Botulism

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Is botulism neurotoxin really considered to be a potential biological weapon?

Yes. However, the neurotoxin rapidly inactivates when exposed to air and is relatively unstable even in liquid formulations in contrast to other disease agents like organisms that cause anthrax. Even with these drawbacks, the neurotoxin has been used sporadically in attempts to harm or kill individuals. Botulinum toxin could be used to contaminate food supplies, but some experts suggest that dissemination of the toxin as an aerosol would be more effective. During the Gulf War, Iraq reportedly produced 20,000 L of botulinum toxin and used 12,000 L for field-testing and to fill warheads, but the shells were not used. The Aum Shinrikyo cult in Japan tried and failed three times to use the toxin as an aerosol weapon. Scientists in Russia also have experimented with botulinum toxin as a weapon. These situations are described in detail in the literature that discusses chemical and biological warfare.

Why are botulism neurotoxins used as cosmetic treatments or treatments for some medical conditions?

Interestingly, purified and highly diluted botulism toxin is being used to treat conditions that are characterized by abnormal muscle contractions. (Some examples of these conditions are torticollis, spasmodic dysphonia, achalasia, strabismus, oromandibular dystonia, cervical dystonia, and blepharospasm.)

Wrinkles are caused by repeated normal muscle contractions...no muscle contractions, no wrinkles. Consequently, many people elect to have an FDA-approved formulation of the dilute toxin injected to reduce or stop wrinkles in the skin. This wrinkle treatment was first approved by the FDA in 2002. Possible side effects of this treatment include bruising, ptosis (abnormal drooping of a body part, especially the eyelid), nausea, and dysphasia (difficulty with speech), but other side effects may also occur. The last reference listed below shows pictures of frown line treatment with Botox.

REFERENCES:

Chan-Tack, Kirk M. "Botulism." Medscape.com. Mar. 23, 2015. <http://emedicine.medscape.com/article/213311-overview>.

Malhotra, Pramit S. "Botox (R) Injections to Improve Facial Aesthetics." Medscape.com. Sept. 17, 2015. <http://emedicine.medscape.com/article/841964-overview>.

United States. Centers for Disease Control and Prevention." Botulism." Apr. 25, 2014.<http://www.cdc.gov/nczved/divisions/dfbmd/diseases/botulism/>.

Waseem, Muhammad. "Pediatric Botulism." Medscape.com. Feb. 23, 2015. <http://emedicine.medscape.com/article/961833-overview>.

Medically Reviewed by a Doctor on 11/16/2015

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