Botulism is a rare, possibly fatal illness caused by a nerve toxin that is produced by the bacterium Clostridium botulinumand sometimes by strains of Clostridium butyricum and Clostridium baratii. Person to person transmission of botulism does not occur.
Botulism is developed if a person ingests the toxin (inhaled or injected) or if the Clostridium spp. organisms grow in the intestines or wounds in the body and toxin is released.
Clostridium botulinum produces seven distinct neurotoxins (types A-G), types A, B, and E (and rarely F) are most common and produce the flaccid paralysis in humans. The other types mainly cause disease in animals and birds, which also develop flaccid paralysis. Most Clostridium species produce only one type of neurotoxin; however, the effects of A, B, E, or F on humans are essentially the same. Botulism is not transmitted from person to person.
Types of botulism
- Food-borne botulism– Thisis caused by eating improperly canned or preserved foods that contain the botulinum neurotoxin. Recent small outbreaks have occurred in Canada due to fermented fish and New York due to unrefrigerated bulk fish contamination.
- Wound botulism– This is caused by neurotoxin produced within a wound that is infected with the bacteria Clostridium botulinum.
- Infant botulism– This occurs when an infant consumes the spores of the botulinum bacteria. The bacteria then grow in the intestines and release the neurotoxin.
Others types that can be rarely seen are;
- Intestinal botulism– It is an adult intestinal colonization that is seen in older children and adults with abnormal gastrointestinal tracts. It rarely occurs in adults because the adult GI tract inactivates ingestedClostridium botulinum bacteria through gastric acid and enzymatic activity.
- Injection botulism– It is seen in patients injected with inappropriately high amounts of therapeutic neurotoxin such as; Botox, Dysport, Myobloc.
- Inhalationbotulism was reported to have occurred in laboratory personnel who work with the neurotoxins
The symptoms of botulism include;
- double vision,
- blurred vision,
- drooping eyelids,
- slurred speech,
- difficulty swallowing,
- dry mouth
- Muscle weakness (resulting in a flaccid paralysis).
Other conditions associated with botulism are;
- dilated pupil(s),
- abdominal discomfort or pain,
- difficulty speaking
- difficulty swallowing
- shortness of breath
- slow or absent reflexes
- urinary retention
- facial weakness
- People who do home canning should follow strict hygienic procedures to reduce contamination of foods such as; Keeping oils infused with garlic or herbs refrigerated, Keeping potatoes that is baked and wrapped in aluminum foil hot until served or refrigerated, Boiingl home-processed, low-acid and tomato canned foods in a saucepan for 10 minutes before serving, even if no sign of spoilage is detected.
- Promptly seek medical care for infected wounds, and do not use injectable street drugs.
- Honey can contain the bacteria that cause infant botulism. Children younger than 12 months old should not be fed honey. Honey is safe for people 1 year of age and older.
- Suspected outbreaks of botulism should be quickly investigated, and if they involve a commercial product, the appropriate control measures should be coordinated among public health and regulatory agencies.
This is carried out if the patient’s history and physical examination suggest botulism. However, other diseases such as Guillain-Barré syndrome, stroke, and myasthenia gravis can appear similar to botulism, and 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.
Botulism can be treated with an antitoxin which blocks the action of toxin circulating in the blood. Severe botulism that causes respiratory failure and paralysis may require a patient to be on a breathing machine (ventilator) for weeks or months, including intensive medical and nursing care until the paralysis slowly improve.
Contaminated food still in the gut may be removed by inducing vomiting or by using enemas. Wounds would be surgically treated, to remove the source of the toxin-producing bacteria followed by administration of appropriate antibiotics. Good supportive care would be provided in the hospital.
Compiled by eDokita Team
- Centers for Disease Control and Prevention. Botulism.2016
- Charles Patrick Davis and Melissa Conrad Stöppler. Botulism. MedcineNet.com. 2017
- Botulism. 2016