Botulism is a potentially deadly illness that is caused by a toxin produced by a bacterium called Clostridium botulinum . This bacterium are found in the soil and at the bottom of lakes, streams, and oceans. The intestinal tracts of fish, mammals, crabs, and other shellfish may contain C botulinum and its spores. The bacterium's spores can survive in improperly prepared foods.
A very small amount of the botulism toxin can cause illness. People come in contact with this toxin in one of three ways:
In some cases, the source of the bacteria is unknown. Botulism toxin is also a potential bioterrorism agent.
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors for botulism include:
Symptoms begin in the face and eyes, and progress down both sides of the body. If left untreated, muscles in the arms, legs, and torso, as well as those used in breathing become paralyzed. Death can occur.
Symptoms can range from mild to severe and include:
In adults:
In babies:
When food is the cause of botulism, symptoms usually start within 36 hours of eating the contaminated food. Some people notice symptoms within a few hours. Others may not develop symptoms for several days. Some people experience nausea, vomiting, and diarrhea .
When a wound is the cause of botulism, symptoms start within 4 to 14 days.
The doctor will ask about your symptoms and medical history, and perform a physical exam. Blood, stool, and stomach contents will be tested for the toxin. In infants, stool will also be tested for C botulinum . If available, samples of questionable food may also be tested for the toxin and bacteria. A wound culture will be done if wound botulism is suspected.
Tests to rule out other medical conditions may include:
The most serious complication is respiratory failure. Treatment aims to maintain adequate oxygen supply, which may require a ventilator and close monitoring in an intensive care unit. Feeding through a tube may also be necessary.
If treatment begins early, an antitoxin can stop the paralysis from progressing and may shorten symptoms. It does not reverse the disease process.
Methods to eliminate the toxin include:
High temperatures can destroy the botulism toxin. Strategies to prevent botulism include:
RESOURCES:
Centers for Disease Control and Prevention
http://www.cdc.gov/
Center for Food Safety and Applied Nutrition
http://www.cfsan.fda.gov/
CANADIAN RESOURCES:
Canadian Partnership for Consumer Food Safety Education
http://www.canfightbac.org/en/
Health Canada
http://www.hc-sc.gc.ca/index-eng.php/
References:
AAP 2000 Red Book: Report of the Committee on Infectious Diseases . 25th ed. American Academy of Pediatrics; 2000.
Cecil Textbook of Medicine . 21st ed. WB Saunders Company; 2000.
Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov .
Nelson Textbook of Pediatrics . 16th ed. WB Saunders Company; 2000.
Principles and Practice of Infectious Diseases . 5th ed. Churchill Livingstone, Inc; 2000.
Last reviewed November 2008 by David L. Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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