Tracing investigation and analysis of a Clostridium botulinum food poisoning incident in Bayingolin Mongolian Autonomous Prefecture, Xinjiang / 中华预防医学杂志

To analyze a suspected case of Clostridium botulinum food poisoning in Bayingolin Mongolian Autonomous Prefecture, Xinjiang and to help validating the diagnosis and providing technical support for clinical treatment. The basic information and clinical manifestations of food poisoning cases were investigated by using the epidemiological method of food safety accidents. The botulinum toxin genes in the samples were detected by real-time PCR and inoculation of KM mouse. The enriched bacteria were further purified and validated. PFGE and cluster analysis were performed on five isolates. Clostridium botulinum type A was detected in two homemade fermented bean samples and stool lavage fluid samples of three patients from enriched samples by toxin test and real-time PCR, and were further validated after isolation of Clostridium botulinum. PFGE showed 100% homology among five isolates. Five isolates of bacteria isolated from the stool lavage fluid of three patients and two homemade fermented bean curd were identified as the same source through PFGE. The cause of this food poisoning cases is food pollution of Clostridium botulinum type A.

A toxina botulínica como alternativa do arsenal terapêutico na odontologia / Botulinum toxin as alternative of therapeutical arsenal in dentistry

A evolução dos materiais, técnicas e fármacos culminou com a descoberta e uso da toxina botulínica Tipo A na Medicina e na Odontologia. Longe do escopo e da discussão sobre seu uso cosmético ou funcional, a toxina pode ser empregada em múltiplas terapias no terço inferior da face. A metodologia utilizada foi uma revisão sistemática sobre artigos científicos em revistas e periódicos indexados e de fácil aquisição nas bases de dados PubMed/MEDLINE, Lilacs, BBO, SciELO e Google Acadêmico nos últimos 10 anos, acrescidos de referências clássicas e estudos considerados relevantes para essa publicação. A toxina botulínica é considerada um procedimento minimamente invasivo clássico, pois não é agressiva e nem penetra o organismo de forma extensiva, com ato operatório que não exige uma hora clínica longa e permite o retorno do paciente às suas atividades laborais de maneira bastante precoce. Empregada na Odontologia: na sialorreia, nas assimetrias faciais com origem muscular, nas disfunções e nos problemas da articulação temporomandibular, no bruxismo, no controle do sorriso gengival, na distonia orofacial, no controle da força muscular após aposição de fixações em Implantodontia, entre outros. Foi possível concluir que a toxina botulínica é uma alternativa promissora dentro do arsenal terapêutico do cirurgião-dentista devido ao seu múltiplo emprego, com possibilidade de correções e reversibilidade superiores quando comparadaa técnicas cirúrgicas, por exemplo, com menor índice de morbidade, maior conforto e resultado imediato para o paciente

The evolution of materials, techniques and drugs culminated in the discovery and use of Botulinum Toxin, Type A, in Medicine and Dentistry. Far from the scope and discussion of its cosmetic or functional use, the toxin can be employed in multiple therapies in the lower third of the face. The methodology used was a systematic review of scientific articles in indexed and easily retrieved journals and papers in the PubMed/ MEDLINE, Lilacs, BBO, SciELO and Google Academic databases in the last 10 years, along with classic references and studies considered relevant to this publication. Botulinum toxin is considered a classic minimally invasive procedure, since it is neither aggressive nor penetrating the organism extensively, with an operative procedure that doesn´t require a long clinical time and allows the patient to return to his work activities in a very precocious way. Employed in Dentistry: in sialorrhoea, facial asymmetries with muscular origin, dysfunctions and temporomandibular joint problems, bruxism, gingival smile control, orofacial dystonia, muscle strength control after fixations placement in Implant Dentistry, among others. It was possible to conclude that botulinum toxin is a pr omising alternative within the therapeutic arsenal of the dentist due to its multiple use, with the possibility of superior corrections and reversibility when compared to surgical techniques, for example, with lower morbidity index, greater comfort and immediate result for the patient.

Óleo essencial de Lippia gracilis: atividade antioxidante e antimicrobiana contra Clostridium botulinum / Essential oil of Lippia gracilis: antioxidant and antimicrobial activity against Clostridium botulinum

Apesar da utilização dos aditivos nos alimentos, alguns microrganismos, como o Clostridium botulinum ainda causam preocupação. Óleos essenciais são opções de aditivo para a indústria de alimentos, pois podem apresentar atividade antimicrobiana e antioxidante. Diante disso, o objetivo foi extrair o ó leo essencial de Lippia gracilis, caracterizar sua composição química por CG/ EM, avaliar a atividade antioxidante pela redução do radical DPPH e a concentração mínima esporicida (CME) sobreClostridium sporogenes. O óleo essencial é composto majoritariamente pelos monoterpenos carvacrol, p-cimeno e terpineno, e apresentou baixa capacidade de estabilização do radical DPPH, IC50 > 500 μg/ mL. Em relação à ação sobre os endósporos do Clostridium sporogenes, a concentração mínima esporicida foi 1,5% de óleo essencial.

Sinergismo de óleos essenciais sobre endósporos de Clostridium sporogenes / Essential oils sinergisms on Clostridium sporogenes endospores

A forma mais comum de inibir a produção de toxina botulínica em produtos cárneos cozidos é pela adição de sais de nitrito, o que pode gerar substâncias carcinogênicas (nitrosaminas), sendo desejável sua substituição. Os óleos essenciais vêm se destacando como agentes antimicrobianos, sendo interessante seu uso como conservante. O objetivo desse trabalho foi avaliar a ação sinergística de óleos essenciais sobre endósporos de Clostridium sporogenes, utilizado como modelo de pesquisa para C. botulinum. As concentrações mínimas esporicidas (CME) dos óleos de alecrim, tomilho, cravo, manjericão, ho wood e alho foram de 3% e de 0,375% para pimenta e canela. Os óleos de orégano e noz moscada não apresentaram ação esporicida nas concentrações testadas. Entre as combinações, as melhores foram de pimenta chinesa (0,1306%), alho (1,1%) e manjericão (1,1%) e pimenta chinesa (0,1306%), alho (1,1%) e tomilho branco (1,1%). Os resultados sugerem o sinergismo entre os óleos, sendo promissor seu uso em alimentos.

Epidemiologia e fatores de riscos relacionados à intoxicação alimentar causada por Clostridium Botulinum: uma revisão narrativa / Epidemiology and risk factors related to food intoxication caused by Clostridium Botulinum: a narrative review

O botulismo é uma doença resultante da ação de uma toxina produzida pelo Clostridium botulinum. Devido à sua gravidade e alta mortalidade é considerado um problema de saúde pública. Nesta revisão apresentamos os principais fatores de riscos associados à intoxicação alimentar provocada pelo Clostridium botulinum, bem como realizamos um levantamento epidemiológico sobre o botulismo alimentar e infantil. A busca bibliográfica considerou as bases de dados Scielo, Medline, Lilacs e PubMed. Foram selecionados artigos originais e relatos de caso publicados em inglês, espanhol e português, incluindo publicações dos últimos dez anos. A partir das análises dos títulos, resumos e artigos, um total de 26 artigos foram incluídos nesta revisão. Verificou-se predomínio de 54% dos casos referentes ao botulismo alimentar, dos quais aproximadamente 58% confirmaram a ocorrência da toxina tipo A; e 35% referente ao botulismo infantil. Na literatura consultada os principais sintomas, relacionados ao botulismo alimentar, identificados foram: visão turva, vômito, paralisia flácida, náuseas, tontura, diplopia, dificuldade respiratória, disatria, disfagia, fraqueza muscular, boca seca, ptose e cefaleia. Dentre as principais fontes de contaminação, 65% das publicações selecionadas identificaram as conservas como principal causa do botulismo alimentar. Embora o mel (42%) seja a única fonte registrada de alimento veiculador do agente causador do botulismo infantil, alguns relatos na literatura (25%) associaram à doença com a inalação de poeira contendo esporos do Clostridium botulinum, bem como o uso de plantas medicinais (25%). Os sintomas mais comuns observados na literatura foram: constipação dificuldade respiratória e dificuldade de sucção. Apesar de vários relatos na literatura acerca das duas doenças, o botulismo ainda é muito subnotificado dado ao diagnóstico muitas vezes equivocado, ressaltando-se a importância do diagnóstico precoce no tratamento da doença pelos profissionais de saúde, bem como a disponibilidade de informações relevantes para a investigação epidemiológica de doenças de notificação compulsória. Os dados apresentados também demonstram a importância de sensibilizar a população dos principais riscos e medidas de prevenção, já que a maioria dos casos relatados está relacionada a práticas inadequadas de preparo dos alimentos. (AU)

Botulism is a disease resulting from the action of a toxin produced by Clostridium botulinum. Because of its severity and high mortality, it is considered a public health problem. In this review, we present the main risk factors associated with food poisoning caused by Clostridium botulinum, as well as an epidemiological survey on foodborne and infant botulism. A bibliographic search was conducted in SciELO, MEDLINE, LILACS and PubMed databases. Original articles and case reports published in English, Spanish and Portuguese in the past ten years were selected. After analyzing titles, abstracts and articles, 26 articles were used in this review. In total, 54% of the cases were related to foodborne botulism, of which approximately 58% had confirmed type A botulism, and 35% were related to infant botulism. In the literature consulted, the main symptoms related to foodborne botulism were blurred vision, vomiting, flaccid paralysis, nausea, dizziness, diplopia, respiratory distress, dysarthria, dysphagia, muscle weakness, dry mouth, ptosis and headache. Among the sources of contamination, 65% of the published studies reported home-canned foods as the main cause of foodborne botulism. Although honey (42%) is the only reported food source for the agent causing infant botulism, some reports in the literature (25%) associated the disease with inhalation of dust containing Clostridium botulinum spores, as well as use of medicinal plants (25%). The most common symptoms observed in the literature were constipation, difficulty breathing and difficulty suckling. Although several reports on the two forms of the disease exist, botulism remains under-reported because of often incorrect diagnosis. Thus, early diagnosis is important for an adequate treatment provided by health professionals, as well as availability of relevant information for the epidemiological investigation of notifiable diseases. The data presented in this study also demonstrate the importance of raising people's awareness to main risks and prevention measures, as most reported cases were related to inadequate food preparation practices. (AU)

Uso da toxina botulínica na correção do sorriso gengival / Use of botulinal toxin in the correction of gengival smile

Introdução: A beleza do sorriso representa uma expressão primordial na harmonização da face, e está diretamente ligada à autoestima do indivíduo. A atividade do sorriso é determinada pela contração de músculos específicos, e pode apresentar diferentes níveis de exposição gengival. Quando maior que 3mm é denominado sorriso gengival e gera uma condição esteticamente desagradável. Entre as suas diversas causas, a hiperatividade muscular se destaca. Objetivo: apresentar uma revisão de literatura a respeito da toxina botulínica, que se tornou uma ferramenta bastante utilizada como método complementar ou exclusivo na correção do sorriso gengival. Método: Para a pesquisa, foram utilizados os seguintes descritores: toxina botulínica tipo A, estética dentária e clostridium botulinum, utilizando os operadores booleanos AND e OR, inclusos artigos em língua portuguesa, inglesa e espanhola para descrever seu histórico, mecanismo de ação, durabilidade, indicações, contraindicações e técnica de aplicação. Conclusão: Conclui-se que o seu emprego como método de tratamento conservador pelo cirurgião-dentista é viável desde que possua conhecimento da anatomia facial, interações entre os músculos e farmacologia da neurotoxina, garantindo assim segurança, melhoria na estética do sorriso e satisfação do paciente.

Introduction: The beauty of the smile represents a primordial expression in the harmonization of the face and is directly linked to the self-esteem of the individual. Smile activity is determined by the contraction of specific muscles and may present different levels of gingival exposure. When bigger than 3mm, it is called gingival smile, and generates an aesthetically unpleasant condition. Among its many causes, muscular hyperactivity is highlighted. Objective: The objective of this work was to present a literature review about botulinum toxin, which has become a widely used tool as a complementary or exclusive method for gingival smile correction. Method: The following descriptors were used: Botulinum toxin type A, dental aesthetics and clostridium botulinum, using Boolean operators AND and OR, including articles in Portuguese, English and Spanish to describe their history, mechanism of action, durability, indications, contraindications and application technique. Conclusion: It is concluded that its use as a method of conservative treatment by the dental surgeon is feasible if it has a thorough knowledge of facial anatomy, interactions between muscles and neurotoxin pharmacology, thus ensuring safety, improvement in smile aesthetics and patient satisfaction.

Clostridium botulinum spores in Polish honey samples

The aim of this study was an examination of 240 multifloral honey samples collected from Polish apiaries to determine Clostridium botulinum occurrence. Honey was collected from apiaries directly after the extraction process. Samples were inoculated by using the dilution and centrifugation method. Suspected isolates were examined by using mouse bioassay, polymerase chain reaction (PCR), and real-time PCR methods. C. botulinum type A and B strains were detected in 5 of 240 examined honey samples (2.1%). Bacterial strains were also detected that were phenotypically similar to C. botulinum but that did not exhibit the ability to produce botulinum toxins and did not show the presence of the botulinum cluster (ntnh and bont genes) or expression of the ntnh gene. The methods used in the examination, especially the expression analysis of ntnh gene, enabled specific analysis of suspected strains and could be used routinely in environmental isolate analyses of C. botulinum occurrence.

Avaliação dos fatores físico-químicos que controlam o desenvolvimento do Clostridium botulinum em mortadelas comercializadas no estado do Rio de Janeiro / Evaluation of the physical-chemical factors that control the development of Clostridium botulinum in mortadella marketed in the state of Rio de Janeiro

A mortadela é um produto cárneo embutido muito consumido pelos brasileiros. Por ser um alimento embalado à vácuo apresenta condições propícias ao desenvolvimento de esporos bacterianos de patógenos como o Clostridium botulinum. Muitos aditivos usados na produção de carnes industrializadas visam melhorar o sabor, a cor e a aparência do produto, além de estender a sua vida útil. Desta forma, os fatores que garantem a segurança destes produtos são a conservação em baixas temperaturas após sua produção, na comercialização e no transporte; adição dos conservantes nitrato e nitrito de sódio nas concentrações adequadas; e o tratamento térmico adequado durante o seu processamento. Este trabalho teve como objetivo avaliar o risco da presença da toxina botulínica em amostras de mortadela através da análise das características físico químicas do produto. Foram coletadas, no varejo do município do Rio de Janeiro/RJ, dez amostras de mortadelas de cinco diferentes marcas comerciais, que foram analisadas quanto ao pH, atividade de água, teor de umidade, resíduo mineral fixo, temperatura de conservação, data de fabricação e prazo de validade. De acordo com o risco do crescimento do Clostridium botulinum, 100% das amostras apresentaram atividade de água (Aw) acima de 0,955 e pH acima dos valores de 4,5 o que favorece a multiplicação dessa bactéria.(AU)

Avaliação dos fatores físico-químicos que controlam o desenvolvimento do Clostridium botulinum em mortadelas comercializadas no estado do Rio de Janeiro

A mortadela é um produto cárneo embutido muito consumido pelos brasileiros. Por ser um alimento embalado à vácuo apresenta condições propícias ao desenvolvimento de esporos bacterianos de patógenos como o Clostridium botulinum. Muitos aditivos usados na produção de carnes industrializadas visam melhorar o sabor, a cor e a aparência do produto, além de estender a sua vida útil. Desta forma, os fatores que garantem a segurança destes produtos são a conservação em baixas temperaturas após sua produção, na comercialização e no transporte; adição dos conservantes nitrato e nitrito de sódio nas concentrações adequadas; e o tratamento térmico adequado durante o seu processamento. Este trabalho teve como objetivo avaliar o risco da presença da toxina botulínica em amostras de mortadela através da análise das características físico químicas do produto. Foram coletadas, no varejo do município do Rio de Janeiro/RJ, dez amostras de mortadelas de cinco diferentes marcas comerciais, que foram analisadas quanto ao pH, atividade de água, teor de umidade, resíduo mineral fixo, temperatura de conservação, data de fabricação e prazo de validade. De acordo com o risco do crescimento do Clostridium botulinum, 100% das amostras apresentaram atividade de água (Aw) acima de 0,955 e pH acima dos valores de 4,5 o que favorece a multiplicação dessa bactéria.

Mortadella is a sausage widely consumed in Brazil. It is a vacuum packed food, what provides conditions conducive to the development of spores of pathogen bacteria such as Clostridium botulinum. Many additives used in the production of processed meats aim to improve the flavor, color, appearance of the product and extend its shelf-life. The major factors to guarantee the safety of these products are low temperatures stocking, commercialization and transport; addition of preservatives sodium nitrate and sodium nitrite at the appropriate concentrations; and the appropriate heat treatment during processing. This work aimed to evaluate the risk of the presence of botulin toxin in mortadella samples by analyzing the physicochemical characteristics of the product. Ten mortadella samples from five different commercial brands were collected at a market, in the city of Rio de Janeiro, RJ, Brazil. The samples were analyzed for pH, water activity, moisture content, fixed mineral residue, storage temperature, date of manufacture and expiry date. According to the risk of Clostridium botulinum presence, all samples presented water activity (Aw) above 0.955 and pH above 4,5, conditions that favors bacteria proliferation.

O uso da toxina botulínica na correção do sorriso gengival- revisão de literatura / Use of the botulinum toxin in correction of the gingival smile - Literature review

A toxina botulínica inicialmente era utilizada apenas para tratamentos terapêuticos, depois de alguns estudos sua aplicação passou a ser também utilizada para tratamentos estéticos. Esta substância é produzida pela bactéria Clostridium botulinum, responsável pelo botulismo, doença que provoca intoxicação por alimentos mal conservados. Utilizada na medicina para tratar inicialmente patologias, hoje seu uso passa a ser também estético na odontologia. Alguns pacientes se queixam do sorriso gengival causado por uma exposição excessiva da gengiva e buscam tratamentos mais rápidos e com menor morbidade, neste caso a toxina botulínica é muito eficaz para a correção do sorriso gengival diagnosticado por uma hiperfunção muscular. Quando causado por excesso vertical maxilar, extrusão ou erupção passiva alterada dos dentes ântero-superiores, o sorriso gengival pode ser tratado com a cirurgia ortognática, tratamento ortodôntico, miectomia, reposicionamento labial e/ou gengivoplastia. O uso desta substância na odontologia, pode ser mais uma opção para amenizar ou corrigir o sorriso gengival por hiperfunção muscular ou associar a outros tipos de tratamentos. Desta forma, o objetivo deste trabalho é fazer uma revisão literária sobre o uso da toxina botulínica na correção do sorriso gengival e descrever seu protocolo de uso (AU)

Botulinum toxin initially was used only for therapeutic treatments, after some studies its application was also used for aesthetic treatments. This substance was produced by the bacterium Clostridium botulinum, responsible for botulism, a disease that causes intoxication by poorly preserved foods. Used in medicine to treat initially pathologies, today its use is now also aesthetic in dentistry. Some patients complain of the gingival smile caused by excessive exposure of the gums and seek faster treatments with lower morbidity; in this case the botulinum toxin is very effective for the correction of the gingival smile diagnosed by a muscular hyperfunction. When caused by excessive vertical jaw, extrusion or passive eruption of the upper anterior teeth, the gingival smile may be treated with orthognathic surgery, orthodontic treatment, myectomy, lip repositioning and / or gingivoplasty. The use of this substance in dentistry may be another option to soften or correct the gingival smile due to muscular hyperfunction or to associate with other types of treatments. In this way, the objective of this work is to make a literary review on the use of botulinum toxin in the correction of the gingival smile and to describe its protocol of use. (AU)

Molecular and Epidemiological Characterization of Infant Botulism in Beijing, China / 生物医学与环境科学（英文）

Laboratory-based pathogen isolation, identification, and toxicity determination were performed on samples from a suspected case of infant botulism. Mice injected with cultures generated from the enema sample and ingested Powered infant formula (PIF) presented typical signs of botulism. Antitoxins to polyvalent botulinum neurotoxins (BoNTs) and monovalent BoNT type B antitoxin had protective effects. Clostridium botulinum isolated from the enema and residual PIF samples were positive for type B toxin. Pulsed-field gel electrophoresis (PFGE) revealed that the two strains of C. botulinum isolated from the two samples produced indistinguishable pulsotypes. These findings confirmed this case of type B infant botulism associated with the ingestion of PIF contaminated by type B C. botulinum spores.

Clinical analysis of three cases with infant botulism and review of literature / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics and diagnosis of three cases with infant botulism.</p><p><b>METHOD</b>Clinical data of three clinically diagnosed cases with infant botulism in May 2015 in Peking University First Hospital were retrospectively analyzed. Literature search at databases of PubMed, Wanfang, China National Knowledge Infrastructure and VIP with the key words"infant AND botulism". The date of literature retrieval was from the database founding to November 2015. The characteristics of infant botulism were summarized through review of literature.</p><p><b>RESULT</b>Three patients were infants of 4-8 months of age, and all had acute onsets of anorexia and poor response. All of them had normal psychomotor development previously, and without clear history of exposure to poisons. The main findings on physical examination were reduced muscle strength and hypotonia, dullness or disappeared pupillary light reflex, reduced facial expression, weak crying and dysphagia. Unexpectedly their states of consciousness were relatively normal. Finally, through identification and PCR genotyping of bacteria in stool, 2 cases were confirmed as Clostridium (C.) botulinum type B infection. Totally 446 reports were retrieved from foreign language literature and 52 reports from Chinese literature. More than 3,000 cases of infant botulism cases were reported in the world. Rare cases were reported in China and only 1 case was reported in 2000.</p><p><b>CONCLUSION</b>Most cases of infant botulism had no clear exposure history. The main clinical manifestations are hypotonia, cranial nerve paralysis, flaccid paralysis, but different patients may have different presentations. Detection of C. Botulinum and its toxin in stool can help to confirm the diagnosis. Infant botulism is relatively rare in China, which may be related to the insufficient understanding and inspection level of the disease. It might be underestimated in China.</p>

Estudo retrospectivo de surtos de botulismo no Brasil e no mundo

A distribuição do botulismo é mundial, com casos esporádicos ou surtos familiares, em geral, relacionados à produção e à conservação de alimentos de maneira inadequada. As intoxicações alimentares constituem um dos significantes problemas de saúde pública. O botulismo é uma doença grave, causada pelo Clotrisdium botulinum e deve ser considerado emergência médica e de saúde pública. De ocorrência súbita, caracteriza-se por manifestações neurológicas seletivas, de evolução dramática e elevada mortalidade, entre 30 e 65%. Devido a importância do botulismo como um problema de saúde pública, é indispensável relatar que o maior perigo de contaminação está nos alimentos preparados de forma artesanal, principalmente em conservas caseiras.

The distribution of botulism is worldwide, with sporadic cases or outbreaks family usually related to production and conservation of food improperly. The food poisoning is one of the significant public health problems. Botulism is a serious illness caused by Clostridium botulinum should be considered a medical emergency and public health. The sudden occurrence characterized by neurological manifestations selective evolution of dramatic and high mortality between 30 and 65%. Due to the importance of botulism as a public health problem, it is essential to report that the greatest danger of contamination in food is prepared by hand, especially in home canning.

Surto de botulismo tipo C em aves domésticas no semiárido do Nordeste, Brasil / Outbreak of type C botulism in poultry in the semiarid Northeast, Brazil

O presente estudo tem como objetivo relatar um surto de botulismo tipo C em galinhas (Gallus gallus domesticus), patos (Anas platyrhynchos) e em galinhas-d'-angola (Numida meleagris) criadas no semiárido do Rio Grande do Norte, Brasil. As aves incluídas neste estudo foram oriundas de um criatório com 80 animais, sendo 48 galinhas, 12 patos e 20 galinhas-d'angola. Os animais apresentaram paralisia flácida simétrica das patas, asas, pescoço e pálpebras, desprendimento de penas e dispneia. Vinte e quatro horas após início dos sinais clínicos constatou-se a mortalidade de 30 aves (37,5%). Após 48 horas, os 50 animais restantes também apresentaram sinais clínicos similares e vieram a óbito. Três aves com sinais clínicos de botulismo foram enviadas ao Laboratório de Patologia Veterinária da Universidade Federal Rural do Semi-Árido, onde coletou-se sangue e realizou-se necropsia seguida de avaliação anatomopatológica. Não foram observadas lesões macro e microscópicas nos órgãos da cavidade celomática e encéfalo. As alíquotas de soro foram encaminhadas para o Setor de Clostridioses do Laboratório Nacional Agropecuário de Minas Gerais (LANAGRO-MG) para pesquisa da toxina botulínica por soroneutralização em camundongos, que resultou na detecção da toxina botulínica tipo C. Este é o primeiro relato de botulismo em aves na região Nordeste do Brasil, e a primeira descrição da doença em galinhas d'Angola.

This study aims to report an outbreak of type C botulism in chickens (Gallus gallus domesticus), ducks (Anas platyrhynchos) and guinea fowls (Numida meleagris) created in semiarid region of Rio Grande do Norte, Brazil. The birds included in this study were derived from a farm with 80 animals (48 chickens, 12 ducks and 20 guinea fowls). The birds had symmetrical flaccid paralysis of the legs, wings, neck and eyelids, shedding feathers and dyspnea. After 24 hours of onset of clinical signs, 30 (37.5%) of the birds were found dead. After 48 hours, the 50 remaining animals also showed similar clinical signs and came to death. Three birds with clinical signs of botulism were sent to the Laboratory of Veterinary Pathology, of the Universidade Federal Rural do Semiárido, where blood was collected and held necropsy followed by histopathologic evaluation. There were no gross and microscopic lesions in the organs of the coelomic cavity and brain. There were no gross and microscopic lesions in the organs of the coelomic cavity and brain. The serum samples were sent to the Clostridial Section of the Laboratório Nacional Agropecuário de Minas Gerais (LANAGRO- MG) to search botulinic toxin by serumneutralization, which resulted in the detection of type C botulinic toxin. This is the first description of botulism in avian in the Northeastern Brazil and the first report of the disease in guinea fowls.

Efeitos terapêuticos da toxina botulínica na estética periodontal / Therapeutic effects of botulinum toxin on aesthetic periodontal

A Odontologia está vinculada à estética facial através do sorriso, que se retrata na expressão realizada pelos lábios, dentes e gengivas saudáveis. Mas, esta expressão facial segue alguns parâmetros estéticos de exposição dos dentes e gengivas. Quando não se tem uma harmonia ao sorrir, devido à grande quantidade de gengiva exposta, torna-se necessária as correções desse sorriso através de cirurgias plásticas gengivais e osteotomias. Em contrapartida, com o uso terapêutico da toxina botulínica pelos cirurgiões-dentistas, torna-se possível a correção dessa elevada exposição de gengivas sem intervenções cirúrgicas, apenas com a desativação dos músculos responsáveis pelo sorriso, diminuindo a elevação labial durante a mímica facial; sem desrespeitar o que reza o código de ética odontológica.

Dentistry is related to the facial aesthetics through the smile, which is shown in the expression held by the lips, teeth and gums healthy. However, this facial expression follows some aesthetic parameters of exposure of teeth and gums, principally when there isn’t a harmony to smile, due to the large amount of exposed gum. Becomes necessary corrections of that smile through plastic surgeries and osteotomies. On the other hand, with the therapeutic use of botulinum toxin by dentists, it becomes possible to correct this high exposure of gums without any surgery, just disabling the muscles responsible for smiling and decreasing the lip elevation during facial expressions. And all this obviously without breaching the code of ethics of dentistry.

Botulismo por herida traumática / Traumatic wound botulism

El botulismo por herida es una enfermedad rara, causada por una potente neurotoxina, producida por bacterias de la familia Clostridium. El Clostridium botulinum es la más frecuente, pero existen otras, como el Clostridium baratti y el Clostridium butyricum, que también son productoras de neurotoxinas. Se conocen siete tipos de neurotoxinas (de A a G), entre las cuales los tipos A, B, E, F y G causan botulismo humano. Esta forma, la menos frecuente, resulta de la colonización de una herida por Clostridium botulinum. Clínicamente, es semejante a las otras formas de presentación, pero con fiebre y/o leucocitosis por sobreinfección. La enfermedad debe sospecharse en pacientes lúcidos con parálisis fláccida, simétrica y descendente. Estos síntomas no exceden los 20 días y suelen ser lentos en su presentación, pero más lento suele ser el diagnóstico clínico ya que, muchas veces, se desconoce la enfermedad. El tratamiento es de sostén; la administración de la antitoxina específica debe ser precoz y realizarse antes del debridamiento de la herida infectada.

Botulism is a rare illness caused by a potent neurotoxin produced by the bacterium of the Clostridium family. Clostridium botulinum is the most frequent one, but Clostridium baratti and Clostridium butyricum are also neurotoxins producers. There are seven neurotoxins types, A to G; A, B, E, F and G cause human botulism. Every neurotoxin type blocks cholinergic transmission at the myoneural junction. The least frequent syndrome results from Clostridium botulinum colonization of a wound and it is clinically similar to the other botulism syndromes, but with fever due to an infected wound. Disease should be suspected in lucid patient with a symmetric descending, flaccid paralysis. This syndrome appears within the first twenty days, but it could be present for weeks or months before the disease is diagnosed. This disease is poorly known, so to be diagnosed it requires a high index of suspicion. The treatment is a supportive one; administration of the specific antitoxin must be early in order to neutralize the toxin before the debridement and cleaning of the infected wound.

Botulism in children: a diagnostic dilemma in developing countries

Botulism is a well-known disease of the neuromuscular junction. It is a rare but curable cause of paralysis in paediatric population. In addition to classical clinical signs and symptoms, the diagnosis of botulism requires laboratory confirmation of intoxication by various biological tests. These include demonstration of botulinum toxin in serum or isolation of the Clostridium botulinum from stool/gastric aspirates. However, it is not always possible to confirm intoxication due to unavailability of technical facilities, especially in resource limited countries like Pakistan. Under these circumstances, electrophysiological studies serve as an excellent diagnostic tool. These studies can provide quick diagnosis of botulism so that early administration of botulism immunoglobulin, if available, can reduce morbidity, mortality and length of stay in hospital. We report a case of botulism from Pakistan diagnosed on the basis of electrophysiological studies

Expression and purification of neurotoxin associated protein HA-33/A from clostridium botulinum and evaluation of its antigenicity

Botulinum neurotoxin [BoNT] complexes consist of neurotoxin and neurotoxin-associated proteins. Hemagglutinin-33 [HA-33] is a member of BoNT type A [BoNT/A] complex. Considering the protective role of HA-33 in preservation of BoNT/A in gastrointestinal harsh conditions and also its adjuvant role, recombinant production of this protein is favorable. Thus in this study, HA-33 was expressed and purified, and subsequently its antigenicity in mice was studied. Initially, ha-33 gene sequence of Clostridium botulinum serotype A was adopted from GenBank. The gene sequence was optimized and synthesized in pET28a [+] vector. E. coli BL21 [DE3] strain was transformed by the recombinant vector and the expression of HA-33 was optimized at 37°C and 5 h induction time. The recombinant protein was purified by nickel nitrilotriacetic acid agarose affinity chromatography and confirmed by immunoblotting. Enzyme Linked Immunoassay showed a high titer antibody production in mice. The results indicated a highly expressed and purified recombinant protein, which is able to evoke high antibody titers in mice

case of adult botulism following ingestion of contaminated Egyptian salted fish [[Faseikh]]

Food-borne botulism is a rare and serious disease caused by potent neurotoxin of the Clostridium botulinum which is a Gram-positive strictly anerobic organism. It manifests clinically as descending paralysis characterized by prominent oculo-bulbar palsies and symptoms and autonomic signs in an afebrile patient with normal sensorium. If not promptly and aggressively treated it may lead to fatality. In this communication, we report a case of food poisoning resulting in adult botulism that responded to early and effective treatment with specific antitoxin and supportive therapy. The patient made a remarkable recovery and was discharged home three weeks after admission. This case is the first to be reported for adult variant botulism in Arabian Gulf States

Development of immunodetection system for botulinum neurotoxin type B using synthetic gene based recombinant protein.

Background & objectives: Botulinum neurotoxins (A-G) are among most poisonous substances in the world, produced by obligate anaerobic bacteria Clostridum botulinum. Among the seven serotypes A, B, E and F are of human importance. In India, the prevalence of C. botulinum as well as botulism outbreaks have been reported. Due to its extreme toxicity it has been classified in the Category A of biological warfare agent. So far, there is no commercial detection system available in India to detect botulism. The present study aims to develop an immuno detection system for botulinum neurotoxin serotype B using synthetic gene approach. Methods: The truncated fragment of the botulinum neurotoxin type B from amino acid 1-450 was synthesized using PCR overlap primers; the constructed gene was cloned in the pQE30UA vector and transformed to Escherichia coli SG 13009. The recombinant protein expression was optimized using various concentration of isopropylthiogalactoside (IPTG) induction, further the expression was confirmed by Western blot analysis using anti-His antibody. Recombinant protein was purified under denatured condition using Ni-NTA affinity chromatography. Antibody was generated against the recombinant protein using alum adjuvant in BALB/c mice and tested for cross reactivity with other serotypes of C. botulinum as well as closely related clostridia. An ELISA test was developed for the detection of botulinum neurotoxin and the minimum detection limit was also estimated. Results: The recombinant protein was expressed at maximum yield at 4.3 h of post-induction with 0.5 mM IPTG concentration. The recombinant protein was purified using Ni-NTA affinity chromatography up to the homogeneity level. The polyclonal antibodies were raised in mice with a titre of 1:2048000. The developed antibody was highly specific with a sensitivity of detecting approximately 15 ng/ml of recombinant protein and not showing any cross-reactivity with other serotypes. Interpretation & conclusions: There is no commercial immunodetection system available in India to detect botulism. The developed detection system is highly specific. It will be useful for growing food industry to detect botulinum neurotoxin in food samples as well as in clinical samples.