The latest case, the most recent of the many that appear in the news, speaks of an elderly lady who died botulismbotulinum poisoning. But what is it? The picture is linked to the toxin produced by a bacterium, the Clostridium botulinumand what happens is due to one neuroparalytic syndrome. So we are faced with a very fearsome germ. Here are the characteristics of the bacterium and what you need to pay attention to.
An anaerobic bacterium
The Clostridium botulinum it is a Gram-positive, spore-forming, obligate anaerobic, poorly motile germ. It produces spores able to resist up to 3-5 hours at a temperature of 100 degrees while at temperatures of 121 degrees the spores are destroyed in three minutes. Heat resistance is decreased acidic environment and in the presence of high salt and sugar concentrations. Botulinum toxin, on the other hand, is thermolabile and is destroyed by exposure to temperatures above 80 degrees for at least 10 minutes.
There are different types of botulinum toxin. And not all are associated with foodborne botulism: those most frequently with food poisoning they are A, B and E. The bacterium is potentially found in many conditions, and its spores present in the soil can affect various food products.
What foods are most at risk?
Generally the problem is linked to the consumption of vegetable preserves in oil or water (aubergines, courgettes, hot peppers and mushrooms) almost always of domestic productionas well as ad sausages always homemade. Precisely that of food origin, however, it is the most classic form of botulism and is linked to the ingestion of preformed toxin in food contaminated with Clostridium botulinum spores. The period of incubation of various food poisoning from 12 hours to two days but it can also last, albeit rarely, even longer.
How it manifests itself
The clinical manifestations in this form almost exclusively concern the nervous system. Initially they may appear visual disturbances: ranging from simple accommodation disorders to diplopia and eyelid ptosis. At the same time, slight symptoms may also occur dysphagia and dry mouth.
In the more serious forms, the involvement of the nervous system tends to increase and actual symptoms may appear paralysis of the limbs with serious respiratory difficulties linked to the blockage of the functioning of the brain bulb.
Not just food
As with tetanus, there is theoretically a form linked to Clostridium botulinum as well direct contamination dthe wounds. However, it should be remembered that botulinum infection in this case is much rarer than tetanus. It can be found especially in lacerated and bruised wounds which are contaminated by spores of the germ which germinate and multiply in an anaerobic environment. The incubation period in this case is longer than the food form and can vary from 4 to 14 days, while the symptoms are similar to those of food-induced botulism.
A particular form of botulism is that which affects i newborns and infants. In this form, the ingestion of Clostridium spores can lead to intestinal colonization and the production of the toxin. The first symptom of infant botulism is often a stubborn constipationwhich they follow numbness and difficulty sucking and swallowing. Later, growth retardation and the “floppy-baby” picture may appear, with head lolling and generalized hypotonia.
How to recognize and prevent it
The symptoms of foodborne botulism are often classic and must be linked to the medical history. It is necessary to associate the picture with the patient’s recent clinical history to understand if there has beenintake of a suspicious food and potentially capable of containing botulinum toxin.
Returning to the symptoms, however, there are some typical symptoms of botulism:
- the absence of fever
- maintenance of the sensorium
- the symmetrical and descending trend of flaccid paralysis
- the absence of abnormalities on CSF examination.
Added to this is the particular electromyographic finding which presents an increase in muscle potentials following high frequency stimulation. Finally, there are basically two means to confirm or not the suspicion of botulism: the search for the toxin produced by the germ or the direct isolation of Clostridium botulinum in the feces or, in the case of wound botulism, directly from the tissues where the lesion is located.
These microbiological investigations should be carried out as early as possible with respect to the onset of symptoms. Having said that for treatment it is up to the doctor to best deal with each individual case, in a preventative way it is necessary to aim at the treatment phase preparation of vegetable preserves and other foods.
