Case racing against time
From July 2025 to now, Quang Ngai province has recorded 5 cases of botulinum poisoning after eating pickled fish.
In 2023, Da Nang recorded 10 cases of sour fermented fish poisoning (1 death); Ho Chi Minh City had 6 cases related to food, 1 death due to lack of medicine, WHO had to support 6 bottles of Botulism Heptavalent Antitoxin (BAT).
In early 2026, poisoning cases continued to appear. In March 2026, 3 severely poisoned children in Da Nang were saved thanks to 5 BAT bottles coordinated by WHO; after about 10 hours of infusion, their health improved significantly but still needed long-term monitoring.
Dr. Angela Pratt - WHO Chief Representative in Vietnam - said that 5 bottles of Botulism Antitoxin Heptavalent (BAT) antidote were transported from Switzerland to Noi Bai airport (Hanoi), then the Da Nang Department of Health sent officials to directly receive and quickly bring them to the locality to serve treatment work.
This is a very rare specific antidote and costs about 8,000 USD per bottle, used to neutralize the toxins of Clostridium botulinum bacteria - the agent causing botulinum poisoning. Due to the rare disease, this type of drug is often not stored in medical facilities but must be urgently imported when a case arises.
Need to soon put the rare drug reserve center into operation
According to Dr. Nguyen Trung Nguyen - Director of the Poison Control Center, Bach Mai Hospital, detoxifying drugs play an extremely important role in the treatment of poisoned patients, can reverse the patient's condition from a person in a severe poisoned state to quickly return to a state of no poisoning, significantly improving the mortality rate.
Dr. Nguyen Trung Nguyen said that C.botulinum bacteria have anaerobic characteristics (only develop in air-deficient environments). Food when processed contains a few bacterial spores (the production process is not guaranteed to be clean), after production, food is tightly packaged in bottles, jars, boxes, cans, bags that are not acidic and salty enough will create conditions for bacteria to develop and secrete botulinum toxin. Botulinum toxin is extremely toxic, can be considered one of the most toxic substances today, with less than 0.1mg it can be fatal.
At the time of 2020, when the Minh Chay pate poisoning incident occurred, because Vietnam did not have the detoxifying drug Clostridium botulinum, Bach Mai Hospital urgently sent an official letter to the Ministry of Health to report. Immediately after that, Bach Mai Hospital, Ministry of Health, WHO had to work very urgently to be able to bring 2 bottles of detoxifying medicine from a poison control center in Thailand to Vietnam" - Dr. Nguyen Trung Nguyen recalled.
In 2023, the Ministry of Health planned to build 3-6 rare drug reserve centers (15-20 types, including botulinum detoxifiers), located in many areas and assigned leading hospitals to manage and coordinate with WHO to interlink supply sources. However, to date, this system has not been implemented.
Representatives of the Drug Administration of Vietnam (Ministry of Health) said that this agency is amending Circular No. 26/2019/TT-BYT regulating the list of rare drugs. The first step is to identify the list of drugs with limited supply, from which to consider the funding and payment mechanism of health insurance, associated with regulations on rare diseases. It is expected that in 2026, the Ministry of Health will issue a circular on rare diseases and support policies to ensure the supply of treatment drugs.
