Receiving and treating 3 children with Botulinum poisoning

Cho Ray Hospital doctor examines a child with Botulinum poisoning

On the morning of May 16, information from Cho Ray Hospital, Ho Chi Minh City, this unit has just diagnosed and determined that 3 children in the area were poisoned by Botulinum.

Immediately, 2 bottles of BAT antidote were urgently transported from Quang Nam to Ho Chi Minh City for timely treatment.

On May 14, three siblings, NVH (14 years old), NVĐ (13 years old) and NTX (10 years old), all residing in Thu Duc City, were taken to Children's Hospital 2 in a state of exhaustion, pain, and muscle weakness.

The family said that on the morning of May 13, the aunt and three siblings bought pork roll from a street vendor to eat with bread. The pork roll was wrapped in 2 layers of nylon and 1 layer of banana leaves.

By the afternoon of the same day, all four people had stomachaches, nausea, vomiting and diarrhea many times; then symptoms of fatigue and body aches appeared, of which three children gradually had weak arms and legs.

At Children's Hospital 2, doctors noted that NVĐ had symptoms of drooping eyelids, weakness in both legs, then respiratory failure, requiring intubation and mechanical ventilation.

The other two children also had drooping eyelids, gradually weakening limbs, and muscle strength of about 4/5.

Suspecting that the children were poisoned, Children's Hospital 2 invited doctors from Cho Ray Hospital to assist.

On the afternoon of May 15, after an inter-hospital consultation, doctors from the two hospitals agreed to diagnose the child with suspected Botulinum poisoning due to eating pork roll.

At 7:00 p.m. the same day, paraclinical tests were consistent with a diagnosis of Botulinum poisoning.

Due to the urgency, doctors decided to treat Botulinum poisoning as soon as possible to avoid serious complications.

Cho Ray Hospital immediately contacted the Northern Mountainous Region General Hospital of Quang Nam to transfer 2 vials of BAT antidote to Ho Chi Minh City.

This is the remaining medicine after the treatment for a cluster of poisoning cases after eating pickled fish in March 2023, in Quang Nam.

At 1:00 a.m. on May 16, two vials of BAT antidote arrived in Ho Chi Minh City and were immediately used for three children with Botulinum poisoning.

After being given the medicine, all 3 victims were stable, showed no signs of anaphylaxis after receiving the antidote and continued to be monitored, examined and assessed for their health status at Children's Hospital 2.

In recent times, many poisoning cases have occurred when people consumed foods containing botulinum toxin. Many cases have left serious sequelae and some have died.

BAT antidote used to treat botulinum poisoning in 3 children

A typical example is the "Minh Chay pate" poisoning incident that occurred in July 2020. Test results of a number of "Minh Chay pate" products in different batches detected Clostridium botulinum type B bacteria.

This is an absolutely anaerobic, spore-forming bacteria; the toxin of Clostridium botulinum bacteria is very virulent, has a severe impact on health, is long-lasting and can easily lead to death.

The most recent case of poisoning from pickled carp has left one person dead and many hospitalized in three communes of Phuoc Duc, Phuoc Kim and Phuoc Chanh in Phuoc Son district, Quang Nam province. The cause of the poisoning was determined to be botulinum toxin in pickled carp – a specialty dish of the local people.

Many people are worried and ask whether pickled fish is the cause of botulinum toxin proliferation. How to prevent food poisoning caused by botulinum toxin?

According to the Food Safety Department (Ministry of Health), botulinum toxin is produced by the bacterium Clostridium botulinum in an anaerobic environment (an environment lacking air). This is a rod-shaped, anaerobic (anaerobic) bacterium that forms spores when conditions are favorable. The toxin is only produced in anaerobic conditions.

Clostridium botulinum is a common bacterium found in many parts of the world, especially in soil. However, it only produces toxins under anaerobic conditions, and does not produce toxins under normal conditions. This toxin can be destroyed at a temperature of 100 degrees Celsius for about 10 minutes.

Botulinum is the most dangerous and most toxic toxin, with a lethal dose of 1.3mcg-2.1mcg/kg.

This toxin appears when food is processed unhygienic, because this bacteria is present in soil and water; the product is not treated with heat, leading to the development of toxins and causing poisoning. Along with that, the current food containers are very airtight, so it is easy to create anaerobic conditions.

With very small amounts of this toxin, it can be fatal, so people poisoned by botulinum toxin show symptoms of nausea, vomiting, bloating, abdominal pain, paralysis in the order of paralysis starting from the head, face, neck, spreading down to the arms, then to the legs, paralysis of the respiratory muscles; severe paralysis can cause respiratory failure, which is the cause of death.

According to Vietnam+