Botulism

by Dolores R.
Botulism

Botulism is not a disease that’s unheard of. It’s rare, yes, but it happens. Is Botulism deadly? What happens when the disease attacks the human body? How do you catch it?

Unfortunately, many are misinformed about Botulism, especially after knowing that the same causative agent is used for the treatment of wrinkles–the ever-popular Botox injection.

What is Botulism?

The bacterium Clostridium botulinum is responsible for this disease, and is named after the causative agent itself. Botulism results in muscle paralysis, beginning from the face and extending to the limbs. When left untreated, the toxin reaches the respiratory muscles resulting in lung failure.

Botulism is considered a medical emergency and patients who contract this disease need immediate and intensive care to ensure full recovery.  Here’s an interesting video that shows you key facts about Botulism:

Botulism Signs and Symptoms

The manifestations of various types of Botulism are explained below:

1. Food-borne botulism:

Nausea, vomiting and diarrhea occur, after which constipation, abdominal distention, weakness and breathing difficulty takes place . It takes 18-36 hours or 3-8 days for the manifestation of the symptoms after the consumption of contaminated food. Botulinum spores may be found in improperly handled food and thrive well on raw honey.

2. Wound botulism:

The cranial nerves connect the brain to the spinal cord, and these constitute a complex communication that keeps the nervous system working. The botulinum toxin, through an open wound, enters the bloodstream and spreads to other parts of the body. Wound botulism has an incubation period of 2-4 weeks for adults and 3-30 days for infants. It takes a relatively longer period for the neurological signs to appear compared to food-borne botulism.

Other signs and symptoms include:

  1. Blurred vision
  2. Drooping eyelids
  3. Facial weakness
  4. Dryness of mouth
  5. Trouble during swallowing
  6. Slurry speech
  7. Muscle weakness
  8. Constipation
  9. Excessive drooling
  10.  Listless behavior
  11. Absence of gag reflex

The classic triad of botulism consists of descending paralysis, lack of fever and normal mental status. The person appears alert and conscious, but is gravely paralyzed.

Causes of Botulism

In essence, there is only one known cause of Botulism, which is the bacterium Clostridium botulinum, as previously discussed. Perhaps what you’re wondering is–how do you get infected with this toxin? Where does it thrive?

First of all, you should be aware that C. botulinum is naturally found in soil and untreated water. Because they are a form of a resistant spore, they survive in such environments.

Improper food handling

Food-borne botulism results from bad food handling practices. Poor quality control in canned food may also increase the risk for the toxin to survive. When consumed in minute quantities, it can lead to severe food poisoning.

Drug users

The illegal practice of injecting recreational drugs is extremely unsterile. The botulinum toxin thrives well in unsterile needles and may enter open wounds.

Raw honey

There’s a reason why it’s absolutely contraindicated for babies below 12 months of age to take anything with honey. Because botulinum spores grow well in honey, they can easily attack a baby’s body and paralysis occurs in a short period.

Iatrogenic botulism

This is a type of man-made botulism, as it happens as an adverse effect after a Botox treatment. Since the active ingredient of Botox is the diluted form of toxin derived from C. botulinum, some paralysis of the face may happen, but this only occurs in the rarest of all cases–almost unheard of, even. See this page by the CDC.

Diagnosis of Botulism

Thorough medical history and careful medical assessment give plenty of telling signs that lead doctors to consider botulism. In infant botulism, clinical manifestations are usually enough for diagnosis, though further testing may be recommended.

In adults, tests like brain CT scan, cerebrospinal fluid exam, electromyography and blood tests may be required to exclude other diseases with similar signs and symptoms such as myasthenia gravis. A definitive diagnosis of botulism is possible when the toxin is identified in the food, stomach, vomitus or feces of the patient.

Treatment of Botulism

The gold standard of treating botulism include botulinum anti-toxin and supportive therapy.

Immediate hospitalization is necessary for botulism cases. It is crucial to administer a botulism anti-toxin, which is horse-derived, even before the results of the tests are released. Botulism Immune Globulin Intravenous-Human, which is also referred to as BIG-V or BabyBIG, is given to babies if infant botulism is confirmed.

Supportive care is indicated for those afflicted with respiratory problems. A mechanical ventilator and intensive care are essential as the body recovers from paralysis. For wound botulism that results in infection, debridement or removing dead skin and debris from the area around the wound stops the infection from spreading elsewhere.

Complications of Botulism

Death is the worst complication of botulism, but even when alive, there are plenty other complications of this disease that affect the activities of daily living, particularly:

  1. Long-term respiratory difficulty requiring the use of a mechanical ventilator
  2. Shortness of breath and fatigue
  3. Permanent paralysis
  4. High risk for sepsis resulting from pneumonia, ear infection and urinary tract infection

Botulism Prevention

They say prevention is better than cure. Although deadly when left untreated, botulism is easily prevented if you take careful measures.

  • Practice proper wound care In case of cuts, scrapes, and abrasions. In case of an infected wound, consult a doctor immediately.
  • Avoid the temptation of using recreational and street drugs.
  • Get Botox injections from trained doctors only. Read about their qualifications, experience and testimonials from other patients. Be wary as knock-offs may be circulating, as what is implied in this article:
  • Handle food properly. When possible, avoid canning food at home and leave it to the experts. When in doubt about food or ingredients for cooking, throw them out.
  • Boil meats and vegetables for a minimum period of 10 minutes, even if there is no visible evidence of spoilage. Boiling is the preferred method of destroying the botulinum toxin. When using a pressure cooker, cook for at least 30 minutes.
  • Discard canned food found to be bulging or leaking. Never taste it, even if it appears physically undamaged.
  • Avoid giving honey or corn syrup to infants under the age of 12 months.
  • Thoroughly cook your food before consuming, especially if you are pregnant.
  • Oils mixed with garlic and herbs should be kept in the refrigerator.

According to the World Health Organization, following these 5 simple steps can make food safe for consumption:

  1. Maintain cleanliness.
  2. Separate raw and cooked food.
  3. Cook food thoroughly.
  4. Store food properly.
  5. Use clean water and materials.

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