Botulism (cont.)

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How is botulism treated?

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If diagnosed early, food-borne and wound botulism can be treated with an antitoxin that blocks the action of neurotoxin circulating in the blood. The trivalent antitoxin (effective against three neurotoxins: A, B, and E) is dispensed from quarantine stations by the U.S. government's Centers for Disease Control and Prevention (CDC). The antitoxin can prevent the disorder from worsening, but recovery still takes many weeks. Another heptavalent antitoxin (effective against seven neurotoxins: A, B, C, D, E, F, and G) may be available from the U.S. Army or FEMA. Physicians may remove whatever contaminated food is still in the gut by inducing vomiting or by using enemas. Wounds should be treated, usually surgically, to remove the source of the toxin-producing bacteria. Good supportive care in a hospital is the mainstay of therapy for all kinds of botulism.

Antitoxin is not routinely given for the treatment of infant botulism; however, a new product that recently became available from the orphan drug program can be used to treat botulism in infants. The product is comprised of immune globulins that can be given intravenously to infants who have been diagnosed with infant botulism. The new treatment is named BabyBIG (Botulism Immune Globulin, given IV) and is only currently available from a special site. Call 510-231-7600 for specific information about this treatment.

The respiratory failure and paralysis that occur with severe botulism may require a patient to be on a breathing machine (ventilator) for weeks and may require intensive medical and nursing care. After several weeks, the paralysis slowly improves as axons in the nerves are regenerated.


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