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VOLUME 25 , ISSUE 4 ( April, 2021 ) > List of Articles

ORIGINAL RESEARCH

Clinical Predictive Values in Botulism, A 10-year Survey

Sara Saeidi, Bita Dadpour, Lida Jarahi, Anahita A Ghamsari, Mahdi J Nooghabi

Keywords : Clinical toxicology, Foodborne, Predictive, Prognostic factors,Botulism

Citation Information : Saeidi S, Dadpour B, Jarahi L, Ghamsari AA, Nooghabi MJ. Clinical Predictive Values in Botulism, A 10-year Survey. Indian J Crit Care Med 2021; 25 (4):411-415.

DOI: 10.5005/jp-journals-10071-23777

License: CC BY-NC 4.0

Published Online: 00-04-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Botulism occurs periodically or in outbreaks in Iran. Botulism is lethal and accordingly a considerable issue in environmental health, although it is uncommon. This study was performed to evaluate the potential predictive factors in foodborne botulism in a 10-year span. Patients and methods: All medical records from patients with foodborne botulism admitted to Imam Reza Hospital in 10 years (2005–2015) were analyzed retrospectively. Results: 61 cases were included (38 men, mean age ± SD 28.93 ± 19.14 years). All cases were treated with antitoxin. 6.6% of cases died. Canned beans were correlated with the admission to intensive care unit (ICU), and also, it increased the length of ICU stay significantly (P = 0.007 and 0.023, respectively). The incidence of dizziness and diplopia significantly induced excess demands for higher doses of antitoxin (P = 0.038 and 0.023, respectively). Risk of dysphagia was remarkably higher in cases with ptosis (P = 0.039, odds ratio: 3). While in this study, time elapsed between the onset of clinical manifestations and antitoxin administration was correlated with the occurrence of dysphagia, constipation, and blurred vision, and early treatment did not improve the outcomes. Multiple analysis of potential variables by a logistic regression model disclosed that the independent significant factors affecting mortality were the need for mechanical ventilation (P = 0.000), dyspnea (P = 0.044), general weakness (P = 0.044), and lack of consciousness (P = 0.008) at the time of admission. Conclusions: Taking clinical signs and symptoms into account upon patient arrival is important and, of course, is a key to further management in the emergency setting.


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  1. Lonati D, Rossetto O, Fenicia L, Locatelli C. Botulism. General, applied and systems toxicology. Chichester: John Wiley; 2009.
  2. Fenicia L, Anniballi F. Infant botulism. Ann Ist Super Sanita 2009;45(2):134–146.
  3. Roberts T, Tompkin R. Microorganisms in foods 5: characteristics of microbial pathogens. New York: Springer Science & Business Media; 1996.
  4. McLauchlin J, Grant K, Little C. Food-borne botulism in the United Kingdom. J Public Health 2006;28(4):337–342. DOI: 10.1093/pubmed/fdl053.
  5. Terranova W, Palumbo JN, Breman JG. Ocular findings in botulism type B. JAMA 1979;241(5):475–477. DOI: 10.1001/jama.1979.03290310015004.
  6. Vahdani P, Sharifian HA, Aminzadeh Z, Jahromi MK, Zamiri SA. An 18 year old boy presenting with nausea, vomiting and diplopia. Arch Clin Infect Dis 2008;18(3):191–192. DOI: 10.1177/000992287901800319.
  7. Dembek ZF, Smith LA, Rusnak JM. Botulism: cause, effects, diagnosis, clinical and laboratory identification, and treatment modalities. Disaster Med Public Health Prep 2007;1(2):122–134. DOI: 10.1097/DMP.0b013e318158c5fd.
  8. Arnon SS, Schechter R, Maslanka SE, Jewell NP, Hatheway CL. Human botulism immune globulin for the treatment of infant botulism. N Engl J Med 2006;354(5):462–471. DOI: 10.1056/NEJMoa051926.
  9. Chalk C, Benstead TJ, Keezer M. Medical treatment for botulism. Cochrane Database Syst Rev 2011(3):CD008123. DOI: 10.1002/14651858.CD008123.pub2.
  10. Hatheway CH, Snyder JD, Seals JE, Edell TA, Lewis Jr GE. Antitoxin levels in botulism patients treated with trivalent equine botulism antitoxin to toxin types A, B, and E. J Infect Dis 1984;150(3):407–412. DOI: 10.1093/infdis/150.3.407.
  11. Afshari R, Shafiei S, Sayyahjezhad M, Dadras-Moghaddam D, Balali-Mood M. A botulism outbreak following a wedding in a rural area in North East Iran, 2006. Clin Toxicol 2007;45(4):388. DOI: 10.4172/2161-0495.1000115.
  12. Asl HM. Identification of botulinum toxin type in clinical samples and foods in Iran. Arch Iranian Med 2013;16(11):642. PMID: 24206405.
  13. Keramat F, editor Outbreak of food borne botulism in a family in Hamedan (Iran) due to consumption of soup prepared with traditional kashk. In: 8th congress of infective diseases, Tehran, Iran; 2000.
  14. Tavakoli H, Zeynali M. Epidemiological survey of food-borne botulism in Iran during 2004–2008. Epidemiology 2009;20(6):S113. DOI: 10.1097/01.ede.0000362394.97915.47.
  15. Sobel J. Botulism. Clin Infect Dis 2005;41(8):1167–1173. DOI: 10.1086/444507.
  16. Louis MES, Peck SH, Bowering D, Morgan GB, Blatherwick J, Banerjee S, et al. Botulism from chopped garlic: delayed recognition of a major outbreak. Ann Intern Med 1988;108(3):363–368. DOI: 10.7326/0003-4819-108-3-363.
  17. Control CfD, Prevention. National center for emerging and zoonotic infectious diseases. Available from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter/technical html. Accessed January 2014.
  18. Secretariat E. Eurobats: the agreement on the conservation of populations of European bats, 2004. Retrieved April 1, 2009.
  19. Cowden J. Food-borne Clostridium botulinum intoxication from mass produced foodstuffs in Europe. Eurosurveillance 2011;16(49):20033. DOI: 10.2807/ese.16.49.20033.
  20. Tavakoli H, Zeynali M, Mehrabi Tavana A. Scrutiny of food-borne botulism intoxication in Iran during 2003-2007 with the food hygiene view point. Hakim Res J 2009;11(4):38–46. DOI: 10.1097/01.ede.0000362394.97915.47.
  21. Habibiyan Nejad Z, Afshari R. Foodborne botulism in Mashhad from 2003 to 2010. J Clin Toxicol 2011;1:115–119. DOI: 10.4172/2161-0495.1000115.
  22. Aminzadeh Z, Vahdani P, Mirzaei J. A survey on 80 cases of botulism and its clinical presentations as a public health concern. Arch Clin Infect Dis 2007;2(2):77–81.
  23. Tavakoli H, Meshgi MA, Jafari NJ, Izadi M, Ranjbar R, Fooladi AI. A survey of traditional Iranian food products for contamination with toxigenic Clostridium botulinum. J Infect Public Health 2009;2(2):91–95. DOI: 10.1016/j.jiph.2009.03.001.
  24. RahbarTaromsar M, Badsar AR, Akhoundzade N, Oojaghi F, Karkan MF. A survey on the clinical presentations in food-borne botulism for patients refering to Razi Hospital during 2001-06. Iranian J Toxicol 2012;5:15.
  25. Afshari R, Habibiyan Nejad Z, Shafiei S, Sayyahnejezhad M, Dadras-Moghaddam D, Balali-Mood M. A botulism outbreak following a wedding in a suburban area of Mashhad, 2006. J Birjand Univ Med Sci 2010;17(1):59–65.
  26. Varma JK, Katsitadze G, Moiscrafishvili M, Zardiashvili T, Chokheli M, Tarkhashvili N, et al. Signs and symptoms predictive of death in patients with foodborne botulism—Republic of Georgia, 1980–2002. Clin Infect Dis 2004;39(3):357–362. DOI: 10.1086/422318.
  27. Wongtanate M, Sucharitchan N, Tantisiriwit K, Oranrigsupak P, Chuesuwan A, Toykeaw S, et al. Signs and symptoms predictive of respiratory failure in patients with foodborne botulism in Thailand. Am J Trop Med Hyg 2007;77(2):386–389. DOI: 10.4269/ajtmh.2007.77.386.
  28. Tacket CO, Shandera WX, Mann JM, Hargrett NT, Blake PA. Equine antitoxin use and other factors that predict outcome in type A foodborne botulism. Am J Med 1984;76(5):794–798. DOI: 10.1016/0002-9343(84)90988-4.
  29. Kongsaengdao S, Samintarapanya K, Rusmeechan S, Wongsa A, Pothirat C, Permpikul C, et al. An outbreak of botulism in Thailand: clinical manifestations and management of severe respiratory failure. Clin Infect Dis 2006;43(10):1247–1256. DOI: 10.1086/508176.
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