Uruguay: Botulism, cause unknown

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http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1060,86669

Spanish to English translation
Archive Number 20110115.0183
Posted 15-ENE-2011
Title PRO / ESP> Botulism, cases of unknown origin - Uruguay (Paysand? ?? ? ??)

Botulism, CASE OF UNKNOWN ORIGIN - URUGUAY (PAYSAND?)
************************************************** ****
A statement by ProMED-mail
<http://www.promedmail.org>
ProMED-mail is a program
International Society for Infectious Diseases
<http://www.isid.org>

Date: January 15, 2011
Source: Notes, Uruguay
<http://www.observa.com.uy/actualidad/nota.aspx?id=107464&ex=25&ar=1&fi=23&sec=8>
[Edited by J. Torres]

Still in serious condition two persons in Montevideo
Botulism. These two cases arising out of department
Paysandu, where another patient hospitalized in ICU.

In the case of Montevideo is a Spanish Hospital with best
forecast, according to El Espectador reported Saturday. This is the
youngest of the three affected.

The third patient was admitted to the Hospital Maciel and
more than 20 days has a flaccid paralysis. This is the case
more serious now, assisted with mechanical ventilation.

It is unknown at this time causes some of these poisonings.

The National Director of Health, Gilberto R?os, told El Espectador
a person intoxicated with botulism? is gradually taking a
general paralysis? and? muscle paralysis
breathing difficulty breathing?.

On Friday the Ministry of Health (MOH) issued a statement
where the three reported cases of botulism identified in the
country are under investigation by the technical team
Epidemiology Division.

The statement said that botulism poisoning is a rare but
serious illness caused by a toxin produced by bacteria _Clostridium
botullinum_. The disease can arise from eating food that
contain the toxin, with the most canned foods
frequently involved, but it is also possible to connect the
consumption of other foods.

To prevent this disease, the MSP recommended a series of measures
food security. First, proper handwashing,
and food containers before the start of the preparation.

Second, home-prepared canned food must comply
criteria of time, pressure and temperature appropriate for
destruction of the toxin (food boiling for 10
minutes destroys the toxin).

Avoid giving honey to infants (ie under 12 months) and
this is a possible source of exposure to botulinum toxin
this age group.

The health authorities show that when the container of a food
canned or preserved is deformed (including inflation)
This may suggest the presence of gas produced by the presence of
the bacteria. In such a case is recommended to discard the food.

Finally, it is advisable to boil for 10 minutes
canned foods, making it possible to destroy the toxin,
avoiding the risk of disease


Reported by: Jaime R. Torres <torresjaime@cantv.net>

- ProMED-ESP

 

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Re: Uruguay: Botulism, cause unknown

http://www.observa.com.uy/actualidad/nota.aspx?id=107494&ex=25&ar=1&fi=23&sec=8

Spanish to English translation
SALUDNo determined the source of botulism that affects three personasEl National Health director, Gilberto R?os, according to notes that have not been able to determine the source that caused the Botulism three personasAntecedente of botulism in canned Uruguay broke for Public caserasSalud asked to verify if symptoms are reported to the authorities

Those affected are in serious condition in intensive care on life support.
The chief said Sunday that one of the cases the diagnosis was delayed. He said it is estimated that the trigger occurred in December. "It's very difficult to track reconstruction and the cause of the disease," he said.
Rivers said it was not possible to say that the pollutants come from home canning.
So far only been able to determine the territorial nexus, the department of Paysandu. Among the three ill persons are a mother and daughter, in the case of the first was found in less than 24 hours that it was the same symptoms of the daughter, so it could proceed to a specific treatment for botulism .
Rivers Watch said that both the portfolio of Health and food science are stepping up work in Paysandu to find the source of the disease.
The chief recommended discarding any dented cans, as an extreme measure can boil unopened cans for 10 minutes.
In the website of the Ministry of Public Health describes the symptoms of the disease, "blurred vision, diplopia (seeing double objects) and paralysis that may progress to respiratory failure and respiratory arrest."
The secretary of state calls upon all people to notify, within 24 hours, the Department of Health Surveillance, if it finds any of the symptoms.

 

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Re: Uruguay: Botulism, cause unknown

http://www.elpais.com.uy/110115/pna...sp-alerta-por-casos-sospechosos-de-botulismo/

National
The MSP alert suspected cases of botulism
Investigated three patients, the last outbreak was in 2002

Are you interested in this story?
The Ministry of Health (MOH) said yesterday it identified three suspected cases of botulism, a severe degenerative disease that no data in Uruguay for eight years when there was an outbreak in Cologne.

Patients (two of them are Paysand?) are placed in Montevideo pending the results of medical tests that will confirm or rule out the disease in the next week. The director general of health, Gilberto R?os, told El Pais that of all forms is the "near certainty" that these are cases of botulism and therefore decided to alert the national medical staff and the public to take precautions.

Botulism is a severe intoxication caused by a toxin that is produced by the bacterium clostridium botullinum. The disease can arise from eating foods that contain this toxin, usually found in canned food or home-canned foods.

Among the measures of prevention, the MSP advises proper handwashing, and food containers, to avoid giving honey to infants (under one year) because this substance is a possible source of exposure to botulinum toxin in this age group; disposing of containers of canned or preserved food that are deformed (especially swollen) and boil for 10 minutes of canned foods before eating.

The recommendations of health authorities also add that homemade canned food must meet the criteria of time, pressure and temperature suitable for the destruction of the toxin (food boiling for 10 minutes destroyed).

Disease. Rivers said that was communicated to physicians to be alert and to include within this disease diagnostic hypotheses. The primary symptoms are general weakness, no fever, and fatigue easily.

"Then he incorporates some difficulty in articulating words, weakness of the muscles of the face, drooping eyelids. If the disease progresses is affecting more muscles, flaccid paralysis is generated," the chief of the Ministry of Health.

He added that the "serious point" of the disease occurs when the muscles attached affects the respiratory system, resulting in the patient having to be subjected to assisted ventilation. The disease can be fatal, said Rios.

While waiting for the confirmation of three suspected cases, the surveillance system seeks to establish the cause and origin. The focus could be in Paysandu, since two of the patients are in that department.

 

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Re: Uruguay: Botulism, cause unknown

http://www.elpais.com.uy/110116/pnacio-541351/sociedad/botulismo-hay-dos-pacientes-graves/

National
Botulism: there are two serious patients
Argentine specialist checked and confirmed cases

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While the three cases "suspicious" of botulism identified by health authorities await confirmation of the disease from medical tests, there is full assurance that this condition is that eight years ago was not recorded in Uruguay.

In fact, on Friday, an Argentine expert, head of the Muniz Hospital of Buenos Aires, visited two of the patients who are hospitalized in Montevideo and confirmed that its clinical manifestations are typical of botulism, said the director general of health, Gilberto R?os.

All patients are from Paysandu and are unrelated to each other. In that department there is a woman hospitalized in serious local CTI. The other two are hospitalized in the Hospital Maciel Spanish and Montevideo. The patient is in Spanish has a good prognosis, but admitted to the Maciel is the most complicated. According to Rivers for over 20 days presented a flaccid paralysis, muscle weakness, and is being assisted with mechanical ventilation to breathe.

As reported yesterday sanducero The Daily Telegraph, those affected would have shared a meal that was not in good condition. Some canned foods and canned foods may contain the toxin produced by the bacterium clostridium botullinum, which is what causes the disease.

Diagnosis. The Directorate General of Health issued a statement Friday urging the medical profession to consider the diagnosis of botulism to patients with clinical manifestations of the nervous system primarily, ptosis (drooping eyelid), blurred or double vision and descending flaccid paralysis symmetrical which may lead to respiratory failure and respiratory failure.

In the case of infants the symptoms are constipation, loss of appetite, listlessness, difficulty swallowing and progressive onset of weakness that may progress to liver failure and respiratory arrest.

To the identification of a suspected case should complete the notification to the Department of Health Surveillance, within the first 24 hours.

Prevention. Precautionary measures include maintaining a proper washing of hands and vessels before cooking, discard the canned or preserved foods that are deformed (swollen) and boil these foods for ten minutes before eating.

 

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Re: Uruguay: Botulism, cause unknown

This is a significant difference if all three cases are family members.

http://www.elpais.com.uy/110117/pnacio-541501/nacional/botulismo-se-agrava-tercer-paciente/

National
Botulism: third patient worsens
MSP still unknown origin of the disease

A woman with botulism hospitalized at the ICU of Hospital de Paysandu worsened his condition this weekend, why are receiving mechanical respiratory assistance, reported yesterday by the director general of health, Gilberto Ríos.

The chief said he keeps three the number of cases of people with this disease. All three patients are from Paysandu and have family ties with each other.

In the latter case, the woman was hospitalized in the ICU since Saturday but mechanical respiratory assistance received so there was a "worsening" of the table. This person will join two others, an inmate at the Spanish Hospital and another in the Maciel, Montevideo. Maciel's patient has a flaccid paralysis for more than 20 days, Rios said.

The MSP still could not determine the source of the disease. In response, the MSP shipping epidemiological team to try to identify the link between the toxin produced by Clostridium Botullinum and "a food that is common to the three"patients.

The MSP has already urged medical staff to take precautions for the detection and reporting of any new cases

 

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Re: Uruguay: Botulism, cause unknown

Just a note that the cses have not been confirmed yet, and the timing does not appear to add up.

The two who became ill in late December and early January are mother and daughter. One source aobve indicates the first patient was related too.

Symptomatically, they should be able to distinguish botulism from GBS or polio because botulism presents a descending paralysis, not an ascending one.

http://www.uypress.net/uc_11920_1.html

Botulism in Paysandu
Paysandu, Uruguay, 17 Jan (UYPRESS) - A technical team from the Ministry of Public Health works to identify the causes of the three cases of botulism in that department.
Health Director, Gilberto Ríos, together with the technical team of the Epidemiology division is reported in video conference with the Health department director, Magdalena Espill and local team, in order to update the information.

In the video room of the Ministry of Public Health conducted a communication from the Epidemiology Division team with the Health department director Paysandu department where they have detected three cases of botulism.

To this instance of exchange, called MSP members of the Ministry of Livestock, Agriculture and Fisheries, the Municipality of Montevideo, the Pan American Health Organization, and the Unit of Decentralization of MSP to analyze the situation.

The Director General of Health, Gilberto Rios, said that his ministry is working hard on finding the causes that might trigger the onset of the disease. In this regard, said the patients detected are confirmed from the clinical and epidemiological subtracting the laboratory analysis, to be sent to Argentina, and the result will be available in 48 hours.

Rios explained that the feature of these cases is that they are different. In the first, the patient was hospitalized from December 10 in the Hospital Maciel and his condition is stable. The second patient is admitted to the Spanish Hospital, also in stable condition. For its part, the third patient remains in Paysandu affected and was the only case in which time was detected at the pathology. Therefore, the serum was administered antibotulinico, presenting a slight improvement in the neurological aspect.

The only coincidence that these three cases are that there are three women living in Paysandu. In addition, the Spanish hospital patient and the patient has remained in Paysandu are daughter and mother respectively. The health chief said that it is still difficult to identify the source of contamination of these people.

He recalled that in our country has a history of the disease in 1999, when after the arrest of the first case and then four involved, the common point was a homemade preserves.

In the current situation, all I can determine is that could have been two sources, as it is very difficult to attach the same food for a person who became ill in November, with two people who became ill in late December and early January.

Rios said that to identify the causes of the emergence of Gobtubby a team has been working hard in Paysandu, questioning the relatives of patients and investigating the food they ate at home people and businesses that were purchased.

Botulism poisoning is a rare but serious illness caused by a toxin produced by Clostridium botullinum. The disease can arise from eating food containing the toxin canned foods being the most frequently involved. However, it is also possible to link the consumption of other foods, such as home canning bad.

Prevention goes through the proper hand washing and containers used for canning. In addition, said the chief, "home preparation of preserved food must meet the criteria of time, pressure and temperature suitable for the destruction of the toxin.

Also, Rivers recalled that calls not give honey to children before one year of age, and not to eat canned showing deformation in the container. He noted the recommendation to dispose of the product when the can is punctured or swollen.

A measure of caution may be boiled for 10 minutes of those canned food before eating.

The symptoms presented "clinical manifestations of nervous system mainly ptosis (inability to raise to its normal position the upper eyelid), blurred vision and diplopia, symmetric descending flaccid paralysis that may progress to respiratory failure and respiratory arrest."

In the case of children, as reported, the disease has "constipation, loss of appetite, listlessness, ptosis, difficulty swallowing and progressive onset of weakness that may progress to liver failure and respiratory arrest."

 

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Re: Uruguay: Botulism, cause unknown

http://www.elpais.com.uy/110118/pna...lismo-analizan-dos-posibles-fuentes-de-casos/

Botulism: analysis of two possible sources of cases
Stronger hypothesis points to the consumption of canned food

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Although not yet have the results of laboratory tests, health authorities take for granted that the three hospitalized patients are carriers of botulism, a disease not had a history since 2002 - and are investigating possible sources of intoxication.

The epidemiological link is clear: the three patients are of Paysandu. But the director general of health, Gilberto Rios, said it is difficult to unite all cases in a single source and that one patient was infected in November and the other two a month later.

Yesterday, at the offices of the Ministry of Health in Montevideo was a videoconference with the epidemiological team is in Paysandu trying to establish the origin of the disease.

"In the current situation, all I can determine is that could have been two sources, as it is very difficult to attach the same food for a person who became ill in November, with two people who became ill in December," said Rios after the conference and stressed that it is questioning the relatives of patients, investigating the food they ate in their homes and businesses in which they were purchased.

Botulism is a severe intoxication caused by a toxin produced by Clostridium botullinum usually found in canned or preserved food. This is the strongest hypothesis is handled so far. In recent cases, in 2002, that was the origin.

Ventilator patients
Undersecretary of Health, Jorge Venegas, told El Pais that inpatients are in a "complex situation" by the characteristic of the disease that causes big problems at the central and peripheral nervous system. " The three infected people are being assisted ventilator. "The fact that they are piped already added problems," said the director general of health, Gilberto R?os.

 

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Re: Uruguay: Botulism, cause unknown

http://www.teledoce.com/noticia/17460_Mujeres-con-botulismo-internadas-en-CTI/

The three women who are currently hospitalized in the ICU because of botulism remain stable.


The three women are Paysandu, two are mother and daughter have no connection with the 3rd. Who contracted the disease a month earlier.

Symptoms of botulism begin with fatigue similar to the flu but no fever. Drooping eyelids, not being able to open my eyes, slurred speech and swallowing, tightness in the shoulders, tingling, spread his arms symmetrically are some of those symptoms.

From the MSP report that when the disease progressed to involve the diaphragm and intercostal muscles then produce respiratory failure and the patient should be treated by intubation, that is the status of the three women with the disease in Uruguay today.

While one of them still communicates by writing on paper, the other two did it through handshakes.

 

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Re: Uruguay: Botulism, cause unknown

http://www.180.com.uy/articulo/16657_MSP-reitera-alerta-por-botulismo-y-gastroenterocolitis

MSP reiterates gastroenterocolitis botulism alert
Listen to the text
The authorities of the Ministry of Public Health reiterated the recommendation to enhance hygiene and hand washing before a peak gastroenterocolitis cases. In addition, although one case was dismissed, reiterated the latent threat of botulism.


Published: January 28, 2011 at 14:34

By: Editor 180

adhoc ? Javier Calvo
Both diseases are closely linked with hygiene and food for what officials called attention to two issues. Intensify the washing of hands before meals and after using the bathroom, and cooking food thoroughly and certification of its accuracy.


These days, as usual, there was a peak gastroenterocolitis cases.


With respect to botulism, so far only three cases have been detected in Paysandu. Patients are stable but recovery is slow. Was also reported that a fourth case was ruled [out] in a girl of Paysandu, where are from the other three infected.


For this disease must take care of the health of the packaged food on all canned. Do not drink packaging products when present deformations. It also warns about the control of home canning.

 

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Re: Uruguay: Botulism, cause unknown

Apparently, the first three cases are confirmed and recovering.

http://www.prensa-latina.cu/index.php?option=com_content&task=view&id=259141&Itemid=1

January 28, 2011, 00:16 Montevideo, Jan. 28 (PL) Ministry of Public Health (MSP) of Uruguay announced recommendations and precautions to the public and medical personnel, respectively, to prevent further cases of botulism food poisoning.

This month the disease were detected with three people, all women coming from the Department of Paysandu, 380 miles northwest of Montevideo, who evolve favorably as hospital reports.

A fourth patient, a nine year old girl also in the region "sanducera" was admitted with symptoms suggestive of infection, botulism was dismissed after a review by experts in the field.

Precautionary measures directed by the MOH include maintaining a proper washing of hands and vessels before cooking, discard the canned or preserved in containers deformed, and boil these products for 10 minutes before eating.

For medical staff the portfolio called to consider the diagnosis to patients with clinical manifestations of the nervous system mainly fall eyelid, blurred or double vision and flaccid paralysis.

For infants, the MSP recalled that the symptoms are constipation, loss of appetite, listlessness, difficulty swallowing and progressive onset of weakness that may progress to liver failure and respiratory arrest.

Given the doubtful identification of a patient, the orientation of the portfolio is the notification to the Department of Health Surveillance, within the first 24 hours.

MSP authorities recalled that Uruguay has a history of this disease in 1999, when they were detected four infected and the common point was a homemade preserves.

Botulism poisoning is a rare but serious illness caused by a toxin produced by Clostridium botullinum, and may arise primarily by eating contaminated food cans.

However, according to the literature, it is also possible to link the consumption of meals prepared at home and in poor condition, and prevention techniques for proper handwashing and containers.



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