Joint International Conference on Long-term Experiments ...

BOTULISM: CLINICAL – EPIDEMIOLOGICAL STUDY
Ildiko Lenard*, Sonia Draghici*, Viorica Coldea**, Mirela Indries*,
Nicoleta Negrut*, Andrei Csep*, Timea Lenard***
* University of Oradea, ** County Clinical Hospital of Oradea,
*** County Clinical Hospital of Cluj-Napoca
ABSTRACT
Botulism is an alimentary toxiinfection caused by exoneurotoxina, clinically
characterized through bilateral and symmetric motional paralysis, secretor troubles,
asthenia. OBJECTIVE: clinical – epidemiological assessment of patients with botulism
hospitalized in the Clinical Hospital of Infectious Diseases, Oradea. PATIENTS AND
METHODS: retrospective study on 29 patients with botulism hospitalized between
January 1997 – December 2006, in whom there were analyzed epidemiological and
clinical parameters. RESULTS: There was observed: an increased incidence of botulism
in Bihor county, because of culinary customs, being predominate the cases in the
months of February and May (both at the end of winter and Easter period); there
weren’t evidenced significant differences as concerns the sex and area of provenience
distribution of cases, with a morbidity level on the group of age of 15-24 years; most of
the clinical forms were moderate , without being noticed particular forms of botulism;
68,96% of cases were formally hospitalized in other medical services, because of the
non – recognition of the clinical symptomatology; the favorable evolution of the disease
under treatment with antibotulinic serum.
Key words: botulism, symmetrical paralysis, antibotulinic serum.
1./ Introduction
Botulism is a systemical disease, making the clinical table of alimentary toxiinfection,
through the action of an exoneurotoxina of protean nature, delivered by Clostridium
botulinum (positive, anaerobe, sporuled and telluric gram bacillus which persists in the
soil, marine bank, ponds or rivers banks ). Clinically there is observed a bilateral and
symmetrical motional paralysis of the ocular muscles, pharynx +/- respiratory muscles
(by blocking the parasympathic colinergical synapses and the neuromuscular junctions
by the botulinic toxin ) (Rummel et al, 2007), associated with secretor troubles and
marked asthenia (Mandell et al, 2005; CDC 2005).
Botulinic toxin is the most popular toxic biological substance, supposing that 200g
of botulinic toxin could be enough to destroy the globe population (Villar et al, 2007).
At present there are known 7 types of botulinic toxin (A, B, C, D, E, F, G), the
frequency of human decays being caused by A, B and E types (Garcia-Rodriguez et al,
2007). Botulism is a rare disease, with different spread around the world, its seriousness
being in accordance with the type of botulinic toxin (A type from the vegetals and E
type from the fish being the most virulent ) and the infecting doze. The transmission is
made through contaminated aliments: vegetables, fruits ( under juice form or tinned
food ), meat and prepared meat (mostly pork), fish (Kirk, 2007). Depending on the
transmission way there are described three particular forms of botulism, but with similar
clinical tables Mandell et al, 2005; Mayo Clinic, 2006; Rebedea et al, 2000):
1. botulism of ingestion-the most frequent way, being resulted the toxiinfection;
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