Botulism

 Botulism is a rare and potentially fatal paralytic illness caused by a toxin produced by Clotridium botulinum. The bacterium lives naturally in soil, dust and river or sea sediments.  

The bacteria are not harmful, but they can produce highly poisonous toxins when they are deprived of oxygen (such as in closed cans or bottles, stagnant soil or mud, or occasionally the human body). The toxins are ingested through improperly processed food in which the bacteria or the spores survive and produce the toxins. 

Though it is mainly through foodborne intoxication, botulism can also be caused by intestinal infection in infants, wound infections, and by inhalation.

1.      Food-borne botulism can occur when someone eats food that is contaminated with infected soil if the food has not been properly canned, preserved or cooked.

2.      Wound botulism can occur when a wound becomes infected with the C. botulinum bacteria. It is usually caused by injecting illegal drugs contaminated with the bacteria, such as heroin, into muscle rather than a vein

3.      Infant botulism can occur when a baby ingests spores of the C. botulinum bacteria in contaminated soil or food, such as honey, home-canned vegetables and fruits, corn syrup.

Home-canned foods with a low acid content, improperly canned commercial foods, home-canned or fermented fish, herb-infused oils, baked potatoes in aluminium foil, cheese sauce, bottled garlic, foods held warm for extended harbour the bacteria.

SIGNS AND SYMPTOMS

Botulinum toxins, produced by the bacterium blocks nerve functions and can lead to respiratory and muscular paralysis. They attack the nervous system (nerves, brain and spinal cord) and cause paralysis (muscle weakness) that gradually spreads down the body from the head to the legs. . Most common are the facial muscles and the muscles controlling chewing and swallowing.

The clinical manifestations of botulism include:

·                     Fatigue, weakness and vertigo

·                     Vomiting, diarrhoea, constipation and abdominal swelling may also occur.

·                     Dry lips (due to decreased production of saliva)

·                     Reduced movement of the muscles of respiration

·                     Double  or blurred vision

·                     Drooping of both eyelids

·                     Loss of facial expression

·                     Difficulty swallowing (dysphagia)

·                     Difficulty speaking (dysarthria)

 

A diagnosis is mainly based on your symptoms, although tests will be carried out on a sample of blood, faeces (stool), stomach contents, food, pus or tissue to detect the C. botulinum bacteria or toxin in order to confirm the diagnosis.

TREATMENT

Treatment is supportive and^, requires intensive medical and nursing care. The primary treatment of botulism is with an antitoxin (human botulinum immunoglobulin) which blocks the action of toxin circulating in the blood. It is administered as soon as diagnosis is confirmed.

Proper wound care is essential as well.

A vaccine against botulism exists but it is rarely used as its effectiveness has not been fully evaluated

Your doctor may remove contaminated food still in the stomach by inducing vomiting or by using enemas.

PREVENTION

Ø  Be careful when canning foods at home. The toxin is destroyed by heating to more than 85 °C for longer than 5 minutes. It is not recommended to give honey to children who are less than one year of age due to the risk with this food. Homemade canned, preserved or fermented foodstuffs require extra caution.

Ø  Do not let babies eat honey. A recommended prevention measure for infant botulism is to avoid giving honey to infants less than 12 months of age, as botulinum spores are often present. In older children and adults the normal intestinal bacteria suppress development of C. botulinum.

Ø  Get prompt medical care for infected wounds