On the evening of March 18, Cho Ray Hospital reported to the Ministry of Health about 10 cases of Botulinum poisoning, including 1 death in Quang Nam.
Bring the antidote to Quang Nam
According to the report, on the same morning, Cho Ray Hospital received a request for support from the Northern Quang Nam General Hospital about 3 clusters of suspected cases of Botulinum poisoning (toxin produced by Clostridium Botulinum bacteria).
Immediately, Cho Ray Hospital held an online consultation with the Northern Quang Nam General Hospital.
Doctors at Cho Ray Hospital evaluate patients with Botulinum poisoning in Quang Nam
Through the results of consultation and assessment, the possibility of patients suffering from Botulinum poisoning was very high, the leaders of Cho Ray Hospital decided to send leading experts in poison control and resuscitation to Quang Nam. Including Dr. Le Quoc Hung, Head of Department of Tropical Diseases; Doctor CK.2 Tran Thanh Linh, Head of ICU, and pharmacist Nguyen Trong Loc (Pharmacy Department). Experts brought the remaining 5 bottles of Botulinum antidote (very rare) of Cho Ray Hospital to the Northern Quang Nam Regional General Hospital to support the treatment of the patient.
At 13:30, the group of experts was on their way to Quang Nam.
Poisoning after eating pickled carp
At the Northern Quang Nam General Hospital, the team of Cho Ray Hospital conducted an epidemiological investigation and assessed that there were 3 clusters of cases with a total of 10 people at very high risk of Botulinum poisoning.
The first cluster of cases includes 3 women and 2 men, living in Phuoc Duc commune, Phuoc Son district (Quang Nam). All 5 people ate silage salted carp.
Accordingly, on March 5, 12-24 hours after eating, these cases all had symptoms of abdominal pain, vomiting, fatigue and gradual weakness in limbs. The patients were admitted to the Northern Quang Nam Regional General Hospital. After 3 days of treatment, due to severe progression, there was a 40-year-old female death. The remaining 4 cases are currently stable.
Resuscitate the patient
The second cluster of cases was identified as a female patient (37 years old) in Phuoc Chanh commune, Phuoc Son district (Quang Nam). The patient ate silage salted carp on March 14. After 1 day of vomiting a lot, weak limbs, was taken to General Hospital North Quang Nam. On March 16, the patient suffered from respiratory failure and was on mechanical ventilation until now.
The third cluster of cases, including 4 people (3 men, 1 woman with their families in Phuoc Kien commune, Phuoc Son district, Quang Nam). On March 16, the whole family ate silage carp. On March 17, the patients vomited a lot, so they were admitted to the Northern Quang Nam General Hospital. On March 18, 2 patients with quadriplegia had respiratory failure and had to be mechanically ventilated until now. The remaining 2 patients (1 boy 12 years old and 1 female 24 years old) had mild weakness in extremities, muscle strength 4/5 – 5/5, could breathe on their own.
The patients are on ventilators
The doctors said that 3 clusters of patients ate the same food as silage salted carp. During the processing of pickled vegetables, put them in a glass container with glass closed after 2-3 weeks to eat (creating anaerobic conditions for Clostridium Botulinum bacteria to grow). Less than 24 hours after eating, there are symptoms of digestive disorders that make the extremities gradually increase. Severe cases lead to respiratory failure due to muscle paralysis and mechanical ventilation. However, all of them were awake and in contact.
Preliminary assessment, the patients suffered Botulinum poisoning from eating silage salted carp.
Test results for Clostridium Botulinum bacteria
At 6:30 p.m. on March 18, the test results of cultured samples of silage salted fish were performed by the Pasteur Institute in Nha Trang (food of the first cluster of cases). It can be confirmed that the patients have botulinum poisoning.
Direction treatment plan
Doctors of Cho Ray Hospital gave the treatment direction to the patients after epidemiological assessment and confirmed testing.
3 mechanically ventilated patients (1 female, 2 adult males) each received 1 bottle of Botulinum antidote BAT, closely monitored for anaphylaxis during and 8 hours after the infusion. Closely monitor arrhythmia complications and take care of mechanically ventilated patients.
In 2 other patients, continue to closely monitor the patient’s paralysis to decide whether to use BAT or not.
Critically ill patients are given an antidote for Botulinum poisoning
Doctors of Cho Ray Hospital asked the Northern Quang Nam General Hospital to respond to the case to the Department of Health of this province to notify people in the district and prevent the risk of people being infected. Next Botulinum poisoning. It is recommended to coordinate with relevant agencies to find the source of infection for 3 clusters of cases in 3 different communes under 100 km, not caused by a production facility but occurring over a period of time.
After administering the drug and recommending detailed monitoring measures, the medical team of Cho Ray Hospital and the Head of the ICU Department of the Northern Quang Nam General Hospital will set up a group “Botulinum” to continue monitoring and exchanging professional change during the subsequent treatment of patients with Botulinum toxicity. At the same time, Cho Ray Hospital also sent a report to the Ministry of Health.
