Botulism
Medical Author: Charles Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
What is botulism?
Botulism is a serious illness that causes flaccid paralysis of muscles. It is caused by a neurotoxin, generically called botulinum toxin, that is produced by the bacterium Clostridium botulinum. There are seven distinct neurotoxins (types A-G) that Clostridium botulinum produce, but types A, B, and E (rarely F) are the most common that produce the flaccid paralysis in humans. The other types mainly cause disease in animals. Most Clostridium species produce only one type of neurotoxin.
The recorded history of botulism begins in 1735, when the disease was first associated with German sausage (food-borne disease, or food poisoning after eating sausage). In 1870,
a German physician by the name of Muller derived the name botulism from the Latin word for
sausage. Clostridium botulinum bacteria were first isolated in 1895, and a neurotoxin that it produces was isolated in 1944 by
Dr. Edward Schantz.
How many kinds of botulism are there?
There are three main kinds of botulism, which are categorized by
the way in which the disease is acquired:
- Food-borne botulism is
caused by eating foods that contain the botulinum neurotoxin.
- Wound botulism is caused
by neurotoxin produced from a wound that is infected with the bacteria Clostridium botulinum.
- Infant botulism occurs
when an infant consumes the spores of the botulinum bacteria. The bacteria
then grow in the intestines and release the neurotoxin.
Three other kinds of botulism have been described but are seen rarely. The first is adult intestinal colonization that is seen in older children and adults with abnormal bowels. Only rarely does intestinal infection with the Clostridium
botulinum bacteria occur in adults. Typically, the adult form of
this intestinal botulism is related to abdominal surgical procedures. The second kind (injection botulism) is seen in patients injected with inappropriately high amounts of therapeutic neurotoxin (for
example, Botox, Dysport), while the third kind (inhalation botulism) has occurred in laboratory personnel who work with the neurotoxins. All of these six kinds of botulism are potentially fatal.
How serious is botulism?
Botulinum neurotoxin is considered one of the most potent, lethal
substances known. As little as about one nanogram/kg can be lethal to an individual, and scientists have estimated that about one gram could potentially kill one million people. All forms of botulism can be fatal and are
considered medical emergencies. Food-borne botulism can be especially
dangerous because many people can be poisoned by eating even small
amounts of neurotoxin-contaminated food. A botulism outbreak is a public-health
emergency that is reportable to the U.S. government.
How does botulism neurotoxin affect the body?
A neurotoxin actually paralyzes the nerves so that the muscles cannot contract. This happens when the neurotoxin enters nerve cells and eventually interferes with the release of acetylcholine so the nerve cannot stimulate the muscle to contract. Unless the nerve can regenerate a new axon that has no exposure to the neurotoxin, the interference at the neuromuscular junction is permanent. This is why it takes so long to recover from botulism and also why cosmetic and therapeutic uses of diluted neurotoxin can be effective for relatively lengthy time periods.
What kind of organism is Clostridium botulinum?
Clostridium botulinum is the name of bacteria commonly found in soil all over the world. The bacteria are considered to be anaerobic, which means these rod-shaped organisms grow best in low or absent oxygen levels. Clostridium form spores which allow the bacteria to survive in a dormant state until exposed to conditions that can support growth. There are seven types of botulism neurotoxin designated by the letters A through G. Only types A, B, E, and F cause illness in humans.
Next: How common is botulism? »
- Electromyogram (EMG) - EMG (electromyogram) can detect abnormal muscle electrical activity in conditions such as neuropathy, carpal tunnel syndrome, pinched nerves, herniated discs, peripheral nerve damage, ALS, and more.
- Food Poisoning - Read about the types of food poisoning from bacterium infection from Campylobacter, Salmonella, Shigella, E. coli O157:H7, Listeria, and botulism. Symptoms, diagnosis, treatment and prevention information is included in the information.
- Botox - Botox is the brand name of a toxin produced by the bacterium Clostridium botulinum.Small, diluted amounts can be directly injected into specific muscles causing controlled weakening of the muscles.
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