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Thailand battles major botulism outbreak

Public HealthMar 23, 06

Thailand flew 17 people with severe botulism to Bangkok on Thursday, while dozens more were being treated in rural hospitals after one of the world’s worst outbreaks of the muscle-paralyzing disease.

The 17, including 12 women and a young girl, were among 160 villagers who fell ill after eating contaminated bamboo shoots during a festival in the northern province of Nan.

More than 100 are in hospital, including 42 who needed respirators after they became too weak to breathe on their own.

“This is one of the largest outbreaks, that we are aware of, in decades anywhere in the world,” said Christopher Braden, an expert sent from the Atlanta-based Centers for Disease Control and Prevention (CDC).

In the last major recorded outbreak in 1991, ninety people in Egypt fell ill from the disease, which can occur after eating food containing a nerve toxin produced by the Clostridium botulinum bacteria.

“The toxin is one of the most potent known to man,” Braden told Reuters, noting that it can be used as a biological weapon.

“It causes death by paralyzing the respiratory muscles so people can’t breathe. There’s obviously a need for mechanical ventilation to keep people alive until their nerves can regenerate,” he said.

Thai health officials believe the Nan outbreak was caused by improper canning of the bamboo shoots, a staple food in rural Thailand, which allowed the bacteria to survive and produce the deadly toxin.

Some 70 doses of anti-toxin serum were rushed from the United States, Canada and Britain this week, and Japan has agreed to supply another 70 doses, the Thai News Agency reported.

With the main hospital in Nan overwhelmed, 17 critically ill patients, including eight on respirators, were airlifted to Bangkok on a Thai Air Force C-130 transport plane.

They were sent to seven Bangkok hospitals where treatment could last a month or more.

“They need lot of intensive care to prevent infections and pneumonia,” said Braden, Chief of Outbreak Response and Surveillance at the CDC’s Foodborne and Diarrheal Diseases Branch.

The sheer size of the outbreak will require more study.

“It’s important to learn how the patients respond to the anti-toxin and whether this type of food is a source of botulism. All those things are important,” he said.



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