Botulism is a rare condition and can be fatal, caused by
poisoning toxins (poisons) produced by Clostridium botulinum. This toxin is
extremely potent venom and can cause nerve damage and muscle weight. For
causing severe damage to the nerves, the toxin is called neurotoxins. There are
three types of botulism, namely:
- Foodborne botulism, is the result of contaminated food
digest
- Wound botulism, caused by a contaminated wound
- Infant botulism, occurs in children, due to contaminated
food digest.
Cause
Clostridium botulinum bacterium spores have form. These
spores can survive in a dormant state (sleep) for several years and hold
tehadap damage. If the surrounding moist environment, there is enough food and
no oxygen, the spores will begin to grow and produce toxin. Some of the toxin
produced by Clostridium botulinum has a high protein content, which is
resistant to degradation by intestinal protective enzymes. If eating
contaminated food, toxins enter the body through the digestive tract, causing
foodborne botulism. The main source of botulism is canned food. Vegetables,
fish, fruits and spices is also a source of the disease. Similarly, meat, dairy
producti, pork and poultry. Wound botulism occurs when wounds are infected by
Clostridium botulinum. In the wound, the bacteria produce a toxin which is then
absorbed into the bloodstream and eventually cause symptoms. Infant botulism is
common in infants 2-3 months old. In contrast to foodborne botulism, infant
botulism is not caused by ingesting toxins that have been formed earlier.
Botulism is caused by eating foods that contain spores, which then grow in the
intestines and produce toxins baby. The cause is unknown, but some cases are
related to the provision of honey. Clostridium botulinum is found in the
environment and many cases are the result of inhaling a small amount of dust or
soil.
Symptom
Symptoms occur suddenly, usually 18-36 hours after toxin
entry, but can occur later than 4 hours or 8 days after toxin entry. The more
toxins that enter, the sooner someone will be sick. In general, a person who
became ill within 24 hours after eating contaminated food, will have a severe
illness. The first symptom is usually a dry mouth, double vision, sagging
eyelids and inability to see the focus on close objects. Pupillary reflexes
diminished or none at all. In some patients, the initial symptoms are nausea,
vomiting, abdominal cramps and diarrhea. In patients with other
gastrointestinal symptoms did not show up, especially in patients with wound
botulism. Patients have difficulty speaking and swallowing. Difficulty
swallowing can lead to inhalation of food into the respiratory tract and cause
aspiration pneumonia. Arm muscles, limbs and respiratory muscles weaken.
Failure of nerve mainly affects muscle strength. At two thirds of infant
botulism patients, constipation (constipation) is an early symptom. Then there
was paralysis of the nerves and muscles, which starts from the face and head,
finally got to the arms, legs and respiratory muscles. Nerve damage can be
confined to one side of the body. Problems caused varied, ranging from mild
lethargy and difficulty swallowing, until the loss of weight and muscle tension
respiratory disorders.
Diagnosis
On foodborne botulism, the diagnosis is made based on the
typical pattern of nerve and muscle disorders. But these symptoms are often
confused with other causes of paralysis, such as stroke. Any food suspected as
the source of these abnormalities are also additional instructions. If botulism
occurred in 2 or more people who eat the same food and in the same place, it
will be easier to diagnose. To confirm the diagnosis, blood examination to find
any toxin or culture of a stool sample to grow the bacteria causing the
infection. Toxins can also be identified in the suspected food.
Electromyography (examination to test the electrical activity of muscles)
showed abnormal muscle contractions after being given electric stimulation. But
this is not found in any case of botulism. Diagnosis of wound botulism is
reinforced by the discovery of toxins in the blood or by culturing the bacteria
in tissue samples wounded. Discovery of bacteria or toxins in the baby's stool
sample, confirms the diagnosis of infant botulism.
Treatment
Patients with botulism should be immediately taken to the
hospital. Treatment to be done though not yet obtained the results of
laboratory tests to confirm the diagnosis. To remove toxins that are not
absorbed performed:
- Stimulation of vomiting
- Emptying of the stomach through gastric lavase
- Giving laxatives to accelerate intestinal evisceration.
The greatest danger of botulism is respiratory problems. Vital signs (blood
pressure, pulse, breathing frequency and temperature) should be measured
routinely. If respiratory problems began to occur, the patient was taken to
intensive care and can use a respirator. Intensive care have reduced mortality
due to botulism, from 90% in early 1900 to 10% now. Feeding may be done through
an IV. Giving antitoxin can not stop the damage, but it can slow down or stop
the deterioration of physical and mental further, so that the body can make
repairs over several months. Antitoxin is given as soon as possible after
diagnosis. This provision is generally effective when performed within 72 hours
after the occurrence of symptoms. Antitoxin is not recommended to be given to
infants, because of its effectiveness in infant botulism is still unproven.
Prevention
The spores are very resistant to heating and can stay
alive for several hours in the boiling process. But toxins can be destroyed by
heating, therefore cook food at a temperature of 80ï ¿½ Celsius for 30 minutes,
can prevent foodborne botulism. Cooking food to eat before the people, is
almost always able to prevent foodborne botulism. But the food is not cooked
properly, can cause botulism if stored after it is cooked, because the bacteria
can produce toxin at temperatures below 3i ¿½ Celsius (refrigerator
temperature). Important to heat canned food before serving. Canned foods that
have been damaged can be deadly and should be discarded. When the can dented or
leaking, it should be discarded. Children under 1 year should not be given
honey because there may be spores in it. Toxin that enters the human body,
either through the digestive tract, air or absorption through eyes or wounds in
the skin, can cause serious illness. Because of that, the food may have been
contaminated, should be discarded. Avoid skin contact with an infected person
and always wash your hands immediately after handling food.
