About Botulism

Botulism is a rare, but very serious condition. It’s caused by toxin produced by bacteria called Clostridium botulinum. The toxins that this bacterium produces are among the most poisonous substances.

Botulism comes in three main forms:

  • Food-borne botulism. The harmful bacteria thrive and produce the toxin in environments with little oxygen, such as in canned food.
  • Wound botulism. If these bacteria get into a cut, they can cause a dangerous infection that produces the toxin.
  • Infant botulism. This is the most common form of botulism. It begins after Clostridium botulinum bacteria grow in a baby’s intestinal tract. It typically occurs between the ages of 6 weeks and 6 months.

All types of botulism present medical emergencies, since they can cause death.

Prevention

Use proper canning techniques
Be sure to use proper techniques when canning foods at home to ensure that any botulism germs in the food are destroyed:

  • Pressure cook these foods at 250 F (121 C) for at least 30 minutes.
  • Consider boiling these foods for 10 minutes before serving them.
  • Contact your county extension service, provided by the Department of Agriculture, for detailed information on safe canning procedures.

Prepare and store food safely

  • Don’t eat preserved food if its container is bulging or if the food smells spoiled.
  • If you wrap potatoes in foil before baking them, eat them hot or store them in the refrigerator — not at room temperature.
  • Store oils infused with garlic or herbs in the refrigerator.

Avoid infant and wound botulism
To reduce the risk of infant botulism, avoid giving honey or corn syrup — even a tiny taste — to babies under the age of 1. To prevent wound botulism and other serious blood-borne diseases, never inject street drugs.

Symptoms

Signs and symptoms of food-borne botulism typically begin between 12 and 36 hours after the toxin gets into your body. Infant botulism usually produces problems within this timeframe, too. However, the symptoms of wound botulism typically start about 10 days after you’re infected by the bacteria.

Food-borne and wound botulism
Signs and symptoms of food-borne and wound botulism include:

  • Difficulty swallowing or speaking
  • Facial weakness
  • Double vision
  • Trouble breathing
  • Nausea, vomiting and abdominal cramps
  • Paralysis

Infant botulism

  • Constipation (often the first sign)
  • Floppy movements due to muscle weakness, and trouble controlling the head
  • Weak cry
  • Drooping eyelids
  • Tiredness
  • Difficulty sucking or feeding
  • Paralysis

Causes

Food-borne botulism
When you eat food containing the toxin, it disrupts nerve function, causing paralysis. The source of food-borne botulism is often home-canned foods that are low in acid, such as green beans, corn and beets. A common source of the illness in Alaska is home-canned seafood. However, the disease has also occurred from chili peppers, oil infused with garlic and baked potatoes.

Wound botulism
When Clostridium botulinum bacteria get into a wound, they can multiply and produce toxin. Wound botulism has increased in recent decades in people who inject heroin, which can contain spores of the bacteria.

Infant botulism
Babies get infant botulism after consuming spores of the bacteria, which then grow and multiply in the intestine and make toxins. The source of infant botulism is often honey, corn syrup or exposure to soil contaminated with the bacteria.

Benefits of botulinum toxin?
The paralyzing effect of botulinum toxin makes it useful as a medication when prescribed by your doctor. Botox, which contains a tiny amount of botulinum toxin, reduces facial wrinkles by preventing contraction of muscles beneath the skin. Other uses for Botox include treating eyelid spasms and severe underarm sweating.

Complications

Because it affects muscle control throughout your body, botulism can cause many complications. The most immediate danger is that you won’t be able to breathe, which is the most common cause of death in botulism. You may have shortness of breath after the poisoning, as well. Other complications include difficulty speaking and swallowing and long-lasting weakness.

Diagnosis

To diagnose botulism, your doctor will check you for signs of muscle weakness or paralysis, such as drooping eyelids and weak voice. Your doctor will also ask about the foods you’ve eaten in the past few days, and ask if you may have been exposed to the bacteria through a wound.

In cases of possible infant botulism, the doctor may ask if the child has eaten honey or corn syrup recently and has had problems such as constipation and sluggishness.

Analysis of stool or vomit for signs of the toxin may help confirm an infant or food-borne botulism diagnosis, but your doctor’s clinical examination is the primary means of diagnosis.

Treatment

For cases of food-borne botulism, doctors sometimes clear out the digestive system by inducing vomiting and giving medications to induce bowel movements. If you have botulism in a wound, a doctor may need to remove infected tissue surgically.

Antitoxin
If you’re diagnosed early with food-borne or wound botulism, injected antitoxin reduces your chances of complications. The antitoxin attaches itself to toxin that’s still circulating in your bloodstream and keeps it from harming your nerves.

Antitoxin is not, however, recommended for cases of infant botulism, since it doesn’t affect the disease-causing germs in the baby’s digestive system. A treatment called botulism immune globulin has been investigated to treat infants. It appears effective in reducing the duration and severity of the illness.

Breathing assistance
If you’re having trouble breathing, you will probably need a mechanical ventilator. The ventilator forces air into your lungs through a tube inserted in your airway through your nose or mouth. You may remain on the ventilator for up to several weeks as the effects of the toxin gradually lessen.

Rehabilitation
You may also require therapy to improve your speech, swallowing and other functions affected by the disease.