Summer is in full swing, and hence the season of botulism, because the bacteria that cause this most dangerous infectious disease actively produce toxins at + 35 ° C. So, over the past month, three Ukrainians have died from botulism (the young guy ate homemade pate, and the spouses from Energodar - homemade dried fish), eight people are in the hospital. At the same time, anti-botulinum serum is not available not only in the clinics of the country, but also in pharmacies.. But the mortality rate in this disease is from 50%.

The Ministry of Health of Ukraine promises that there will be medicines within two weeks - the serum will be purchased in Poland and delivered to the regions. And the current deficit is explained as follows. " Head of the Department of Pharmaceutical Activity and Quality of Pharmaceutical Products of the Ministry of Health of Ukraine Taras Lyaskovsky.

But! These standards were introduced in Ukraine more than 10 years ago, and the last time serum was re-registered in 2012. The ministry could not explain this discrepancy with the dates, as well as why the department began to search for an alternative supplier of serum only after the deaths of people from botulism and the hype in the media.

In the meantime, there is no serum in hospitals, and Ukrainians remain defenseless against a dangerous infection, we figured out how not to get sick with botulism. Our expert Tatyana Egorova, the chief infectious disease specialist of the Kiev health department, answered the most important questions about this disease.

Rating of products that may contain clostridia More dangerous than other food cooked with your own hands. This applies to both taranka and homemade sausage and canned food.. The latter are especially dangerous, since clostridia multiply and secrete toxin in the absence of oxygen.. By the way, for the same reason, pickled (and not pickled) vegetables (cucumbers, cabbage) are safe 1. Dried fish.

Canned meat / fish.

Stew / pates.

Marinated mushrooms.

Canned vegetables / fruits.

Sausages without compliance with GOSTs.

SIX QUESTIONS ABOUT BOTULISM.

Is the infection transmitted from person to person?

Never. The causative agents of the disease are clostridia. These are bacteria that can enter our body through food.. This is 95% of the time. The remaining 5% is a wound type of botulism, when bacteria enter the wound, botulism of unknown etiology and botulism of newborns. In the latter case, the risk increases during childbirth at home, when feeding a baby with honey of unknown origin and unsanitary conditions.. Honey is dangerous because bacterial spores are carried into the nectar with dust.. Also, spores can be contained in house dust, especially on the floor, since they live in the ground for decades and are brought into the house with shoes..

Does the body develop immunity on clostridia

Not. Clostridia are bacteria, therefore the body has no immunity for them.

How to distinguish a product infected with Clostridia?

By eye - no way. But you need to know that there are a number of products that are a priori under suspicion.. Especially if they are home-cooked and / or poorly washed. The fact is that spore and vegetative forms of bacteria live in the intestines of animals (domestic and wild), various fish, waterfowl. Spore forms persist in the soil for a long time. Thus, almost all food products can contain both vegetative and spore forms of the pathogen.. At the same time, the spores can withstand boiling even for 30 minutes and die only in an autoclave - a special device in which boiling is carried out under pressure, only then the destruction of pathogenic microorganisms is ensured. For example, fish is cooked in this way for 45 minutes, and beef - 60. At home, it is quite difficult to achieve compliance with the sterile technology for preparing canned meat.. And then the following happens. Not completely destroyed spores in canned food, as they say, bloom in a violent color, since the optimal growth of clostridia and toxin formation occur precisely under anaerobic conditions (in the absence of oxygen). It is easier with vegetable and fruit preparations - the risk of botulism will practically be reduced to zero if you wash vegetables and fruits well from the soil and sterilize the jars before canning. Note that just 1 g of botulinum toxin contains about one million lethal doses! Therefore, never taste a suspicious product - even touching your tongue a little to it, you are already swallowing poison.

Will boiling save bloated canned food?

In no case. Botulinum toxins are theoretically destroyed at a temperature of + 100 ° С in literally 5 minutes. But you do not know if there are only toxins there as a waste product of Clostridia or also their spore forms, and how stable they are has already been said above. Bloated cans should be thrown away without regret.

Is botulism always deadly?

The most dangerous variant of botulism with lightning-fast development of acute respiratory failure is shortness of breath, cyanosis, tachycardia, shortness of breath. The death of a patient can occur 3-4 hours after infection, and in such acute types of botulism, the mortality rate is at least 50%. In other cases, recovery can occur even in the absence of serum, moreover, without health consequences.. And in the mildest form, a person may not even understand that he has had botulism, decides that there was a slight poisoning.

What are the signs you should see a doctor?

For any ailments similar to poisoning (for more details on symptoms, see. in the chart) if you have eaten potentially hazardous foods in the past 10 days. After all, neurological complications specific to botulism can appear both after a few hours and after a few days.. Therefore, it is better to play it safe. After all, botulism, in contrast to the so-called conventional food poisoning, in some cases is fraught with death..

Serum against botulism is not the only drug, the absence of which endangers the health of Ukrainians. Antivenom for snakebites, hepatitis B vaccine, drugs for cystic fibrosis, phenylketonuria, oncology, HIV / AIDS, BCG vaccine - this is an incomplete list of medicines that the state should provide in hospitals, but has not yet done so: partially or completely.

For example, the anti-tuberculosis vaccine hit all regions of the country, as reported in the Ministry of Health, on June 22 of this year.. There it is considered an achievement. In fact, this is “just”, since the vaccine shortage arose in family outpatient clinics back in March 2014! The reason is the same - the period for registration of the vaccine has expired, and therefore the use of all batches of this drug was suspended.. After the hype raised by journalists, amendments were made to the Law of Ukraine "

But! These changes took effect already nine months later.. At the same time, those doses were still not enough for everyone, no matter how much the Ministry of Health assured in the opposite. And this could turn into an epidemic of long-controlled diseases..

The drug crisis was confirmed on his Facebook page by the well-known pediatrician Yevhen Komarovsky: “A man died of botulism in the Lviv region. At the end of May in the Zaporozhye region, two people died from botulism. This is all the tip of the iceberg as reviewed by the media.. There are many times more deaths. No anti-botulinum serum. There is nothing to treat botulism. Vaccines are still a mess. Whooping cough is full. Anti-diphtheria serum, which is still available, is valid until September (2 months left). The diphtheria epidemic could break out at any minute. "

Why is there such a problem with the procurement of medicines “The main reason is corruption, due to which up to 1000 Ukrainians die every day,” says Dmitry Sherembey, head of the board of the Patients of Ukraine charitable foundation.. - High-ranking officials from medicine simply do not want to give the right to procurement to international agencies (WHO and UNICEF with the involvement of USAID specialists). They started talking about such an agreement at the end of 2014.. In February 2015, it was finally signed. But as of the beginning of the seventh month, the list of drugs that will be subject to government procurement has not even been compiled.! But the purchase of drugs through international relations would cost the treasury at least 30% cheaper than it was under the old scheme "

The ministry comments on these accusations as follows: “Moldova, Georgia, which use the procurement mechanism through international organizations, spent more than two years to prepare them.. In Ukraine, we are working to resolve this issue in a much shorter period of time, " According to him, today the procurement of vaccines against measles, mumps and rubella, hepatitis B, as well as medicines for the treatment of HIV / AIDS have already been preliminary agreed with UNICEF..

DIAGNOSTICS: THE TYPE OF THE DISEASE IS DETERMINED ON THE MOUSE.

How doctors can tell botulism from poisoning? " , then he is under suspicion. Then the wash water and his blood will be sent to a sanitary station.. There they will infect mice. And they will inject them with three types of antibotulinic serum (A, B and C). Depending on which mice survive, they will determine what type of botulism a person has. Such serum will also be administered to the patient, - explains Tatyana Egorova, the chief infectious disease specialist in Kiev.. - But even in the absence of serum, do not neglect a visit to the infectious disease specialist. Only a doctor can prescribe competent therapy "

HOW THEY WILL BE TREATED: WILL CARRY OUT A LARGE-SCALE DETOXIFICATION.

If there are no botulism serums throughout the country, then how will they treat? " - Therefore, in the hospital, the patient through special probes will be washed with the stomach, intestines, sorbent droppers will be placed, and antibiotics will also be prescribed. In addition, the hospital will be able to support the body in case of respiratory arrest or heart rhythm irregularities. "

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