ENLmedical.com: Conditions And Concerns: Medical Encyclopedia: Botulism

Botulism

Causes and Risks:
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 minute amounts of this toxin can lead to severe poisoning. Foods most commonly contaminated are home-canned vegetables, cured pork and ham, and smoked or raw fish. Botulism may also occur if the organism enters open wounds and produces toxin there.

Infant botulism is a special type of botulism in which living bacteria or its spores, Clostridium botulinum, are ingested and grow within the infant's gastrointestinal tract and produce a toxin responsible for the infant's symptoms. Clostridium botulinum also appears as normal flora in the stool of some infants.

Approximately 20 cases of food-borne botulism in adults and 250 cases in infants are reported per year. Respiratory failure caused by weakness in the muscles that control breathing can cause death in up to 10% of food-borne illness and 2% of infant disease.

Prevention:
Sterilize home canned foods by pressure cooking at 250 degrees Fahrenheit for 30 minutes. Discard bulging cans or off-smelling preserved foods. DO NOT TASTE TEST!

Symptoms:

difficulty swallowing and speaking, progressive weakness
nausea , vomiting
abdominal cramps
dry mouth
double vision
breathing difficulty that may lead to respiratory failure
breathing, absent temporarily
in infants:
- constipation
- weakness, loss of muscle tone
- weak cry
- poor feeding and weak sucking
- respiratory distress
- appears alert but weak

Note: Symptoms usually appear between 8 to 36 hours after consuming contaminated food.

Additional symptoms that may be associated with this disease:

speech impairment
muscle function/feeling loss
eyelid drooping
absent or decreased gag reflex
absent or decreased deep tendon reflexes

Signs and Tests:

blood test to identify toxin
laboratory analysis of suspected food
stool culture

Treatment:
The objective of treatment is to establish a clear airway, provide aid with breathing, give botulinus antitoxin, and provide supportive therapy. Emergency hospitalization is recommended for immediate detection of respiratory impairment.

If breathing difficulty develops, intubation (a tube inserted through the nose or mouth into the trachea to provide an airway for oxygen) and mechanical ventilation are given. Intravenous fluids can be given while swallowing difficulties persist. Also, naso-gastric (feeding through a tube inserted in the nose) feeding should be initiated.

Occurrences of the disease are reported to state health authorities or the CDC (Centers for Disease Control and Prevention) by health care providers so that contaminated food can be removed from stores. Antibiotics have not been shown to be beneficial in the infant form of botulism.

Prognosis:
Death occurs in 70% of untreated cases. Prompt treatment significantly reduces the risk of death.

Complications:

aspiration pneumonia and infection
respiratory distress
infant botulism has been associated with sudden infant death syndrome ( SIDS )

Call Your Healthcare Provider:
Go to the emergency room or call the local emergency number (such as 911) if botulism food poisoning is suspected.