The above information was shared by a representative of Cho Ray Hospital late on March 18. In the morning of the same day, this facility received a request for professional support for poisoning cases being treated at North Quang Nam General Hospital. Through urgent online consultation, the doctor assessed the very high possibility that the patient had Botulinum poisoning. This is also the toxin that caused the vegetarian pate poisoning in 2020.
Cho Ray Hospital decided to send leading experts in poison control and resuscitation to support colleagues. The team of experts includes: Dr. Le Quoc Hung (Head of Tropical Diseases Department), specialist 2 Tran Thanh Linh (Head of Emergency Resuscitation Department) and pharmacist Nguyen Trong Loc (Pharmacy Department).
The crew brought the last 5 bottles of the Botulinum antidote from Cho Ray Hospital to the rescue. These are very rare antidotes, costing about 8,000 USD/bottle.
All patients eat silage salted carp
Present at the Northern Quang Nam Regional General Hospital, the expert team conducted epidemiological investigations and evaluated 3 clusters of cases (total of 10 people) with a very high probability of Botulinum poisoning. They all eat silage salted carp.
The first cluster of cases includes 5 people living in Phuoc Duc commune, Phuoc Son district, Quang Nam province. On March 5, these people all had abdominal pain, vomiting, fatigue, and weakness in their limbs. Symptoms appear 12 to 24 hours after eating. The patient was admitted to the Northern Quang Nam Regional General Hospital. After 3 days of treatment, a 40-year-old female patient died due to severe progression. The remaining 4 patients are fine.
The second cluster of cases is a 37-year-old female patient, living in Phuoc Chanh commune, Phuoc Son district, Quang Nam province. She ate silage carp on March 14. A day later, she vomited a lot, gradually weakened her limbs, and was admitted to the Northern Quang Nam General Hospital. On March 16, the patient suffered from respiratory failure and has been on mechanical ventilation until now.
The third cluster of cases is 4 people with their families, living in Phuoc Kien commune, Phuoc Son district, Quang Nam province. On March 16, the whole family ate silage carp and vomited and was hospitalized the next day. On March 18, two patients suffered from quadriplegia, respiratory failure, and required mechanical ventilation. The other two cases (with a 12-year-old boy) had mild weakness in the extremities and could breathe on their own.
Need to stop early so that there are no more patients
According to experts, this type of food is put into a glass container after 2-3 weeks to eat, creating anaerobic conditions for Clostridium Botulinum bacteria to grow. Less than 24 hours after eating, the patients all had symptoms of digestive disorders, which made the extremities gradually weaken. Severe cases lead to respiratory failure due to muscle paralysis and mechanical ventilation.
At 6:30 p.m. on March 18, the test results of silage salted fish samples performed by the Pasteur Institute in Nha Trang confirmed that the cause of poisoning was Botulinum.
Right after that, the team of Cho Ray Hospital consulted on the direction of remote treatment for the patients before coming to Quang Nam. For 3 ventilated patients, each person will use 1 vial of BAT antidote, closely monitor anaphylaxis during and 8 hours after infusion.
The remaining 2 patients will continue to be closely monitored for their weakness to decide whether to use the BAT antidote or not.
The case was reported directly to the Director of the Quang Nam Department of Health and the Ministry of Health. At the same time, experts suggested coordinating with the authorities to find the source of infection due to 3 clusters of cases in 3 different communes, the food was not produced by the same establishment but occurred over a period of time.
In addition, doctors suggested that authorities should notify people in the area, preventing the possibility of people being poisoned again.
The Food Safety Department, the Ministry of Health has just sent an official dispatch to a number of units following information about suspected vegetarian pate poisoning cases in Binh Duong.
