Signs of botulism in humans indicate the presence of a dangerous disease. It is insidious that infected products most often look quite benign, but at the same time they can become a source of severe pathology. Untreated botulism is fatal. The initial symptoms of this disease resemble food poisoning. Often, patients begin to be treated with home remedies and seek medical help only when the pathology has already affected the nervous system.
Causative agent of the disease
The causative agents of botulism are clostridia. This microorganism belongs to rod-shaped bacteria. His body is equipped with special flagella with which clostridia move.
These bacteria live inside the body of waterfowl, fish, and also warm-blooded mammals. Animals are often asymptomatic carriers of infection. Clostridia go out with feces. Once in the soil, bacteria turn into spores. In this state, microorganisms can persist for quite a long time.
Bacteria enter the food from the soil. In the absence of oxygen access, botulinum toxin is released. It is these conditions that are created in canned food; this product most often becomes a source of infection. Clostridia are anaerobic bacteria. This means that an oxygen-free environment at a temperature of +35 degrees is the most favorable for their life.
Botulinum toxin is one of the most powerful natural poisons. Even in the smallest doses, it is deadly to humans. This poison cannot be destroyed by the use of salt and spices during canning. Clostridia in the form of rod-shaped bacteria die during boiling for 5 minutes. However, it is very difficult to destroy this microorganism in the form of spores, this is only possible with autoclaving.
Infection pathways
There are several ways to get infected with toxin and spores:
- Fecal-oral. The causative agent enters the body when eating infected canned food.
- Wound. Spores penetrate from infected surfaces into the body through damaged skin.
- Respiratory. Infection occurs by inhalation of spores.
With fecal-oral infection, botulinum toxin enters the body, and with wound and respiratory infection - spores. In the vast majority of cases, infection occurs with the use of canned food. The wound infection method is quite rare. It is possible if soil enters the bloodstream with spores of clostridia.
Cases of infection through the respiratory system are very rare. You can get infected only by inhaling a large number of spores.
In this case, the patient does not pose a danger to others. It does not secrete or spread clostridia. This disease proceeds as intoxication with botulinum poison, which cannot be transmitted from person to person.
Botulism does not give persistent immunity. A person can become infected with this disease repeatedly. A close to lethal dose of toxin is needed to form an immune response. If such an amount of botulinum poison enters the body, then most often a fatal outcome occurs. For this reason, an effective vaccine against this disease has not yet been created.
Pathogenesis of the disease
Botulinum toxin is a protein compound. This is the strongest nerve poison. Once in the body, it does not break down in the digestive tract under the influence of hydrochloric acid and enzymes. In addition, a person can swallow not only the toxin with infected canned food, but also living clostridia, which will produce new portions of the poison in the body.
Botulinum toxin blocks the transmission of impulses from the central nervous system to the muscles. As a result, the muscles do not receive a signal for contraction and relaxes. A sharp decrease in muscle tone occurs, up to a complete cessation of their function. Pseudo-paralysis occurs. This condition should be distinguished from true paralysis when anatomical changes occur in the central nervous system. Botulinum toxin causes only functional disorders, after treatment, muscle function is restored.
First of all, the muscles of the eyes, larynx and pharynx are affected. It becomes difficult for the patient to swallow, his vision is impaired, his voice becomes hoarse. Then the muscles of the ribs and diaphragm are involved in the pathological process, which leads to disruption of the breathing process. A strong oxygen deficiency is formed in the body. Respiratory failure is one of the main causes of death in botulism.
In addition, the effect of botulinum toxin negatively affects the condition and function of blood cells - white blood cells and red blood cells. Because of this, a person's resistance to infections decreases sharply and the level of hemoglobin decreases.
Signs of food contamination
In most cases, the signs of botulism in conservation cannot be determined. This is the insidiousness of the disease. Contaminated canned foods may look normal. It is impossible to detect the presence of clostridia in the appearance of the product. Infected preservation does not change color, taste and does not have an unpleasant odor.
However, there are signs of botulism in the bank that may indicate infection of the product. These include:
- Swelling and other deformations of the lid (bombing). This does not always indicate the presence of clostridia. Other anaerobic bacteria can also be the cause of the bombing. But such canned food should never be eaten. The probability of their infection with botulinum toxin is very high. Sometimes people believe that boiling canned food can help kill the infection. But this is an erroneous opinion. Heat treatment does not affect botulinum toxin.
- Spontaneous opening of the can due to the opening of the lid. This indicates increased gas formation and the presence of anaerobic bacteria.
- Mold on the product. This is an indirect sign of botulism in conservation. Mold is formed due to the multiplication of fungal bacteria. Such a bank creates favorable conditions for the life of clostridia.
- Expiration date. The use of expired canned foods carries a high risk of infection with clostridia.
It is important to remember that the absence of the above defects does not indicate that there is no botulism in canned food. An infected product may appear to be benign. The toxin has no taste or smell.
Some types of foods carry an increased risk of botulism. These include the following canned food:
- Home preservation. If the processing rules are violated, clostridia may enter the product. The correct preservation technology is not always followed at home. Disputes enter the product with insufficient washing of fruits and vegetables, as well as with poor sterilization of cans. Infection can enter homework through hands contaminated with soil particles.
- Canned mushrooms made at home. You can get infected by using any preservation: vegetable, fruit, berry. However, fungi most often cause botulism. They grow in land that may contain spores. High quality peeling of mushrooms from soil particles is sometimes difficult. As a result, clostridia fall into the bank. Even the heat treatment of the product before canning does not always destroy the spores. The use of vinegar also does not destroy the toxin. Therefore, the product must be processed in special autoclaves before harvesting. Frozen mushrooms are not dangerous, since the toxin is released only at high temperatures.
- Homemade canned meat and fish. Such a product requires professional processing. Homemade stew and canned fish very often cause botulism. The product is usually cooked in the oven and then rolled into a jar. Such heat treatment is not enough to destroy spores. In the manufacture of canned meat and fish at home, it is necessary to use autoclaving.
It should be remembered that the release of botulinum toxin occurs only in hermetically sealed cans. Under such conditions, there is no oxygen, and the anaerobic environment is favorable for clostridia. If plastic and metal screw caps are used, botulism is unlikely to develop. In this case, the bank is not closed tightly and no anaerobic conditions are created.
The first symptoms of the disease
The incubation period usually lasts from 2 to 12 hours after bacteria or spores enter the body. After this, there are signs of botulism in humans. About it further. However, the duration of the latent period may be longer. It depends on the amount of botulinum toxin ingested. Symptoms of the disease may appear after 2 - 3 days, and in isolated cases - and after 9 - 12 days. With the wound method of infection, the incubation period is from 4 to 14 days. The faster the signs of botulism poisoning occur, the more severe the disease will be. A short incubation period indicates that a large amount of toxin has entered the body.
The first signs of botulism are similar to manifestations of a gastrointestinal disease or food poisoning. They are associated with the effects of toxin on the gastrointestinal mucosa. The following symptoms are noted:
- acute abdominal pain localized in the center of the abdomen;
- diarrhea (up to 3 to 10 times a day);
- repeated vomiting.
In addition, there may be: fever, malaise, headaches. The characteristic clinical signs of botulism have not yet been observed. In the initial period of the disease, only a digestive tract lesion occurs. This lasts about 24 hours. By the end of the first day of illness, the patient's temperature decreases. Diarrhea passes, severe constipation occurs due to intestinal atony. This suggests that botulinum toxin has already begun to affect the nervous system.
Typical signs of infection
The most characteristic clinical signs of botulism appear a day after the first gastrointestinal manifestations. First, the toxin affects the cranial innervation of the eye muscles. The following visual impairment develops:
- fog or grid feeling in front of the eyes;
- double vision
- dilated pupils;
- deterioration in visual acuity;
- prolapse of the upper eyelid (ptosis);
- strabismus;
- disturbances in the movements of the eyeballs (up to immobility).
At the same time, the toxin disrupts the innervation of the throat. The characteristic signs of botulism from the oropharynx and larynx appear:
- It becomes difficult for a person to swallow solid food, and then liquid food. When you try to drink, water can pour out through the nasal passages.
- Discomfort and constant presence of a lump in the throat are felt.
- The patient's voice changes the timbre, nasal appears. Then hoarseness occurs. In severe cases, the voice is completely lost.
If a person has such symptoms after consuming canned food, then an ambulance must be called immediately. Before the doctor arrives, the patient needs to rinse the stomach with a solution of soda and give enterosorbent. Otherwise, the disease will progress and without treatment can lead to death.
In the future, the muscles of the ribs and abdominals are involved in the pathological process. Because of this, respiratory function is impaired. The most characteristic signs of botulism at this stage of the disease are as follows:
- pain and a feeling of tightness in the chest;
- difficulty breathing
- a feeling of lack of oxygen;
- frequent and shallow breathing movements.
Then a person develops weakness of all skeletal muscles. The patient hardly holds his head due to impaired transmission of impulse to the cervical muscles. The patient becomes inactive, his face looks masky and pale. In addition, there is severe constipation with bloating, as well as a delay in urination due to a decrease in the tone of smooth muscles.
Botulism in infants
The signs of botulism in adults and children over 1 year old were listed above. However, this pathology is observed in infants. There is the term "infant botulism", this disease is found only in infants up to 6 months. In this case, not the toxin but the spores of clostridia enter the body.
A child may become infected through dirty hands. Also, various objects that the baby pulls in his mouth can become a source of infection. Spores enter the body along with dust. There are known cases of infection through honey, which is used in the preparation of infant formula for artificial nutrition. Therefore, doctors do not recommend giving this product to babies up to 1 year old.
In infants, the gastrointestinal period of the disease is absent. The following neurological signs of botulism appear in infants:
- loss of appetite;
- mild breast sucking;
- difficulty swallowing;
- severe hoarse crying;
- persistent constipation;
- inability to hold the head due to neck muscle weakness.
If such symptoms are found in babies up to 6 months old, you should immediately call a doctor. Botulism is extremely dangerous for babies and can lead to the death of a child.
Diagnosis and treatment
When clinical signs of botulism occur, the patient is placed in a hospital. This disease cannot be cured at home. A blood test is taken from the patient to detect botulinum toxin. This must be done before starting treatment. Also sow feces and vomit. In addition, the presence of botulinum poison is examined and canned food, which the patient consumed as food.
If the patient has obvious signs of botulism, then treatment is started without waiting for the results of the tests. The following methods of therapy are used:
- administration of anti-botulinum serum along with corticosteroid hormones (effective in the first 3 days of illness);
- infusion therapy with detoxification solutions;
- antibacterial prophylaxis to prevent secondary infection;
- gastric lavage (in the early stages);
- resuscitation measures aimed at supporting breathing.
Clostridium toxin poisoning is manifested by extremely severe symptoms. But in the process of treatment, all signs of botulism gradually disappear. After a course of therapy, the motor function of the muscles is fully restored. However, this takes a fairly long time.
The patient is treated in a hospital for at least 3 to 4 weeks. Then the patient is 14 days under outpatient medical supervision. The rehabilitation period after an illness takes from 3 to 6 months.
Complications and prognosis of the disease
With proper treatment, all body functions are restored. Botulism does not lead to subsequent disability. However, in the acute period of the disease, the following complications may occur:
- respiratory failure;
- pneumonia;
- purulent tracheitis and bronchitis;
- muscle inflammation (most often gastrocnemius);
- inflammation of the parotid glands (very rare).
The prognosis of the disease depends on how timely the patient seeks medical help. If a large amount of toxin enters the body, and the treatment was prescribed too late, then a fatal outcome occurs in 30-60% of cases. It is important to remember that anti-botulinum serum helps only in the first 3 days of illness. Therefore, it is necessary to consult a doctor at the initial signs of botulism. If the serum was introduced on time, and the necessary treatment was carried out, then mortality is reduced to 3 - 4%.
Prevention
The main preventive measure is compliance with the rules of conservation of products. When preparing homemade preparations, it is necessary to rinse vegetables, fruits and berries well. It is also important to thoroughly sterilize the cans. Before canning, wash your hands so that no soil particles remain on the skin.
At home, you should not make canned mushrooms with sealed lids. The oxygen-free environment is favorable for clostridia. It is better to cook salted mushrooms in a jar with a plastic lid, such preservation is not dangerous, or use an autoclave.
Very often, infection occurs when consuming home-made canned meat and fish. In the manufacture of such a product, preliminary autoclaving is necessary. No other heat treatment will help to destroy clostridia.
You should also avoid eating canned food with obvious signs of poor quality. Swollen cans should be discarded immediately. It is also unacceptable to preserve expired. Compliance with these rules will help prevent a serious and dangerous disease.