Treatment of Survivors After Botulism Outbreak

This study has been completed.
Rajavithi Biomolecular Research Center
Information provided by:
Rajavithi Hospital Identifier:
First received: March 30, 2006
Last updated: October 23, 2008
Last verified: August 2007

Background. Northern Thailand's biggest botulism outbreak to date occurred on 14 March 2006 and affected 209 people. Of these, 42 developed respiratory failure, and 25 of those who developed respiratory failure were referred to 9 high facility hospitals for treatment of severe respiratory failure and autonomic nervous system involvement. Among these patients, we aimed to assess the relationship between the rate of ventilator dependence and the occurrence of treatment by day 4 versus day 6 after exposure to bamboo shoots (the source of the botulism outbreak), as well as the relationship between ventilator dependence and negative inspiratory pressure.

Methods. The investigators reviewed the circumstances and timing of symptoms following exposure. Mobile teams treated patients with botulinum antitoxin on day 4 or day 6 after exposure in Nan Hospital (Nan, Thailand). Eighteen patients (in 7 high facility hospitals) with severe respiratory failure received a low- and high-rate repetitive nerve stimulation test, and negative inspiratory pressure was measured.

Condition Intervention
Respiratory Failure
Drug: Botulinum AntiToxin
Procedure: neuro-electrophysiologic study, repetitive nerve stimulation
Procedure: Protocol early weaning ventilator after recovery of repetitive nerve stimulation and stable negative inspiratory pressure

Study Type: Observational
Official Title: An Outbreak of Botulism in Thailand: Clinical Manifestations and Management of Severe Respiratory Failure

Resource links provided by NLM:

Further study details as provided by Rajavithi Hospital:

Estimated Enrollment: 18
Study Start Date: March 2006
Estimated Study Completion Date: April 2006

Ages Eligible for Study:   1 Year and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No


  • Ate the bamboo shoots in Banluang district, on March,14 2006
  • Clinical of respiratory failure and need ventilator assistant
  • Needed to referred to other hospital
  • The staffs of referred hospital willing to participate in the Thai Botulism study group

Exclusion Criteria:

  • Patients who did not eat bamboo shoots in Banluang district on March14,2006.
  • No clinical of respiratory failure.
  • Not referred to other hospital.
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Please refer to this study by its identifier: NCT00314080

Rajavithi Hospital
Bangkok, Thailand, 10400
Sponsors and Collaborators
Rajavithi Hospital
Rajavithi Biomolecular Research Center
Principal Investigator: Subsai Kongsaengdao, M.D. Rajavithi Hospital
  More Information

Additional Information:
Pubmed  This link exits the site

World Health Organization .Botulism in Thailand: Epidemic and Pandemic Alert and Response (EPR). (Accessed March 22, 2006, at
P Wongwatcharapaiboon, L Thaikruea, and K Ungchusak et. al. Foodborne Botulism Associated With Home-Canned Bamboo Shoots,Thailand, 1998. ). (Accessed March 22, 2006, at Identifier: NCT00314080     History of Changes
Other Study ID Numbers: RVH_CER_001
Study First Received: March 30, 2006
Last Updated: October 23, 2008
Health Authority: Thailand: Ministry of Public Health

Keywords provided by Rajavithi Hospital:
Botulinum anti-toxin
Repetitive nerve stimulation
Respiratory failure

Additional relevant MeSH terms:
Respiratory Insufficiency
Bacterial Infections
Chemically-Induced Disorders
Clostridium Infections
Foodborne Diseases
Gram-Positive Bacterial Infections
Nervous System Diseases
Neuromuscular Diseases
Neuromuscular Junction Diseases
Neurotoxicity Syndromes
Respiration Disorders
Respiratory Tract Diseases
Botulinum Antitoxin
Immunologic Factors
Pharmacologic Actions
Physiological Effects of Drugs processed this record on October 13, 2015