2023-11-02 17:54:46
Italy “is consistently one of the European countries with the highest incidence rate of foodborne botulism. From 1986 to 30 September 2022, 406 incidents of botulism involving 599 people were confirmed in the laboratory”. The Istituto Superiore di Sanità (ISS) takes stock of the situation on its website. At a regional level, Campania has recorded the highest number of accidents, almost 100, followed by Puglia and Lazio. The hypothesis of botulinum food poisoning is being examined following the death of a 46-year-old from Ariano Irpino (Avellino) who died in hospital, while her husband was hospitalized in serious conditions after a dinner at a pizzeria.
“The foods most involved in cases of botulism that occur in Italy belong to the category of vegetable preserves in oil (47.7%), vegetable preserves in water/brine (25.5%), meat preserves (7.8 %), preserved fish (7.8%), ham (4.6%) salami and sausages (3.3%), preserved cheese (2.0%), macrobiotic foods (1.3%)”, highlights the ISS. The preparations most frequently implicated in cases of foodborne botulism that have occurred in Italy “are home-produced mushroom preserves in oil. Olive and turnip green preserves are also very frequent”, we read in the report. “Botulism is a neuro-paralytic disease caused by the toxins of clostridia that produce botulinum toxins. These microorganisms are ubiquitous and can be found, mainly in the form of spores, in many environments such as soil, marine and lake sediments, atmospheric dust and foods – underline the ISS experts – Spores are forms of resistance that the microorganism adopts in adverse conditions. They allow it to remain quiescent for long periods (even several decades) and to transform into vegetative cells as soon as environmental conditions become favorable”.
Clostridium botulinum, the best known of the botulinum toxin-producing clostridia, was described as the microorganism responsible for botulism for the first time in 1897 by Emile van Ermengem, following an outbreak of foodborne botulism that occurred in the Belgian town of Ellezelles, on the occasion of a funeral. The disease takes its name from the Latin term ‘botulus’ (sausage) because its description was initially associated with the consumption of home-prepared sausages. However, at least in Italy, most cases of botulism are related to the consumption of products of plant origin.
“Food botulism – the ISS further describes – can strike at all ages and is not transmissible from person to person. Symptoms usually appear from a few hours to over a week after consuming the contaminated food (6 hours 15 days However, in cases of foodborne botulism that occur in Italy, the symptoms appear on average within 24-72 hours after consuming the contaminated food. Obviously, the earlier the symptoms appear, the more severe the disease will be.”
Symptoms can vary from mild forms that self-resolve to very severe forms that can have a fatal outcome. The most common symptoms are: blurring and double vision (diplopia); dilation of the pupils (bilateral mydriasis); difficulty keeping the eyelids open (ptosis); difficulty articulating speech (dysarthria); difficulty swallowing; dry mouth and mouth (xerostomia); constipation. “In many cases – the ISS experts illustrate – urinary retention also appears. In the most serious forms there is respiratory failure which can have a fatal outcome due to blockage of nerve conduction to the muscles responsible for breathing. The characteristic symptoms of botulism have a progression symmetrical, affects both the right and left hemisphere of the body, descending from the head, to the neck, to the chest, up to paralysis of the limbs and manifests itself with a flaccid paralysis”.
“Although the disease can be fatal, if diagnosed in time it resolves completely in times that can vary from a few weeks to several months. The treatment – specify the ISS – includes ventilation support therapy and intestinal decontamination with activated charcoal. In more serious cases, it may be necessary to resort to assisted ventilation as well as parenteral nutrition. The specific therapy consists in the administration of a hyperimmune serum. This botulinum antitoxin serum, distributed by the Ministry of Health through the national antidote stock network, must be administered as soon as possible, without waiting for the results of the laboratory diagnosis and in a controlled environment. Therefore the patient suffering from botulism requires hospitalisation, possibly in intensive care”.
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