Foodborne Botulism: A Study of 57 Cases in Northwest Iran

Nejadrahim, Rahim; Delirrad, Mohammad

doi:10.29252/arakmu.10.6.45

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…This finding is in line with other cases reported in the united states, San Francisco (19) and Atlanta, Georgia (20) especially in patients who were poisoned with BoNT type A or B. It is important to differentiate botulism and other central nervous system deficits which may mimic botulism such as Guillain-Barre syndrome, Myasthenia Gravis and Lambert-Eaton myasthenic syndrome (3,9). These patients usually have fever, ataxia and elevated cerebrospinal fluid (CSF) protein, but they often have normal pupils (18,21).…”

Section: Discussionsupporting

confidence: 88%

A Foodborne botulism Occurrence in Mashhad: Clostridium botulinum in local cheese

Kamaloddini

Kheradmand

2020

J Emerg Pract Trauma

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Introduction Foodborne botulism is caused by the anaerobic bacterial agent-Clostridium botulinum-that is a gram-positive bacteria (1) and one of the most common life-threatening agents in the United States, Europe and Iran (2-4). In 2011, 140 cases of botulism were reported to the US Centers for Disease Control and Prevention which 14% of cases were due to food-borne botulism (5). Seven types of clostridium named A-G are studied (6) in which A, B, E, and F are the main potent poisoning types in human that produce botulinum neurotoxin (BoNT). These types of clostridium get absorbed in GI after ingestion and may lead to morbidities such as paralysis and mortality, although their toxins are sensitive to heat (4,7). Mostly, foodborne botulism is associated with consuming canned tuna fish, home-preserved or commercial food which contain vegetables (4,8-10). C. botulism releases neurotoxins into the blood and they bind to cells and lead to the impairment of the voluntary motor presynaptic cholinergic receptors and autonomic neuromuscular junctions (11-13). This leads to dizziness, blurred vision, slurred speech, ptosis (14) descending flaccid paralysis and respiratory failure because of the failure of transmission (11-13). All in all, the clinical symptoms can be observed after an incubation period and they are dependent on the serotype and degree of exposure to the toxin (15,16). Therefore, clinical findings are the principal key to the early diagnosis of botulism (2). Case Presentation A 48-year-old Caucasian woman referred to the emergency department complaining about acute dysphonia accompanied with dysarthria which cooccurred with dizziness, progressive symmetric hypotonia in upper and lower limbs, dilated pupils, facial paresthesia and bilateral ptosis. She had no dysphagia, fever, respiratory distress or vertigo. She had a history of consuming local dairy cheese. Based on clinical findings, the patient was admitted with the impression of botulinum intoxication. Botulism anti-toxin was administered. One vial of tetravalent botulism antitoxin was given intravenously as a 1:10 vol/vol dilution in 0.9% sodium chloride TDS. Since the most common cause of mortality is respiratory failure (17), supportive care was prepared and O 2 therapy, cardiac monitoring, pulse oximetry, and rapid sequence intubation equipment were considered and prepared in case of necessity. To rule out other probable causes, a neurology consult was requested. Blood and feces sample were taken and the probable occurrence of botulism was informed to the Health Center. The patient gradually became better. On the fifth day, the patient still had dysphonia and perioral paresthesia. She was hospitalized

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Section: Discussionsupporting

confidence: 88%

A Foodborne botulism Occurrence in Mashhad: Clostridium botulinum in local cheese

Kamaloddini

Kheradmand

2020

J Emerg Pract Trauma

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“…In previous reviews conducted in Iran, the number of men with botulism was reported higher than women, and their mean age was 22.35 years [16]. Also, in previous studies in Iran, locally produced cheese was the most common food causing botulism, and neurotoxin type A was the highest neurotoxin found in patients [16,17]. Also, in our review, the mean age of the patients was 36.9 years, the number of men was higher than that of women, and dairy products followed by canned foods were the most consumed foods.…”

Section: Discussionmentioning

confidence: 94%

Investigation of the Frequency of Foodborne Botulism in Patients Referred to Loghman Hospital in Tehran City, Iran, From 2008 to 2019

Dallal

Najar

Shabani

et al. 2020

Int J Med Toxicol Forensic Med

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Background: Foodborne botulism is a fatal paralytic illness caused mainly by the neurotoxin produced by an anaerobic bacterium called Clostridium botulinum. In this study, the frequency of foodborne botulism in patients referred to a hospital in Iran has been reviewed for ten years.Methods: In this routine database study, medical records of patients with foodborne botulism referred to Loghman Hospital in Tehran City, Iran, from March 20, 2008, to March 20, 2019, were reviewed. Information on variables of age, sex, place of residence, food consumed, clinical symptoms of patients (such as dysphagia, nausea, vomiting, ataxia, etc.), toxin type, and length of hospitalization were collected with a researcher-made questionnaire. Finally, the collected data were analyzed in SPSS-24 with descriptive and analytical statistical tests.Results: In this study, 61 suspected botulism patients were clinically diagnosed in Loghman Hospital, of whom 55 patients were clinically suspected of foodborne botulism, 5 patients had iatrogenic botulism, and 1 patient had infant botulism. Of these 55 patients with the clinical diagnosis of foodborne botulism, 19 patients were confirmed by laboratory examinations, and 2 patients died. Sixteen patients confirmed by laboratory had neurotoxin botulinum type A. The mean age of the patients was 36.9 years with a standard deviation of 18.6 years. About 54.5% of the patients were male and 45.5% female. Weaknesses (58.2%), ptosis (droopy eyelid) (56.4%), and diplopia (double vision) (52.7%) were the common clinical symptoms of the patients under study. Canned foods and dairy products were the main foods consumed by the patients. The duration of admission time ranged between 1 and 41 days, with an average of 7.7 days. About 23.64% of patients were admitted to the intensive care unit.Conclusion: The prevalence of foodborne botulism is rare compared with other food poisonings but is still a major public health problem due to the consumption of traditional food products and unboiled canned foods in Iran.

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Perfil epidemiológico de acometidos por botulismo no Brasil entre os anos de 2008 a 2018

Silva

Lima

Cândido

et al. 2020

RSD

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Botulism presents as a bacterial infection, neuroparalytic and non-contagious infection caused by toxins produced by Clostridium botulinum, called botulinum toxins. However, even though this disease has a high lethality, there is a great lack of epidemiological studies on this topic in Brazil. Based on that, this research aimed to trace the epidemiological profile of botulism in Brazil between the years 2008 to 2018. It is an epidemiological, retrospective, analytical and documentary study, in which data were collected from the Department of Informatics of the Unified Health System. Between 2008 and 2018, 69 cases of botulism confirmed in Brazil were evidenced, with the state of São Paulo having the highest number of notifications (30.5%). The profile of those affected was mostly male (58%), low education (26%), 20 to 39 years old (47.8%), white ethnicity (59.4%), residents of the urban area ( 85.5%), contracted botulism, mainly food-type (94.2%), with the presence of AB toxins (15.9%) and clinical cure outcome (68.1%). Thus, the data present in this research can contribute to the development of indicators and public policies related to botulism.

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Foodborne Botulism: A Study of 57 Cases in Northwest Iran

Abstract: Background: Foodborne botulism (FBB) is a rare paralyzing disease caused by ingestion of foods contaminated with botulinum neurotoxin (BoNT). It is still a health concern in many countries. This study aimed to investigate the epidemiology of FBB in West Azerbaijan Province, Iran.

Cited by 3 publications

References 21 publications

A Foodborne botulism Occurrence in Mashhad: Clostridium botulinum in local cheese

A Foodborne botulism Occurrence in Mashhad: Clostridium botulinum in local cheese

Investigation of the Frequency of Foodborne Botulism in Patients Referred to Loghman Hospital in Tehran City, Iran, From 2008 to 2019

Perfil epidemiológico de acometidos por botulismo no Brasil entre os anos de 2008 a 2018

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