Healthcare representatives in Europe botulism outbreak warning associated with unsuccessful weight loss procedures carried out in Turkey, the purpose of which was to paralyze the abdominal muscles to reduce appetite. Authorities have identified 67 cases so far – 53 in Turkey, 12 in Germany and one each in Austria and Switzerland.
Botulism is a life-threatening nerve condition caused by botulinum toxin, which is produced by bacteria. Clostridium botulinum. There several forms of botulism, but in this outbreak, cases are a form called iatrogenic botulism, which occurs when too much toxin is injected during medical procedures. Iatrogenic botulism is associated with generalized muscle weakness, drooping eyes, difficulty swallowing, and difficulty breathing. Outbreak cases ranged from mild to severe, with several people in intensive care. This was announced by the European Center for Disease Prevention and Control (ECDC)..
Botulinum toxin is one of the most poisonous natural substances known; total dose 1 nanogram per kilogram of body weight is lethal. However, it has been used for cosmetic purposes, such as to smooth expression lines and in some cases. medicinal purposesfor example, treatment overactive bladder another chronic migraine headaches.
Although it was also used in the stomach for weight loss. research on this app Was mixed in efficiency. idea is that the toxin paralyzes the muscles of the stomach, slowing down digestion and the rate of gastric emptying. This is intended to keep people feeling full for longer, resulting in decreased appetite for as long as the effects of the toxin last, which can last up to three months. The injection is done using an endoscope, a tube-like device equipped with a syringe to inject the toxin directly into the stomach muscle after passing through the mouth and throat.
But things go wrong when too much botulism is injected, as is apparently the case in Turkey. Officials in Europe have traced cases in Germany, Austria and Switzerland to a single clinic in Istanbul. Cases in Turkey are also associated with this clinic, with the exception of three that were found in a private hospital in Izmir, Turkey. The ECDC noted that European patients were coordinating their risky medical tourism through a WhatsApp group.
In the past, such clusters of iatrogenic botulism have been associated with counterfeit toxin products, as was the case with outbreak in Egypt in 2017. last August, World Health Organization warns of counterfeit batches of botulinum toxin a product called Dysport. Bad batches have been found in several countries, including Turkey. But a Turkish investigation into the current outbreak found it to be related to legal, licensed products, though not approved for stomach use, ECDC said. Turkish authorities have reportedly suspended medical procedures at both identified medical facilities and launched further investigations into the medical workers involved.
Meanwhile, patients with botulism have a long and painful journey ahead of them. Recovery can take weeks to months. During a 2017 outbreak linked to a counterfeit product, it took patients six to 12 weeks to fully recover. Because iatrogenic botulism is relatively rare, the mortality rate is unclear. But food botulism, caused by eating improperly preserved or canned foods contaminated with the toxin, has a mortality rate of 5 to 10 percent, the ECDC notes.
Treatment for botulism may include mechanical ventilation in case of respiratory failure, as well as doses of an antitoxin called heptavalent botulinum antitoxin (HBAT), which is made from horses. HBAT contains antibodies from horses immunized with low doses of botulinum toxin. HBAT antibodies work by binding to the toxin while it is in the blood, before it can irreversibly bind to presynaptic nerve endings and lead to paralysis. Thus, the antitoxin can only prevent further paralysis; it cannot reverse a paralysis that has already occurred. However, even though current mortality rates are below 10 percent, prior to the development of an antitoxin mortality was 50 percentaccording to the US Centers for Disease Control and Prevention.
Horses are often used for such antibody-based therapies because their large body size means a large volume of blood, which in turn means that large amounts of antibodies or other valuable proteins can be collected. In the US, a single Thoroughbred named First Flight was the only source of anti-botulism antitoxin serum from its initial development in the 1970s until the 1990s.
The first flight was a retired racehorse who briefly worked as a caisson horse at a military funeral at the Arlington National Ceremony before reportedly carry the general’s coffin. In 1978, at the age of 10, he was transferred to the U.S. Army Medical Research Institute for Infectious Diseases at Fort Detrick, Maryland, where he became the only living factory in the country to produce botulinum antitoxin, and also earned a reputation for his cheeky personality. After donating nearly 16,000 liters of blood in the 1980s and 1990s, First Flight was retired. He died in his paddock at Fort Detrick of natural causes at the age of 31. the halter and leash are in the Smithsonian National Museum of American History..