Botulism In Adults And Children

Botulism is a rare but potentially fatal disorder. It is caused by a toxin, orpoison, produced by the bacteria Clostridium botulinum.

What is going on in the body?

Botulinum toxins are among the most powerful poisons known. There are threeforms of botulism:

Foodborne botulism can occur when a person eats food containingClostridium botulinum bacteria.

Clostridium botulinum.\ This toxin triggers sudden, progressive weakness and paralysis. Infant botulism is usually seen in babies younger than 6 months old.Infant botulismoccurs when a baby ingests the spores of the bacteria. The spores then grow inthe baby’s intestine and produce toxin.

Wound botulism can be acquired when a wound becomes infected withthe bacteria. Black-tar heroin injections are a modern source of woundbotulism.

What are the causes and risks of the condition?

Botulism is caused by a toxin made by the Clostridium botulinumbacteria. Foodborne botulism in adults and children is acquired by eatingimproperly preserved or stored food that contains the toxin. Home canned foodis a major source of foodborne botulism.

Infant botulism can be caused by eating honey, which maycontain botulism spores. It can also be caused by eating food containing thetoxin.

Wound botulism occurs when the bacteria enter a wound, grow, and produce thetoxin. Black-tar heroin injections are a prime source of wound botulism.

What are the signs and symptoms of the condition?

Symptoms of foodborne botulism in adults and children usually begin within 18to 36 hours of eating the contaminated food. However, symptoms can occur asearly as 6 hours after eating the food, or as long as 10 days later. Thesymptoms include the following:

diarrhea

difficultyswallowing

difficulty talking, including slurred speech

dizziness

double or blurred vision

drooping eyelids

dry mouth

muscle weakness

paralysis

vomiting

Symptoms of wound botulism usually begin 4 to 14 days after the bacteria isintroduced into the wound. The wound may be reddened and painful and may drainpus.

Symptoms of infant botulism include:

constipation

lethargy, or not moving very much

poor feeding

poor muscle tone

weak crying

How is the condition diagnosed?

The bacteria can be detected in stool samples and in foods. The toxin also canbe found in serum, which is the watery portion of blood. Electromyography, or EMG, is measurement of a muscle’selectrical activity. This test may be ordered to measure the electrical activity of the muscles. Brain scans and spinal fluid exams canalso be helpful in making the diagnosis.

What can be done to prevent the condition?

Foods should be preserved or home canned only by those who know how to preventfood contamination. Strict hygienic procedures should be followed whenpreparing and storing food. Pressure cooking at 116 degrees Centigrade (240.8 degreesFahrenheit) can destroy the bacteria. Food containers that bulge should be discarded.

Infants under twelve months of age should never be fedhoney, which can contain botulism spores.

Wounds should be carefully washed with antibacterial soap to prevent Clostridium botulinum infection. Injectable street drugs should not beused.

What are the long-term effects of the condition?

If botulism is untreated, individuals can suffer paralysis or respiratoryfailure. Even with treatment, recovery can be long, especially with infantbotulism. Individuals can suffer complications from the paralysis, such aspneumonia or other infections.

What are the risks to others?

Botulism is not spread from person to person.

What are the treatments for the condition?

Early diagnosis and treatment of botulism is important. It is important to remove any remaining contaminated food from the digestive system. The healthcare providermay order enemas, or induce vomiting.

Foodborne and wound botulism can be treated with an antitoxin. This medicatiion blocks theaction of toxin in the blood. Antitoxin doesn’t undo the damage already done,but it can slow or prevent further damage. Intravenous fluids can be given if aperson can’t swallow. A ventilator, or artificial breathing machine, is often used to treatbreathing difficulties.

Antibiotics should only be used to treat secondary infections. Use ofantibiotics kill botulism spores in the intestine. This can result in the absorption of even more toxin.

What are the side effects of the treatments?

Many people experience allergicreactions to the antitoxin derived from horse serum. There is ahuman-derived antitoxin that does not cause as many reactions.

What happens after treatment for the condition?

With proper treatment, the body is often able to repair the damage over aperiod of several months. An individual may have fatigue and shortness of breath for several more years.

How is the condition monitored?

Botulism is monitored with periodic visits to the healthcareprovider. Any new or worsening symptoms should be reported to the healthcareprovider.