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During September 29-October 6, 2017, the County of San Diego Public Health Services (COSD) was notified of two patients with suspected wound botulism and a history of using black tar heroin. On October 9, COSD, which had reported an average of one wound botulism case per year during 2001-2016, sent a health alert through the California Health Alert Network, notifying Southern California providers of these two patients, including their signs and symptoms and black tar heroin exposure. In collaboration with the California Department of Public Health, COSD conducted an investigation to identify additional cases, determine risk factors for illness, estimate cost of medical care, and develop recommendations to prevent further illness. By April 18, 2018, nine (eight confirmed and one probable) patients with wound botulism were identified, all of whom were hospitalized; one of the nine died. All nine were persons who inject drugs; seven specifically reported using black tar heroin and six practiced subcutaneous injection known as skin popping. Clinically compatible signs and symptoms included muscle weakness, difficulty swallowing, blurred vision, drooping eyelids, slurred speech, difficulty breathing, loss of facial expression, or descending paralysis. All patients were treated with heptavalent botulism antitoxin (BAT). Wound botulism is likely underrecognized because of its rarity and the overlapping signs and symptoms with opioid intoxication, overdose, and other neurologic syndromes including Guillain-Barré syndrome, the Miller Fisher variant of Guillain-Barré syndrome, and myasthenia gravis. Prompt diagnosis, administration of BAT, and provision of supportive care can help stop the progression of paralysis and be lifesaving.
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http://dx.doi.org/10.15585/mmwr.mm675152a3 | DOI Listing |
Adv Sci (Weinh)
December 2024
Medical School, Henan University, Kaifeng, Henan Province, 475004, P. R. China.
Accurately assessing potential side effects following botulinum neurotoxin (BoNT) injection remains a formidable challenge. To address this issue, an innovative approach is developed that combines a wearable temperature sensor with a sophisticated volatilomics technique, aimed at facilitating the rapid and convenient prediction of potential physical discomfort related to latrogenic botulism. The investigation identifies five volatile organic compounds (VOCs)-acetone, styrene, ethanol, 2-pentanone, and n-butano-as promising markers indicative of BoNT poisoning.
View Article and Find Full Text PDFCureus
November 2024
General Surgery, Hospital Professor Doutor Fernando Fonseca, Amadora, PRT.
Open ventral hernia repair is one of the most commonly performed surgeries by general surgeons worldwide. In the case of complex incisional hernias, there are adjunct techniques that can help abdominal wall reconstruction surgery, such as type A botulinum toxin (BTA), whose injection results in muscle relaxation and growth of muscle fiber length, allowing fascial closure without the need for advanced techniques. We report a case of a male patient who underwent ultrasound-guided BTA injection in the abdominal wall and, five days later, was admitted to our emergency department with dysarthria, muscular weakness, dyspnea on small exertion, and constipation.
View Article and Find Full Text PDFBiosens Bioelectron
December 2024
Institute of Agricultural Engineering, ARO, Volcani Institute, Rishon LeZion, 7505101, Israel. Electronic address:
Botulinum neurotoxins (BoNT), the agent causing botulism, exhibit the highest potency among bacterial toxins and pose a significant threat to both humans and animals. The current in vivo method (mouse lethality assay, MLA) is inappropriate for real-time and pen-side assessment of the occurring outbreak or case. Herein, we describe a reflective-based biosensor capable of detecting the toxin's type and activity state by competitive immunoassay and endopeptidase activity, respectively.
View Article and Find Full Text PDFNew Microbes New Infect
December 2024
Research, Policy, and Training Directorate, Jordan Center for Disease Control (JCDC), 11183 Amman, Jordan.
Toxins (Basel)
November 2024
Unité des Toxines Bactériennes, UMR CNRS 6047, Inserm U1306, Université Paris-Cité, Institut Pasteur, 25 rue du Dr Roux, 75724 Paris, France.
Detection of botulinum neurotoxins (BoNTs) involves a combination of technical challenges that call for the execution of inter-laboratory proficiency tests (PTs) to define the performance and ease of implementation of existing diagnostic methods regarding representative BoNT toxin-types spiked in clinical, food, or environmental matrices. In the framework of the EU project EuroBioTox, we organized an international proficiency test for the detection and quantification of the clinically relevant BoNT/A, B, E, and F sero- and subtypes including concentrations as low as 0.5 ng/mL.
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