Definition of Botulism:
Botulism is a rare but serious illness caused by the bacteria
Clostridium botulinum. The bacteria may enter the body through wounds, or they may live in improperly canned or preserved food.
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Causes, incidence, and risk factors:
Clostridium botulinum is found in soil and untreated water throughout the world. It produces
spores that survive in improperly preserved or canned food, where they produce toxin. When eaten, even tiny amounts of this toxin can lead to severe poisoning.
The foods most commonly contaminated are home-canned vegetables, cured pork and ham, smoked or raw fish, and honey or corn syrup. Botulism may also occur if the organism enters open wounds and produces toxin there.
Infant botulism occurs when living bacteria or its spores are eaten and grow within the baby's gastrointestinal tract. The most common cause of infant botulism is eating honey or corn syrup.
Clostridium botulinum also occurs normally in the stool of some infants.
Approximately 110 cases of botulism occur in the U.S. per year. The majority are in infants.
Symptoms:
Symptoms usually appear between 8 - 36 hours after consuming contaminated food.
In adults, symptoms may include:
Abdominal cramps
Breathing difficulty that may lead to respiratory failure
Difficulty swallowing and speaking
Double vision
Dry mouth
Nausea
Temporary lack of breathing
Vomiting
Weakness with paralysis[/ul]
Symptoms in infants may include:
Constipation
Weakness, loss of muscle tone
Weak cry
Poor feeding and weak sucking
Respiratory distress
Alertness, despite weakness[/ul][/align]
Signs and tests:
The doctor will perform a physical exam. There may be signs of:
Speech impairment
Muscle function/feeling loss
Eyelid drooping
Absent or decreased gag reflex
Absent or decreased deep tendon reflexes
Paralyzed bowel
Urine retention with inability to urinate[/ul]
Blood tests can be done to identify toxin. A
stool culture may also be ordered. Lab tests can be done on the suspected food to confirm botulism.
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Treatment:
Botulinus antitoxin is given.
Breathing trouble requires hospitalization. The health care team will establish a clear airway and provide supportive therapy. A tube may be inserted through the nose or mouth into the windpipe to provide an airway for oxygen. A breathing machine may be needed.
Intravenous fluids can be given when the patient has swallowing difficulties. A feeding tube may be inserted in the nose.
Cases of botulism are reported to state health authorities or the U.S. Centers for Disease Control and Prevention by health care providers so that the contaminated food can be removed from stores. Antibiotics are often given, but have not been shown to always be beneficial.
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Expectations (prognosis):
Prompt treatment significantly reduces the risk of death.
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Complications:
Aspiration pneumonia and infection
Respiratory distress
Long-lasting weakness
Nervous system problems for up to 1 year[/ul][/align]
Calling your health care provider:
Go to the emergency room or call the local emergency number (such as 911) if you suspect botulism.
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Prevention:
NEVER give honey or corn syrup to infants younger than 1 year old -- not even just a little taste on a pacifier.
Prevent infant botulism by breastfeeding, if possible.
Always throw away bulging cans or off-smelling preserved foods. Sterilize home-canned foods by pressure cooking at 250 degrees Fahrenheit for 30 minutes.
Keep foil-wrapped baked potatoes hot or in the refrigerator, not out in room temperature.
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