What is
botulism?
Botulism is a rare, muscle-paralyzing disease
caused by nerve toxin spores made by the bacterium
Clostridium botulinum. The spores are found in
soil worldwide. There are three main kinds of
botulism: food-borne botulism, infant botulism,
and wound botulism. Botulism toxin can also be
used in a bio-terrorist attack, released into the
air or contaminating the food and water
supply.
How is
botulism spread?
Food-borne botulism is usually due to
incorrectly prepared or home-canned foods.
Outbreaks from commercial products and foods
prepared improperly in restaurants have also
occurred. Food-borne botulism is especially
dangerous because many people can be infected by
eating the contaminated food.
Infant botulism occurs in a small number of at
risk infants each year. For unknown reasons C.
botulinum is able to grow in some infants’
intestines. Infant botulism is not a public health
emergency because the infants are not consuming
food with toxin; rather they are consuming the
spores which are everywhere in the environment.
Wound botulism is caused by the growth of
living botulism bacteria in a wound, with ongoing
secretion of toxin that causes the paralytic
illness. In the United States, this syndrome is
seen almost exclusively in injecting drug users.
Botulism is not spread person-to-person.
How common
is botulism?
In the United States, an average of 110 cases
of botulism is reported each year. Of these,
approximately 25% are food-borne, 72% are infant
botulism, and the rest are wound botulism.
What are
the symptoms of botulism?
General symptoms of botulism include double
vision, blurred vision, drooping eyelids, slurred
speech, difficulty swallowing, dry mouth, and
muscle weakness which always moves down the body
from the shoulders to the feet. Paralysis of
breathing muscles can cause a person to stop
breathing and die, unless assisted by a
ventilator.
For food-borne botulism, symptoms begin from
six hours to two weeks after eating
toxin-containing foods. Most commonly the delay is
about 12-36 hours.
Infants with botulism appear tired, eat poorly,
are constipated, and have a weak cry and limp
muscles.
What is the
treatment for botulism?
Botulism can be treated with an antitoxin which
blocks the action of toxin circulating in the
blood. This antitoxin stops further development of
the disease, but cannot reverse paralysis that is
already present. The antitoxin is effective in
reducing the severity of symptoms if administered
early in the course of the disease. The Centers
for Disease Control and Prevention (CDC) maintains
the nation’s supply of the antitoxin. A physician
diagnosing a case of botulism must contact the CDC
through their state health department in order to
get the antitoxin. Public health officials must be
contacted immediately about potential cases of
botulism.
The respiratory failure and paralysis that
occur with severe botulism may require patients to
be on a ventilator for weeks, plus intensive
medical and nursing care. After several weeks, the
paralysis slowly improves.
Are there
complications from botulism?
Botulism can result in death due to respiratory
failure; however the number of deaths has
decreased dramatically in past years due to
improved medical knowledge. Patients who survive
an episode of botulism may have fatigue and
shortness of breath for years and long-term
therapy may be needed to aid recovery.
How can
botulism be prevented?
Food-borne botulism can be prevented by
practicing safe home canning and food handling.
Children less than 12 months old should not be
given honey since it can contain spores from the
bacteria. Wound botulism can be prevented by
promptly seeking medical care for infected wounds
and by not using injectable street drugs.
How do I
get more information on botulism?
Other Category A disease agents
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