HCMC botulism patient dies before receiving antitoxin sent from Switzerland

Sent from Switzerland, six vials of botulism antitoxin heptavalent (BAT) arrived on Wednesday to be administered to the three men, aged 18, 26 and 45, the Ministry of Health said.

Two of them are under treatment at Cho Ray Hospital and the other at Gia Dinh Hospital.

But the 45-year-old patient at Gia Dinh died on Wednesday night before he was injected with the drug, the hospital announced Thursday morning.

Produced by Emergent BioSolutions Canada Inc., the drug effectively neutralizes all known botulinum nerve toxin serotypes. Without it, botulism patients could be paralyzed permanently.

Between May 13 and 20 six people in Thu Duc City suffered from botulinum poisoning, five after eating pork bologna sold by street vendors and one due to eating a type of fermented food.

The Thu Duc Department of Health said the bologna was produced by an illegal facility in the city, operating for the last two months despite not having a license.

Of the six patients, three aged 10-14 have been in stable condition after being given BAT at HCMC’s Children’s Hospital 2 shortly after being diagnosed. It is unfortunate that the drug given to those children was the last dose in Vietnam.

But the three adults remained in critical condition and had been on ventilators for almost a week.

Le Quoc Hung, chief of the tropical diseases department at Cho Ray Hospital, said in the past botulism caused high mortality due to a lack of ventilators, but these days doctors could keep patients alive though the antitoxin is needed to save them.

According to WHO, botulinum toxin, or botulinum neurotoxin, is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species.

The growth of the bacteria and the formation of toxin occur in products with low oxygen content and certain combinations of storage temperature and preservative parameters.

This happens most often in lightly preserved foods and in inadequately processed, home-canned or home-bottled foods.

Botulism is rare around the world and therefore the supply of BAT is limited.

It is expensive at US$8,000 vial, and is not covered in Vietnam by health insurance.

Foodborne botulism is characterized by descending, flaccid paralysis that can cause respiratory failure. Early symptoms include marked fatigue, weakness and vertigo, usually followed by blurred vision, dry mouth and difficulty in swallowing and speaking.

Vomiting, diarrhea, constipation and abdominal swelling may also occur.

The disease can progress to weakness in the neck and arms, after which the respiratory muscles and muscles of the lower body are affected. There is no fever and no loss of consciousness.

Symptoms usually appear within 12 to 36 hours.

The disease is fatal in 5-10% of cases.