Identification Clinical features

There are three forms of botulism:

• Classical botulism is a severe and often fatal infection resulting from ingestion of contaminated food. Symptoms include double vision, dysphagia and dry mouth. It can be followed by descending flaccid paralysis which may be associated with respiratory paralysis and result in death. Fever is absent unless a complicating infection occurs.

• Intestinal botulism is the most common form and usually affects infants under one year of age. It can affect adults who have altered gastrointestinal anatomy and microflora. The illness typically begins with constipation followed by lethargy, listlessness, poor feeding, ptosis, difficulty in swallowing and generalized muscle weakness (“floppy baby”).

• Wound botulism is rare but has been seen after contamination of wounds where anaerobic conditions developed.

Method of diagnosis

Diagnosis is made by culture of C. botulinum or demonstration of specific toxin in serum, gastric aspirate, faeces, implicated food or wounds. Electromyography may be useful in corroborating the clinical diagnosis.

Incubation period

Classical botulism occurs within 12-36 hours (sometimes several days) after eating contaminated food. The incubation period for infant botulism is unknown due to difficulty in determining the precise time of ingestion. Shorter incubation periods are associated with more severe disease and higher case fatality rates.

Public health significance and occurrence.

Botulism is a rare disease internationally. However missed diagnoses particularly for intestinal botulism are likely due to low clinician suspicion and limited laboratory diagnostic capacity in many areas. There have been only six cases of botulism reported in Australia between 1991 and 2003. Two of these occurred in Victoria in 2000 and 2001 (Communicable Diseases Network Australia - National Notifiable Diseases Surveillance System). C. botulinum has been identified as a potential bioterrorist agent.

Reservoir

It is most commonly found in soil and agricultural products. Spores have been found in marine sediments and the intestinal tracts of animals, including fish.

Mode of transmission

Classical botulism is acquired by ingestion of inadequately cooked food or processed or refrigerated foods in which toxin has formed, particularly canned and alkaline foods. Most cases of wound botulism are due to ground-in soil or gravel. Several cases have been reported amongst chronic drug users. Infant botulism arises from ingestion of spores rather than pre-formed toxin.

Sources of spores include foods such as honey and dust. Honey has been described in the US literature as a source of infection but never implicated in Australia and surveys of Australian honey have failed to identify C. botulinum.

Period of communicability

Secondary transmission has not been documented.

Susceptibility and resistance

Everyone is susceptible to infection.

Control measures.

Preventive measures Ensure effective control of processing and preparation of commercially canned and preserved foods. Educate people undertaking home canning and other food preservation techniques about cooking time, pressure, temperature, adequate refrigeration and storage. The absence of a bulging lid on tinned food does not preclude C. botulinum contamination.

Control of case

Botulism is a medical emergency. Suspected cases should immediately be referred for specialist care and trivalent botulinum antitoxin (types A, B, E) administered as soon as possible. A limited supply is available from CSL Limited. Antitoxin is not used in infant botulism due to the risk of anaphylaxis. Antibiotics do not affect the course of the disease. For wound botulism, in addition to antitoxin the wound should be debrided or drained, and appropriate antibiotic prophylaxis against other potential infections should be administered. Isolation or quarantine is not needed but hand washing is indicated after handling soiled nappies. Usual sanitary disposal of faeces from infant cases is acceptable. Any implicated food should be retained for collection and investigation by public health authorities. Contaminated utensils should be cleaned by boiling or with household bleach.

Control of contacts

Those who have eaten incriminated food should be purged with emetics, gastric lavage or high enemas. Administration of polyvalent antitoxin to asymptomatic individual should be considered carefully, assessing potential protection against the risk of sensitisation and severe reactions to horse serum.

Control of environment

Environmental health officers and food safety officers should coordinate the appropriate disposal of implicated food.

Outbreak measures.

An outbreak of botulism is defined as one or more cases of disease. The immediate aim is to identify possible sources of the disease and other people possibly exposed. Recall any implicated food immediately and send samples to the Microbiological Diagnostic Unit for analysis. Take sera and faeces from cases as well as exposed but asymptomatic persons for analysis, before administration of antitoxin. Undertake efforts to recover and test implicated foods. This should be coordinated through Food Standards

Australia New Zealand [phone].

 

 

VARIANT 5

Exercise 1.Find the stem of the given bellow derivatives. Give the Ukrainian equivalents of the words. Mind the translation of the misleading words:

Connection, integrated, reliable, unlimited, inclusion, validity, bargaining, hourly, identification, processing, transferring, declaration, coincidence, familiarity, reference, applicant, payable, undoubtedly, caterer, obtainable, inaccessible, scheduled, illegal, exceptional, irrational, renovation, outgoing, marketing, impersonal, rigidity, permission, tranquility, incoming, unskilled, qualitative, contributor, unoriginal, briefing, contracting, negotiator, promotion.

Exercise 2. Translate the following sentences. Pay attention to the polysemantic words:

1. The company’s directing agency is located in Detroit. 2. The new chief executive officer was appointed in May. 2. Price gap has become the main reason for many domestic goods being brought out of the country. 4. Competitive capacity of the enterprises is number one issue. 5. The immediate task is to temper the impact of inflation. 6. This can hardly be treated as the free article. 7. They have been speculating on margin for a couple of years now.

Exercise 3. Form the proper English equivalents of the following Ukrainian words and word-combinations, using the word "living":

рівень життя, умови життя, заробляти на життя, життєвий простір, багате життя, жива матерія, жива істота, прожитковий мінімум, віталь­ня (спільна кімната), квартира на одну сім'ю, просте (скромне) життя.

Exercise 4. Arrange the following words in pairs according to:

a) similar meaning (synonyms): to start, to perform, to call for, to propose, to raise, to carry out,, to suggest, to begin, to increase, to supervise, to require, to control, complex, quick, radically, total, fast, considerably, whole, complicated.

b)opposite meaning (antonyms): to increase, dynamic, dependently, different, static, to decrease, simple similar, possible, low-cost, complex, total, impossible, above, high-cost, independently, below, partial.

Exercise 5. Substitute the following word combinations for one word of identical meaning:

Model: to make smaller - to reduce

To make larger, to make possible, to use instead of, to make steps forward, to work out, to carry out, to make contribution, to make progress, to gain victory, to draw dividing lines, to make sure.

Exercise 6. Render the following sentences into Ukrainian, using different ways of transformation:

1. Typical condensation polymers are polyamides, polyesters, and certain polyurethanes.

2. By using so called superheaters, modern boilers can achieve almost 90 per cent fuel efficiency.

3. A modem converts the digital signals of the sending computer to rivalries.

4. During the 20* century the suburbs of London continued to grow until 1935, when a Great Belt law was instituted to control further growth beyond a ring of parks.

5. Paleoanthropology calls on the skills of many specialists.

6. Governments do not relinquish their authority unless compelled to do so.

7. For unknown reasons Iraq chose not to unleash its chemical weapons arsenal in the Persian Gulf War of 1991.

8. Not until the 18^th century scientists begin to appreciate the complex chemistry of metallurgy.

9. Some anthropologists use the term enculturation to refer to the process of socialization.

10. Bureaucracy is a system for administrating large organizations involving a specific structure of authority and a clear defined set of rules and regulations.

Exercise 7.Read and translate the following Text “Botulism”. Give a summary of the text.

 

The Order of the Wall

Response to the Sun By David Paul Bingham Thesis submitted to the Faculty of the Virginia Polytechnic Institute and State University Blacksburg, Virginia April 2003

The heat retaining mass and wall does triple duty. Not only does it store and ration heat energy in winter, but it serves also as heat absorption mechanism, climate moderator in summer. Moreover, the openings in the wall serve to limit and control the amount of light admitted into the main house. Lastly, it restricts, but more importantly guides and focuses, the views of the exterior obtainable from the interior of the house. The wall is constructed of solid concrete blocks, held together by mortar. The blocks are, for the most part, flush. However, numerous among them project inward and outward in organized groups forming discrete walls within the wall. This serves both to affect the energy properties of the wall and to break up what might otherwise be a mere facade, lifeless and dull. These projections and recesses modulate the light, creating patterns of light and shadow that vary continuously with the movement of the sun through seasons and days.

Adjustable dampers serve to control and moderate energy flow and conservation. Energy flow is further moderated - stretched in time - by the propensity of the differing thicknesses of the wall to give off or absorb heat at different times and rates of exchange. By its combination of openings and solid barriers, the wall unites two disparate structures to make a unified whole.

Elevations of interior wall looking south through the addition's heat retaining wall. Former openings are shown with a dashed line. The existing wall openings propose the location of most of the openings in the new addition wall.

The wall acts as the mediator between the old and the new, deciding how much southern light the interior receives, as well as how much of the existing structure is revealed in the addition.