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Botulism (cont.)

How common is botulism?

Because of better canning processes, especially home canning or home processing of food, the number of yearly cases have dropped to about 1,000 worldwide. In the United States, an average of 110 cases of botulism are reported each year. Of these, nearly 25% of cases are food-borne, approximately 75% are infant botulism, and the remainder are wound botulism, which until recently was rare. Outbreaks of food-borne botulism involving two or more people are usually caused by eating contaminated home-canned foods. The number of cases of food-borne and infant botulism has changed little in recent years. However, the incidence of wound botulism has increased, especially in California, from the use of black-tar heroin, which causes infected wounds at injection sites.

What are the symptoms of botulism?

The classic symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. The doctor's examination may reveal that the gag reflex and the deep tendon reflexes like the knee jerk are decreased or absent.

Infants with botulism appear lethargic, weak, and floppy, feed poorly, become constipated, and have a weak cry and poor muscle tone.

These are all symptoms of the muscle paralysis that is caused by the bacterial neurotoxin. If untreated, these symptoms may progress to cause paralysis in various parts of the body, often seen as a descending paralysis of the arms, legs, trunk, and breathing muscles.

How soon do symptoms appear?

In food-borne botulism, symptoms generally begin 18 to 36 hours after eating a contaminated food, but they can occur as early as six hours or as late as 10 days afterward.



Next: How is botulism diagnosed? »

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