scholarly journals Botulism outbreak in a rural Ethiopia: a case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tigist Bacha ◽  
Ermias Abebaw ◽  
Ayalew Moges ◽  
Amsalu Bekele ◽  
Afework Tamiru ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Family Members ◽  
Case Series ◽  
Case Fatality ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Outbreak Detection ◽  
Mouse Bioassay ◽  
Fermented Foods

Abstract Background Foodborne botulism, a toxin-mediated illness caused by Clostridium botulinum, is a public health emergency. Types A, B, and E C. botulinum toxins commonly cause human disease. Outbreaks are often associated with homemade and fermented foods. Botulism is rarely reported in Africa and has never been reported in Ethiopia. Case presentation In March 2015, a cluster of family members from the Wollega, Oromia region, western Ethiopia presented with a symptom constellation suggestive of probable botulism. Clinical examination, epidemiologic investigation, and subsequent laboratory work identified the cause of the outbreak to be accidental ingestion of botulinum toxin in a traditional chili condiment called “Kochi-kocha,” cheese, and clarified butter. Ten out of the fourteen family members who consumed the contaminated products had botulism (attack rate 71.4%) and five died (case fatality rate of 50%). Three of the patients were hospitalized, they presented with altered mental status (n = 2), profound neck and truncal weakness (n = 3), and intact extremity strength despite hyporeflexia (n = 3). The remnant food sample showed botulinum toxin type A with mouse bioassay and C. botulinum type A with culture. Blood drawn on day three of illness from 2/3 (66%) cases was positive for botulinum toxin type-A. Additionally, one of these two cases also had C. botulinum type A cultured from a stool specimen. Two of the cases received Botulism antitoxin (BAT). Conclusion These are the first confirmed cases of botulism in Ethiopia. The disease occurred due to the consumption of commonly consumed homemade foods. Definite diagnoses of botulism cases are challenging, and detailed epidemiologic and laboratory investigations were critical to the identification of this case series. Improved awareness of botulism risk and improved food preparation and storage may prevent future illnesses. The mortality rate of botulism in resource-limited settings remains high. Countries should make a concerted effort to stockpile antitoxin as that is the easiest and quickest intervention after outbreak detection.

scholarly journals Intra-articular injection of botulinum toxin type A for shoulder pain in glenohumeral osteoarthritis: a case series summary and review of the literature

2018 ◽  
Vol Volume 11 ◽  
pp. 1239-1245 ◽  
Author(s):  
Nicoletta Cinone ◽  
Sara Letizia ◽  
Luigi Santoro ◽  
Michele Gravina ◽  
Loredana Amoruso ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Shoulder Pain ◽  
Botulinum Toxin Type A ◽  
Case Series ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Review Of The Literature ◽  
Glenohumeral Osteoarthritis

scholarly journals «Off-label» use of botulinic toxin type A preparations in neurological practice

2018 ◽  
Vol 20 (2) ◽  
pp. 195-201
Author(s):  
L R Akhmadeeva ◽  
Kh P Derevyanko
Keyword(s):  
Botulinum Toxin ◽  
Therapeutic Option ◽  
Botulinum Toxin Type A ◽  
Case Series ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Off Label Use ◽  
Off Label ◽  
Positive Effects ◽  
Label Use

The modern view on the application of botulinum toxin type A for the off-label use in neurology and foreign experience analysis are presented. The «off-label» category referred to any prescription of a medication in case of using it for unregistered indications, with product instruction violation or in the presence of contraindications including age restrictions. The sources of information about medicines were the leaflets of manufacturers of medicines and the State Register of Medicines. It is well known that Botulinum toxin type A is a good therapeutic option for treating children with cerebral palsy. Increased efficacy of regularly repeated cycles with Onabotulinumtoxin A in medication-overuse headache patients beyond the first year of treatment. Botulinum toxin type A is effective in the management of sialorrhea. Botulinum toxin type A is a safe and effective treatment for primary axillary hyperhidrosis and produces high levels of patient satisfaction. Facing depression with botulinum toxin: positive effects on mood have been observed in subjects who underwent treatment of glabellar frown lines with botulinum toxin and, in an open case series, depression remitted or improved after such a treatment. Botox injection significantly improved foot dystonia, pain and lower limb functional outcomes in patients with Parkinson’s disease with deep brain stimulation. The paper describes the problems associated with the lack of clinical data about the possibility of using botulinum toxin type A in different conditions, emphasizes the need to organize clinical trials and educational programs for neurologists as well as more active implementation of protocols for the treatment of patients.

scholarly journals Pregnancy outcomes following botulinum toxin type A exposure: A systematic review

2018 ◽  
Vol 6 (05) ◽  
Author(s):  
Noha Abdelkader ◽  
Elif Keskin Arslan ◽  
Hilal Erol- Coskun ◽  
Gözde Küçüksolak ◽  
Yusuf Cem Kaplan
Keyword(s):  
Botulinum Toxin ◽  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Case Reports ◽  
Botulinum Toxin Type A ◽  
Case Series ◽  
Fetal Loss ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Major Congenital Malformations

Objective: To evaluate the available human data to-date in order to assess whether the prenatal exposure to botulinum toxin type A (BTX-A) is associated with major congenital malformations and other adverse pregnancy outcomes. Methods: Searches were conducted in PubMed/MEDLINE and Reprotox in November  2017. Cohort and case-control studies, case series, case reports were the primary data of interest. Results: No controlled studies but case series and case reports of therapeutic BTX-A administration during pregnancy were identified. Case reports regarding pregnant women with botulism were also reviewed. Conclusions: Limited data suggests that BTX-A exposure for therapeutic indications during pregnancy does not seem to be associated with an increase in risk of major congenital malformations. Rates of fetal loss were substantially different between prospective and retrospective data. Controlled epidemiological studies are needed to refute or support our findings.

Crystalline Preparation of Botulinum Toxin Type a (Botox): Degradation in Potency with Storage

1993 ◽  
Vol 108 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Michael G. Gartlan ◽  
Henry T. Hoffman
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
The United States ◽  
Mouse Bioassay ◽  
Clinical Implications ◽  
Swiss Webster Mouse ◽  
Intraperitoneal Dose ◽  
And Storage

Laryngeal injection of botulinum toxin type A is currently the most effective method of treating spasmodic dysphonia. Botox, a crystalline preparation of botulinum toxin type A, is the only toxin approved for clinical use in the United States and is packaged in vials of 100 mouse units (MU). One MU corresponds to the calculated median lethal intraperitoneal dose (LD50) injected in mice. The logistic problems arising from the need for repeated injections of small amounts of Botox have been addressed by several investigators by refreezing unused Botox for use at a later time. Although FDA labeling recommends that Botox not used within 4 hours of reconstitution be discarded, data regarding degradation in potency after reconstitution and refreezing are not currently available. Using the LD50 Swiss-Webster mouse bioassay and statistical analysis by the Probit procedure, a 69.8% loss in potency was found when Botox was reconstituted, immediately frozen, and then assayed 2 weeks later ( p < 0.0001). Statistically significant degradation in potency was seen after refrigerator storage for 12 hours ( p = 0.007), but not for 6 hours ( p = 0.16). Clinical implications regarding the dilution, use, and storage of Botox are discussed.

scholarly journals Jaw-opening oromandibular dystonia secondary to Wilson's Disease treated with botulinum toxin type A

2012 ◽  
Vol 70 (6) ◽  
pp. 407-409 ◽  
Author(s):  
Hélio A.G. Teive ◽  
Leandro E. Klüppel ◽  
Renato P. Munhoz ◽  
Nílson Becker ◽  
Paulo R. Müller ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Wilson’S Disease ◽  
Botulinum Toxin Type A ◽  
Case Series ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Wilson's Disease ◽  
Common Side Effect ◽  
Oromandibular Dystonia ◽  
Jaw Opening

We have reported a case series of five patients with jaw-opening oromandibular dystonia secondary to Wilson's disease (WD), in which the patients were treated with botulinum toxin type A (BTX-A). In all cases, dystonia score was partially reduced three weeks after injections. The most common side effect was transient mild dysphagia. This preliminary study showed that jaw-opening oromandibular dystonia in WD may be partially responsive to the use of BTX-A.

scholarly journals Botulinum Toxin Type A vs Type B for Axillary Hyperhidrosis in a Case Series of Patients Observed for 6 Months

2010 ◽  
Vol 147 (1) ◽  
pp. 122 ◽  
Author(s):  
Emma Frasson ◽  
Francesco Brigo ◽  
Michele Acler ◽  
Giuseppe Didonè ◽  
Silvana Vicentini ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Case Series ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Type B ◽  
Axillary Hyperhidrosis

scholarly journals Functional acute acquired comitant esotropia: clinical characteristics and efficacy of single Botulinum toxin type A injection

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Luyao Tong ◽  
Xiaoning Yu ◽  
Xiajing Tang ◽  
Yidong Zhang ◽  
Sifan Zheng ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Single Injection ◽  
Botulinum Toxin Type A ◽  
Case Series ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Rank Test ◽  
Patient Age ◽  
Patient Âgé ◽  
Case Series Study

Abstract Background To examine the clinical features of acute acquired comitant esotropia (AACE) and to evaluate the clinical effectiveness of a single injection of botulinum toxin type A (BTXA) on binocular visual function (BVF). Methods This retrospective, observational case series study enrolled patients with AACE examined from October 2018–May 2019. BTXA was injected into the both medial rectus muscles. The refractive error, best-corrected visual acuity (BCVA), stereoacuity, vergence, accommodation, the horizontal angle of deviation, and the gradient accommodative convergence/accommodation (AC/A) ratio were measured pre- and post-BTXA injection. Data pre- and postinjection were compared by the Wilcoxon signed-rank test. A Spearman correlation coefficient was calculated to explore the relationships between demographic characteristics and BVF. Results Twenty-two AACE cases were included. Compared with preinjection deviation, the postinjection deviation in the primary position was smaller for near (p < 0.001) and distance (p < 0.001) fixation at 3 months after injection (BTXA). Furthermore, convergence was better for near (p = 0.003) and distance (p < 0.001) fixation, divergence was better for near (p = 0.021) and distance (p < 0.001) fixation, accommodation was better in the right (p = 0.011) and left (p = 0.004) eyes, and the gradient AC/A ratio was better at the third month after injection (p = 0.001). Stereoacuity was improved in 11 (50%), unchanged in 5 (22.73%) and decreased in 6 (27.27%) patients. The preinjection stereoacuity (p = 0.013, r = 0.522) and preinjection deviation for near (p = 0.015 r, = − 0.512) and distance (p = 0.009, r = − 0.541) were significantly associated with patient age. Conclusions AACE is characterized by a high AC/A ratio and low accommodation. A single injection of BTXA is effective for AACE. Deviation, stereoacuity, and the therapeutic effect of BTXA may be correlated with patient age.

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