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Botulism - Causes and Symptoms

Definition:

Botulism is a rare but serious illness caused by the bacterium Clostridium botulinum . The bacterium may enter the body through wounds, or they may live in improperly canned or preserved food. Botulism results from an exotoxin produced by the gram-positive, anaerobic bacillus Clostridium botulinum. Mortality from botulism is about 25%, with death most often caused by respiratory failure during the first week of illness.

Causes

Botulism is caused by the bacterium Clostridium botulinum. This bacterium produces a toxin called botulinum that affects the nerves and paralyzes muscles. This syndrome is called botulism.

Even small amounts of botulinum toxin can cause botulism in one of two ways. One way is by ingesting the toxin itself (food borne botulism), as in canned foods. When you eat food containing the toxin, it disrupts nerve function, causing paralysis. The other way is by infection with the bacterial spores that produce and release the toxin in the body (infectious botulism). The infection may occur in the intestine (intestinal botulism), as in a newborn, or deep within a wound (wound botulism). When the germs get into a wound, they can multiply and produce toxin, too. Babies get infant botulism after consuming spores of the bacteria, which then grow in the digestive system and make toxins.

Botulinum toxin Uses

Botulinum toxin can sometimes prove to be usufull too. Botox, which contains a tiny amount of botulinum toxin, harmlessly reduces facial wrinkles by preventing contraction of muscles beneath the skin. Other uses for Botox include treating eyelid spasms and, experimentally, migraine headaches.

Symptoms

Botulism is a very severe, sometimes fatal food poisoning caused by ingestion of food containing botulin. Symptoms of botulism usually appear between 8 - 36 hours after consuming contaminated food.

Botulism is mainly characterized by:

  • Fatigue.
  • Slurred speech.
  • Dry mouth.
  • Poor muscle tone.
  • Progressive weakness with paralysis
  • Difficulty swallowing.
  • Nausea, vomiting.
  • Nausea.
  • Vomiting.
  • Lethargy.
  • Abdominal cramps.
  • Muscle weakness.
  • Disturbed, double or blurred vision.
  • Breathing difficulty that may lead to respiratory failure.
  • Drooping eyelids.
  • In infants, there may be:
    • Weak cry.
    • Poor feeding and weak sucking.
    • Loss of appetite.
    • Respiratory distress.

All the above symptoms are of muscle paralysis, mainly caused by the bacterial toxin. If the disease is not treated in time - it may progress to cause paralysis of the arms, legs, trunk and respiratory muscles.

Treatment

I.V. or I.M. administration of botulinum antitoxin (available through the Centers for Disease Control and Prevention) is the treatment of choice. Antitoxin is not, however, recommended in cases of infants, since it doesn't affect the disease-causing germs in the baby's digestive system. A treatment called botulism immune globulin has been investigated to treat infants; it appears effective in reducing the duration and severity of cases.

ALERT Antibiotics and aminoglycosides should be avoided because of the risk of neuromuscular blockade. They should be used only to treat secondary infections.

The most serious complication is respiratory failure. Treatment aims to maintain adequate oxygen supply, which may require a ventilator and close monitoring in an intensive care unit. Feeding through a tube may also be necessary.

Prevention

Some of the Prevention Tips for Botulism are:

  • Encourage people to use proper techniques in processing, preserving, and storing foods.
  • Avoid even tasting food from a bulging can or one with a peculiar odor, and to sterilize by boiling any utensil that comes in contact with suspect food. Ingestion of even a small amount of food contaminated with botulism toxin can prove fatal.
  • There is a vaccine availaible - which is regularly given to lab workers who may be exposed. Supplies are limited, and protection from this vaccine does not develop for several months.
  • When home-canning food, follow strict hygienic procedures to reduce contamination of foods
  • Boil home-canned foods for 10 minutes before eating it to ensure safety
  • Promptly seek medical care for infected wounds.
  • Dispose off all spoiled food in a place where it will not be eaten by children or pets. One sure way to prevent the spread of toxin is to boil suspect foods 30 minutes before disposing. This will ensure destruction of any toxin that might be present and prevent its spread.
  • Keep foil-wrapped baked potatoes hot or in the refrigerator, not out in room temperature.
  • Breast-feeding can help prevent infant botulism.
  • To reduce the risk of infant botulism, avoid giving honey or corn syrup - even a tiny taste - to babies under the age of 1. To prevent wound botulism and other serious blood-borne diseases, never inject street drugs.
  • Do not use injectable street drugs
  • Bake potatoes without foil. If potatoes are wrapped in foil, keep them hot until served or refrigerate them.
  • Do not inject illicit drugs.

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