From the 1 Department of Internal Medicine.
Infect Dis (Lond). 2015 Mar;47(3):190-4. doi: 10.3109/00365548.2014.979434. Epub 2015 Jan 22.
Botulism commonly occurs when the anaerobic, gram-positive bacterium Clostridium botulinum, under suitable conditions, produces botulinum neurotoxins. Named A-F, these toxins are the immediate causative agent of the clinical symptoms of symmetrical, descending neurological deficits, including respiratory muscle paralysis. We present five cases of foodborne botulism occurring in Greenland, two with fatal outcome, caused by ingestion of tradionally preserved eider fowl. In the cases of the survivors, antitoxin and supportive care, including mechanical ventilation, were administered. In these cases recovery was complete. Microbiological assays, including toxin neutralization bioassay, demonstrated the presence of neurotoxin E in two survivors. The third survivor was shown by PCR to have the BoNT type E gene in faeces. This is the first report of cases of fatal botulism in Greenland. It underscores the importance of prompt coordinated case management effort in a geographically isolated area such as Greenland.
肉毒中毒通常是由厌氧的革兰氏阳性梭菌——肉毒梭菌在适宜条件下产生肉毒神经毒素引起的。这些毒素根据其特性，被命名为 A-F，是导致对称、进行性神经功能障碍，包括呼吸肌麻痹等临床症状的直接致病因子。我们报告了五例在格陵兰发生的食源性肉毒中毒，其中两例因食用传统保存的野鸭肉而导致死亡。幸存者接受了抗毒素和支持性治疗，包括机械通气。这些病例都完全康复了。微生物学检测，包括毒素中和生物测定，在两名幸存者中检测到了 E 型神经毒素。通过 PCR，第三例幸存者粪便中检测到 BoNT 型 E 基因。这是格陵兰首例致命性肉毒中毒报告。这凸显了在像格陵兰这样的地理隔离地区，及时协调病例管理工作的重要性。
