The officer working in A pod calls to medical and reports that several individuals are complaining of feeling generally unwell, with blurred vision, muscle weakness and some difficulty breathing. Nurse McKenzie responds to the unit to evaluate the patients. She is concerned that all these cases are from one housing unit. She completes her evaluation and contacts the provider on-call. She wonders if it could be the flu or COVID-19 or other infectious disease, or something else.
Incarcerated individuals are resourceful, and have been known to make many items for personal use and for trading/selling on the prison/jail black market, including homemade alcohol. Also known as Hooch, Pruno, Juice and Buck, this is often made from fermented fruit or potato peels. Interestingly, this commodity is common in US prison systems, and world-wide in such countries as England, Ireland and India.
Botulism is caused by a toxin produced when a bacteria commonly found in soil is placed in an oxygen-deprived environment – like the closed containers used for DIY alcohol production. The toxin is produced during the fermentation process if no heat is applied to kill the bacteria.
Signs, symptoms and Treatment
Correctional nurses must be aware of the signs and symptoms of botulism, especially if it is known that making hooch is a problem at their facility. In addition, nurses should consider this if, as the scenario above demonstrated, a number of individuals from a housing unit are affected.
It is important to act on early signs of botulism as the nerve paralysis caused by the bacterial toxin can quickly move to the respiratory muscles and lead to death. Often the initial signs and symptoms involve the eyes – double vision, blurred vision, drooping eyelids or difficulty moving the eyes. Slurred speech and dry mouth can follow, along with general muscle weakness and difficulty swallowing. Botulism can quickly progress to respiratory failure if not treated.
Poisoning from botulism toxins from hooch can begin a few hours after ingestion or may take up to 8-10 days to appear. A medical evaluation of signs and symptoms is necessary to rule out other possible causes of progressing paralysis. Information about the potential that symptoms are related to drinking homemade alcohol is important for a quick diagnosis and response, and patients presenting with such complaints should be questioned regarding hooch. As well, if there is a strong suspicion by the nurse/provider conducting the evaluation and the patient is not forthcoming, then officers should be asked to check in the housing unit. Botulism is a serious condition that does not pass from person to person. Treatment may include injection of an antitoxin, but it is important to note that any damage done prior to treatment cannot be reversed, and recovery may take months.
Do incarcerated individuals in your facility create their own homemade alcohol? Share your experiences in the comments section of this post.
Leave a Reply