Eisenberg M S, Bender T R
JAMA. 1976 Jan 5;235(1):35-8. doi: 10.1001/jama.235.1.35.
Since 1947, there have been 21 outbreaks of botulism in Alaska, involving 46 people with 13 deaths (28% fatality). In the last six months of 1974, there were four outbreaks. With one exception to date, type E toxin was involved in all outbreaks for which laboratory confirmation has been obtained, and in all instances, Eskimo and Indian foods were the source. Clinical signs and symptoms of nausea and vomiting, dysphagia, diplopia, dilated pupils, and dry throat occurred with great frequency, forming a diagnostic pentad. We recommend that treatment include close medical supervision, supportive care, and the use of antitoxin, cathartics, and possibly, penicillin. The source of an outbreak must be determined to prevent further cases. Only prompt recognition, therapy and epidemiologic investigation can reduce the death toll from botulism.
自1947年以来，阿拉斯加共发生了21起肉毒中毒事件，涉及46人，其中13人死亡（病死率28%）。1974年的最后六个月里发生了四起疫情。迄今为止，除了一起例外情况，所有经实验室确诊的疫情都涉及E型毒素，而且在所有病例中，爱斯基摩人和印第安人的食物都是传染源。恶心呕吐、吞咽困难、复视、瞳孔散大以及喉咙干燥等临床症状极为常见，构成了一组诊断症状群。我们建议治疗措施包括密切的医疗监护、支持性护理，以及使用抗毒素、泻药，可能还需使用青霉素。必须确定疫情的传染源以防止更多病例出现。只有迅速识别、治疗和进行流行病学调查，才能降低肉毒中毒的死亡人数。
