A) Reason for conducting the study
The study that we chose was conducted because they wanted to find out if there was a possibility to contract the botulinum toxin that comes from Clostridium botulinum by eating clay cheese that he admitted to consuming. The patient went to the emergency room because of the signs and symptoms of botulism, which include dizziness, difficulty breathing, unable to swallow, dry throat, impaired reflex, lack of focal neurological signs, impaired vision, muscle and limb weakness, and respiratory failure (Farzinpoor, 2019). In order to find the cause, they had to run a series of tests to confirm their hypothesis.
B) Hypothesis
They hypothesized that the symptoms he had was related to food-borne botulism from the clay cheese that he consumed. Although there were other foods that he consumed, they were highly suspicious of it being the cheese. Food-borne botulism is the product of the botulinum toxin when Clostridium botulinum is grown in food. Since clay cheese in traditionally made in clay pots that are buried in the ground for months at a time (Gregory, 2018), it can be assumed that Clostridium botulinum is the root cause of his illness due to it being a bacterium that grows in conditions with low oxygen, also known as being an anaerobe (USDA, 2013).
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C) Results and Techniques Used
The doctors ran a battery of tests from a complete blood workup, chest x-rays, monitoring of his heart rate, pulse, and respiratory rate, and even took samples of his gastric fluids to confirm the suspicion of Botulism Toxin. Gram-staining would have been used to identify the bacterium, Clostridium botulinum, and since it is a Gram-positive microbe its rod-shape would have shown purple under a microscope. The patient’s eaten food such as cabbage salad, vegetables, and the cheese were tested as well to confirm the diagnosis and to identify which of the four types of Botulism Toxin he had acquired. All these tests confirmed he was suffering from botulinum toxin and that it had come from his ingestion of clay cheese, and that goes to prove the hypothesis that you can get Botulism Toxin from eating Clay cheese. The tests proved that the clay cheese was the cause since it came back positive, while the other foods came back negative for the toxin. With the advancements of plastics and metals, some have moved away from the traditional clay pots and began to use the new plastic and metal containers (Farzinpoor, 2019).
In order to treat the patient, they had to give him three doses of antitoxin. The antitoxin, Botulism Antitoxin Heptavalent ABCDEFG Equine, is given through an IV by health professionals under instruction of the doctor (Mayo Clinic, 2020). He was also consulted by a neurologist, then transferred to the infectious diseases ward where he spent 11 days to recover until he was discharged and given medication. In addition to this patient, his wife and seven other people in his family also contracted the illness because of the same reason (Farzinpoor, 2019).
D) Significance of Results
This case study is important and significant because it will bring awareness to the potential hazards of using improper techniques of making this traditional food. People have been preparing clay cheese for centuries and are moving away from clay to more modern containers such as metal and plastic. Clostridium botulinum is an anaerobic microbe that thrives and produces spores the grow and flourish in low oxygen environments (Bauman, 2018, p. 605-606). Once you learn how this bacteria survives and thrives and you learn that clay cheese is made by sealing the cheese in a container and burying it underground for months at a time, you come to see how this could be a potential hazard to a countless number of people. Botulinum Toxin is rare with about 60 cases of food-borne botulism a year, which is the type this patient had, and only about 10% of those are fatal; but if we can educate the public on this newfound way of contracting the toxin maybe we can keep that number from growing.
E) Why did we choose this case study?
We chose this case study because of how interesting the case was. Here is someone who contracted Botulism Toxin in a complete and novel way from eating a food that has been around for centuries. Botulism Toxin is not new to the medical community and is not even new to the food industry, but we had never seen it present in a case such as this. Also, the fact that we are seeing a pandemic from a novel version of a well-known virus made this case more interesting. The information in the study was well presented in a way that was easy to digest and comprehend. There was also enough new information presented that peaked one's curiosity to learn more about how this bacterium and how it was thriving in the making of this cheese.
References
- Bauman, R. (2018). Microbiology With Diseases By Body System. (5th ed). Harlow: Pearson Education Limited.
- Gregory, C. (2018, June 12). A Brief History Of Cheese In The Middle East. Culture Trip. Retrieved from https://theculturetrip.com/middle-east/jordan/articles/a-brief-history-of-cheese-in-the-middle-east/
- Farzinpoor, Z. (2019, June 18). Food-borne Botulism Caused by Clay Cheese: A Case Report. Advanced Journal Of Emergency Medicine. Retrieved from
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789077/pdf/AJEM-3-e44.pdf
- Mayo Clinic. (2020, Feb 1). Botulism Antitoxin (Intravenous Route). Retrieved from https://www.mayoclinic.org/drugs-supplements/botulism-antitoxin-intravenous-route/proper-use/drg-20060934
- USDA. (2013, August 7). Clostridium Botulinum. USDA. Retrieved from https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/foodborne-illness-and-disease/clostridium-botulinum/ct_index
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