Botulism is a rare but potentially fatal disorder. It is caused by a toxin, or poison, produced by the bacteria Clostridium botulinum.
Botulinum toxins are among the most powerful poisons known.
There are three forms of botulism: Foodborne botulism can occur when a person eats food containingbacteria.Infant botulism occurs when a baby ingests the spores of the bacteria. The spores then grow in the baby's intestine and produce toxin.Wound botulism can be acquired when a wound becomes infected with the bacteria.
Black-tar heroin injections have been associated with wound botulism.
Symptoms of foodborne botulism in adults and children usually begin within 18 to 36 hours of eating the contaminated food. However, symptoms can occur as early as 6 hours after eating the food, or occasionally as long as 10 days later.
The symptoms include: diarrheadifficulty swallowingdifficulty talking, including slurred speechdizzinessdouble or blurred visiondrooping eyelidsdry mouthmuscle weaknessparalysisvomiting
Symptoms of wound botulism usually begin 4 to 14 days after the bacteria are introduced into the wound. The wound may be reddened and painful and may drain pus. Otherwise, the symptoms are like those of foodborne botulism.
Symptoms of infant botulism include: constipationlethargy, or not moving very muchpoor feedingpoor muscle toneweak crying
Botulism is caused by a toxin made by the bacteria. Foodborne botulism in adults and children is acquired by eating improperly preserved or stored food that contains the toxin. Home canned foods, especially vegetables which are not acidic, are a major source of foodborne botulism.
Infant botulism can be caused by eating honey, which may contain botulism spores. It can also be caused by eating food containing the toxin. Wound botulism occurs when the bacteria enter a wound, grow, and produce the toxin. Black-tar heroin injections are a frequent source of wound botulism.
Foods should be preserved or home canned only by those who know how to prevent food contamination. Strict hygienic procedures should be followed when preparing and storing food. Pressure cooking at 116 degrees Centigrade (240.8 degrees Fahrenheit) can destroy the bacteria. Food containers that bulge should be discarded.
Infants under twelve months of age should never be fed honey. Wounds should be carefully washed with antibacterial soap to prevent infection. Injectable street drugs should not be used.
The bacteria can be detected in stool samples and in foods. The toxin also can be found in serum, which is the non-cellular (fluid) portion of the blood. Electromyography (EMG), the measurement of a muscle's electrical activity, shows abnormalities that can help distinguish botulism from other disorders. Brain scans and spinal fluid exams can also be helpful in making the diagnosis.
If botulism is untreated, individuals can suffer paralysis or respiratory failure. Even with treatment, recovery can be long, especially with infant botulism. Individuals can suffer complications from the paralysis, such as pneumonia or other infections.
Botulism is not spread from person to person.
Early diagnosis and treatment of botulism is important. It is important to remove any remaining contaminated food from the digestive system. The healthcare professional may order enemas, or induce vomiting.
Foodborne and wound botulism can be treated with an antitoxin. This medication blocks the action of toxin in the blood. Antitoxin does not reverse the damage already done, but it can slow or prevent further damage.
Intravenous fluids can be given if a person cannot swallow. A ventilator, or artificial breathing machine, is used if the person's diaphragm and chest muscles are weakened enough to cause difficulty breathing. Antibiotics are useful only in wound botulism and have no role in treating either of the other types.
Many people experience allergic reactions to the antitoxin derived from horse serum. A human-derived antitoxin is available that does not cause as many reactions.
With proper treatment, the body is often able to repair the damage over a period of several months. An individual may have fatigue and shortness of breath for several more years.
Botulism is monitored with periodic visits to the healthcare professional, to whom any new or worsening symptoms should be reported.