takes 100% away from the risks- heat any suspicious foods at 85 ° C for at least five minutessince the toxin is thermolable and is inactive with heat. It is not necessary to consume foods from the smell or an anomalous appearance and it is always necessary to respect the storage temperatures and the expiry dates.
