What is botulism?
Botulism is a rare but serious illness that causes paralysis of muscles. It is caused by a nerve toxin, called botulinum toxin, that is produced by the bacterium Clostridium botulinum.
How many types of botulism are there?
There are three main types of botulism, which are categorized by the way in which the disease is acquired:
Food-borne botulism is caused by eating foods that contain the botulinum toxin.
Wound botulism is caused by toxin produced from a wound that is infected with the bacteria Clostridium botulinum.
Infant botulism occurs when an infant consumes the spores of the botulinum bacteria. The bacteria then grow in the intestines and release the toxin.
Only rarely does intestinal infection with the Clostridium botulinum bacteria occur in adults. Typically, the adult form of this intestinal botulism is related to abdominal surgical procedures.
How serious is botulism?
Botulinum nerve toxin is considered THE most potent, lethal substance known. All forms of botulism can be fatal and are considered medical emergencies. Food-borne botulism can be especially dangerous because many people can be poisoned by eating even small amounts of contaminated food.
How does botulism toxin affect the body?
The toxin actually paralyzes the nerves so that the muscles cannot contract. Interestingly, purified botulism toxin is used to treat conditions that are characterized by abnormal muscle contraction. (Examples of these conditions are torticollis, spasmodic dysphonia, achalasia, strabismus, oromandibular dystonia and blepharospasm.)
What kind of germ is Clostridium botulinum?
Clostridium botulinum is the name of a group of bacteria commonly found in soil. These rod-shaped organisms grow best in low oxygen conditions. The bacteria form spores, which allow them to survive in a dormant state until exposed to conditions that can support their growth. There are seven types of botulism toxin designated by the letters A through G. Only types A, B, E and F cause illness in humans.
How common is botulism?
In the United States, an average of 110 cases of botulism are reported each year. Of these, nearly 25% of cases are food-borne, approximately 75% are infant botulism, and the remainder are wound botulism, which is rare. Outbreaks of food-borne botulism involving two or more persons are usually caused by eating contaminated home- canned foods. The number of cases of food-borne and infant botulism has changed little in recent years. However, the incidence wound botulism has increased, especially in California, from the use of black-tar heroin, which causes infected wounds at injection sites.
What are the symptoms of botulism?
The classic symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. The doctor's examination may reveal that the gag reflex and the deep tendon reflexes like the knee jerk are decreased or absent.
Infants with botulism appear lethargic, weak, and floppy, feed poorly, become constipated, and have a weak cry and poor muscle tone.
These are all symptoms of the muscle paralysis that is caused by the bacterial toxin. If untreated, these symptoms may progress to cause paralysis of the arms, legs, trunk, and breathing muscles.
How soon do symptoms appear?
In food-borne botulism, symptoms generally begin 18 to 36 hours after eating a contaminated food, but they can occur as early as 6 hours or as late as 10 days afterwards.
How is botulism diagnosed?
The patient's history and physical examination may suggest botulism, but these clues are usually not enough to allow a diagnosis of botulism. Symptoms of other diseases, such as a stroke, Guillain-Barré syndrome (another disease of muscle paralysis), and myasthenia gravis (which also causes weakness and eyelid drooping) can appear similar to those of botulism. Special tests may be needed to exclude these other conditions. These tests may include a brain scan, spinal fluid examination, nerve conduction test (electromyography, or EMG), and a tensilon test for myasthenia gravis.
The most direct way to confirm the diagnosis is to identify the botulinum toxin in the patient's blood serum or stool by injecting serum or stool into mice and looking for signs of botulism (mouse inoculation test). The bacteria can also be isolated from the stool of persons with food-borne and infant botulism.
How is botulism treated?
Physicians may remove whatever contaminated food is still in the gut by inducing vomiting or by using enemas. Wounds should be treated, usually surgically, to remove the source of the toxin- producing bacteria. Good supportive care in a hospital is the mainstay of therapy for all kinds of botulism.
If diagnosed early, food-borne and wound botulism can be treated with an antitoxin that blocks the action of toxin circulating in the blood. The antitoxin is dispensed from quarantine stations by the government's Center for Disease Control. The antitoxin can prevent the disorder from worsening, but recovery still takes many weeks.
Currently, antitoxin is not routinely given for the treatment of infant botulism. An antitoxin product is currently under investigation for this use.
The respiratory failure and paralysis that occur with severe botulism may require a patient to be on a breathing machine (ventilator) for weeks, plus intensive medical and nursing care. After several weeks, the paralysis slowly improves.
What are complications from botulism?
Botulism can result in death from respiratory failure. However, in the past 50 years, the proportion of deaths from botulism has fallen from about 50% to 8%. A patient with severe botulism may require not only a breathing machine but also intensive medical and nursing care for several months.
Patients who survive an episode of botulism poisoning may experience fatigue and shortness of breath for years and long-term therapy may be needed to aid recovery.
Can botulism be prevented?
Yes. Food-borne botulism has often come from home-canned foods with low acid content, such as asparagus, green beans, beets, and corn. However, there have been outbreaks of botulism from more unusual sources such as chopped garlic in oil, chili peppers, tomatoes, improperly handled baked potatoes wrapped in aluminum foil, and home-canned or fermented fish. Persons who do home canning should follow strict hygienic procedures to reduce contamination of foods. Oils that are infused with garlic or herbs should be refrigerated. Potatoes that have been baked while wrapped in aluminum foil should be kept hot until served or refrigerated. Because the botulism toxin is destroyed by high temperatures, persons who eat home-canned foods should consider boiling the food for 10 minutes before eating it to ensure safety.
Bulging cans or abnormal-smelling preserved foods should be discarded. Do NOT taste-test them!
Because honey can contain spores of Clostridium botulinum and this has been a source of infection for infants, children less than 12 months old should NOT be fed honey. Honey is safe for persons one year of age and older.
Wound botulism can be prevented by promptly seeking medical care for infected wounds and avoiding injectable street drugs.
Botulism At A Glance
Botulism's nerve toxin is the most potent, lethal substance known.
Botulism is a disease caused by this toxin.
The toxin is produced by bacteria called Clostridium botulinum.
The toxin paralyzes muscles and can be deadly.
There are three types of botulism that differ in how they are acquired: food-borne, wound, and infant botulism.
Food-borne botulism is usually caused by eating contaminated home-canned foods.
Never taste-test food that may have gone bad.
Wound botulism is due to bacteria infecting a wound and releasing the toxin.
In infant botulism, the baby consumes spores of the bacteria which then grow in the baby's intestine and release the toxin.
Honey can contain spores of the bacteria and should not be fed to babies under one year of age.
Early food-borne and wound botulism can be treated with an antitoxin to block the action of the toxin.
hope the above information is useful!!
bless u!!
2007-02-28 13:45:55
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answer #3
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answered by M e o w w 2
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