Eating homemade Laotan pickled cabbage caused a mother and daughter from Dongguan, Guangdong, to stay in the intensive care unit of Guangzhou No. 12 People's Hospital for 20 days. The "culprit" of this incident was actually botulinum toxin , which is widely known and used in micro plastic surgery.
In fact, botulinum toxin is currently the most severe neurotoxin . In addition to iatrogenic poisoning, we may also be poisoned by eating contaminated food such as pickled foods and canned foods, and the mortality rate is extremely high. Fortunately, with the full treatment of the Guangzhou Twelfth People's Hospital and the Critical Care Medicine Department of the Guangzhou Chemical Poisoning Rescue Center, the mother and daughter were out of danger, have gradually recovered, and will be discharged soon.
Mother and daughter were both poisoned Cross-city relay finally saved them
In September this year, Xiaohua (pseudonym) will be in the first grade of high school. Having achieved excellent results in the high school entrance examination, she was excitedly waiting for the admission notice from her favorite high school. On July 3, something happened to her that made her uncomfortable: she ate her home-preserved kimchi and suddenly felt nauseated and vomited. My mother who also ate kimchi also had this symptom.
The condition of the mother and daughter continued to worsen as time went by. Symptoms of weakness in the limbs, chest tightness, shortness of breath, and decreased blood oxygen saturation began to appear. They entered the local hospital ICU for rescue. On July 7, after inspection by the local Center for Disease Control and Prevention, " botulinum toxin " was detected in their vomit and homemade kimchi jars. The family requested to be transferred to Guangzhou No. 12 People's Hospital for treatment. The critical care medicine department of the hospital immediately started the green channel treatment process, prepared a special antidote - botulinum antitoxin from the drug store in advance, and started treatment immediately after admission to the ICU.
The mortality rate of botulinum toxin poisoning can reach 35%, especially for patients with severe botulinum toxin poisoning. Chen Yunchao, director of the Department of Critical Care Medicine, said that botulinum toxin is exotoxin produced by the anaerobic Clostridium botulinum. It is currently the most violent neurotoxin and is defined as a Class A bioterrorism agent. A small amount of toxin can cause death. The lethal dose for humans is 0.1-1.0 μg, which is equivalent to the semi-lethal dose for 3,000-30,000 mice. Botulinum toxin mainly affects peripheral cholinergic nerves, causing muscle weakness and muscle paralysis. It can also penetrate the blood-brain barrier and cause certain effects on cranial nerves. Therefore, antitoxin treatment needs to be used as soon as possible after the clinical diagnosis is established. The effect of
special antidote is immediate. The next day, Xiaohua's hands were able to lift off the bed. However, the mother and daughter had serious infections, respiratory muscle weakness, and inability to expel sputum on their own when they came to the hospital. They needed to rely on a ventilator to breathe, and they also had intestinal paralysis.
After anti-infection, enteral nutrition adjustment, combined with acupuncture, passive limb movement and other rehabilitation physiotherapy, they were able to stop using the ventilator intermittently after a week of treatment in the No. 12 Hospital, and the tracheal intubation was successfully removed on July 22 and 26. His condition was stable and he was transferred out of the ICU on July 27. "Xiaohua's mother suffered from severe botulinum toxin poisoning and experienced severe infection, sepsis shock , and it was not easy to be rescued in the end." Chen Yunchao said.
"At present, the toxicokinetic mechanism of botulinum toxin has not been fully elucidated, so it is difficult to treat poisoning caused by this poison." Chen Yunchao pointed out that patients with food-borne botulinum toxin poisoning mainly show symptoms of muscle weakness. Unlike ordinary food poisoning , its gastrointestinal symptoms such as nausea, vomiting, and abdominal pain are not obvious.
It is reported that the first symptoms of botulinum toxin poisoning are general weakness, fatigue, headache, dizziness, ptosis, and dilated pupils; at the same time, there are difficulties in swallowing, chewing, speech, and breathing. As the disease progresses, the patient will have difficulty raising his head, ataxia, and then the respiratory muscles and bilateral lower limb muscles will weaken. respiratory failure and heart failure may occur. In severe cases, symptoms may occur 3 to 10 days after the onset of illness. Death occurs due to respiratory failure, secondary infection, or unpredictable respiratory arrest.
Botulinum toxin is sensitive to heat These foods should be fully heated before consumption
It turns out that Xiaohua’s family has the habit of eating homemade pickled cabbage. This time, the pickled cabbage altar where botulinum toxin was detected has been used for 6 years, and the family members regularly add it to the altar. Vegetables (beans, leafy vegetables, peppers, radishes, etc.) and salt are then sealed and soaked. The "sour soup" in the jar is never replaced, and the soaked sauerkraut is eaten directly.
During the period of rescue in the ICU, Xiaohua also received the admission notice from her favorite high school. Now, they are undergoing rehabilitation treatment in the Occupational Disease Department of Guangzhou No. 12 People's Hospital. "This successful rescue and recovery will not happen in the future." It will have any impact on Xiaohua’s studies and life.” Chen Yunchao emphasized that botulinum toxin is sensitive to heat and can be destroyed at 100°C for 10 minutes. Fermented foods, frozen foods, and canned foods must be fully heated.
For babies, the threat of botulinum toxin is even greater. Normal adult intestines are in a microaerobic environment and are antagonized by intestinal probiotics. After spores and enter the intestines, they cannot transform into botulinum toxin and do not produce botulinum toxin. However, the intestinal flora of infants has not yet formed a normal probiotic flora. After the spores enter the infant's intestines, they can multiply into botulinum toxin and produce botulinum toxin, causing food-borne poisoning.
Adult food-borne botulinum toxin poisoning is common in privately produced fermented foods and canned products, and is related to the production environment, improper storage and eating habits. Common foods include stinky tofu, sausages, bacon, ham, bean paste and fish products. Canned non-meat (corn, bamboo shoots) and fermented flour products have also been reported to cause botulinum toxin poisoning. Food-borne botulinum toxin poisoning in infants is commonly caused by ingestion of honey, milk powder, fruit and vegetable juices contaminated with botulinum toxin.
To prevent food-borne botulinum toxin poisoning in our daily life, we must pay attention to the following issues:
1. Food preparation, processing and storage processes must be clean and hygienic.
2. Fermented foods, frozen foods, and canned foods must be fully heated.
3. After Clostridium botulinum produces botulinum toxin, the food will not produce any odor or change.
4. Babies under one year old are prohibited from eating honey.
5. Do not buy canned and fermented foods of unknown origin or produced by small workshops.
source/Southern Metropolis Daily
editor/Chen Xiaobing
review/Zhi Fei
producer/Xi Shujun
