Volume 77, Issue 11 (February 2020)
Tehran Univ Med J 2020, 77(11): 720-723 |
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Karbalaei Shabani A, Najari F, Jannani A, Ezoji K, Montazer Khorasan M R, Masoumi H et al . Type A botulism outbreak in members of a family following consumption of homemade whey: brief report. Tehran Univ Med J 2020; 77 (11) :720-723
URL: http://tumj.tums.ac.ir/article-1-10206-en.html
URL: http://tumj.tums.ac.ir/article-1-10206-en.html
Type A botulism outbreak in members of a family following consumption of homemade whey: brief report
Ahdie Karbalaei Shabani1 
, Fares Najari2 , Alireza Jannani3 , Khadijeh Ezoji4 , Mohammad Reza Montazer Khorasan5 , Hossein Masoumi6 , Mohammad Mehdi Soltan Dallal * 7
, Fares Najari2 , Alireza Jannani3 , Khadijeh Ezoji4 , Mohammad Reza Montazer Khorasan5 , Hossein Masoumi6 , Mohammad Mehdi Soltan Dallal * 7
1- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Forensic Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3- Pasteur Institute of Iran, Tehran, Iran.
4- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
5- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran.
6- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran. Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
7- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran. ,msoltandallal@gmail.com
2- Department of Forensic Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3- Pasteur Institute of Iran, Tehran, Iran.
4- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
5- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran.
6- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran. Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
7- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran. ,
Abstract: (6010 Views)
Background: Botulism is mostly caused by Clostridium botulinum neurotoxin which has been described as a bilateral symmetric descending flaccid paralysis. Preventing and responding to botulism outbreaks is a public health emergency. In this study, the disease is reported in a family.
Methods: In a case series study, during an outbreak, four members of a family with symptoms including paralysis, ptosis, blurred vision, diplopia, weakness, dysphagia, dry mouth, respiratory problems, vertigo, and lethargy, referred to Loghman Hospital of Tehran. Among the patients was an elderly woman and a pregnant woman. All clinical signs and symptoms of the patients were recorded daily in a researcher-made questionnaire from 27 August to 3 September 2018. At the time of admission, vital signs (pulse rate, respiration rate, and body temperature) of patients were stable and within normal limits. Following clinical suspicion of food-borne botulism in these patients, samples of the first two patients, including serum, stool, gastric secretions, and homemade whey were sent to the Botulism Laboratory of Microbiology Department of Pasteur Institute of Iran for the mouse bioassay.
Results: Type A neurotoxin was detected in homemade whey after the mouse bioassay. Therefore, foodborne botulism was confirmed in patients with laboratory results. Patients included two men and two women with a mean age of 52.7 years old. The length of hospitalized days was between 2 and 6 days. Two of the patients were admitted to the intensive care unit (ICU). Patients under study were fully recovered with timely diagnosis of the disease, treatment with antitoxin, and supportive care.
Conclusion: When conscious patients referred to the hospital with symptoms of paralysis, foodborne botulism is an important differential diagnosis. On-time diagnosis and antitoxin treatment can prevent serious complications.
Methods: In a case series study, during an outbreak, four members of a family with symptoms including paralysis, ptosis, blurred vision, diplopia, weakness, dysphagia, dry mouth, respiratory problems, vertigo, and lethargy, referred to Loghman Hospital of Tehran. Among the patients was an elderly woman and a pregnant woman. All clinical signs and symptoms of the patients were recorded daily in a researcher-made questionnaire from 27 August to 3 September 2018. At the time of admission, vital signs (pulse rate, respiration rate, and body temperature) of patients were stable and within normal limits. Following clinical suspicion of food-borne botulism in these patients, samples of the first two patients, including serum, stool, gastric secretions, and homemade whey were sent to the Botulism Laboratory of Microbiology Department of Pasteur Institute of Iran for the mouse bioassay.
Results: Type A neurotoxin was detected in homemade whey after the mouse bioassay. Therefore, foodborne botulism was confirmed in patients with laboratory results. Patients included two men and two women with a mean age of 52.7 years old. The length of hospitalized days was between 2 and 6 days. Two of the patients were admitted to the intensive care unit (ICU). Patients under study were fully recovered with timely diagnosis of the disease, treatment with antitoxin, and supportive care.
Conclusion: When conscious patients referred to the hospital with symptoms of paralysis, foodborne botulism is an important differential diagnosis. On-time diagnosis and antitoxin treatment can prevent serious complications.
Type of Study: Brief Report |
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