In mild cases of botulism poisoning, with prompt diagnosis and appropriate treatment, people recover in about 90 to 95 percent of cases within weeks or months.
In serious cases or without immediate medical intervention (early administration of antitoxin and intensive respiratory care) botulism can prove to be fatal in 5 to 10 percent of cases.
If left untreated, botulism can result in death or life-threatening complications.
There are seven distinct forms of botulinum toxin:
- Types A, B, E, and F cause human botulism
- Types C, D, and E cause illness in other mammals, birds, and fish
What is botulism what are the causes?
Botulism is a rare and life-threatening foodborne illness of the nervous system caused by the bacterium Clostridium botulinum (C botulinum).
C botulinum is an anaerobic bacterium, which can only grow in the absence of oxygen and produces spores widely in the environment including:
5 types of botulism
- Foodborne botulism
- Occurs when homemade canned foods are improperly preserved or stored.
- Other sources of foodborne botulism include:
- Oils infused with herbs
- Potatoes baked in aluminum foil
- Canned cheese sauces
- Bottled garlic
- Canned tomatoes
- Carrot juice
- Foods kept warm or left unrefrigerated for too long
- Infant botulism
- Wound botulism
- Botulinum spores can get into open wounds and slowly reproduce, eventually releasing the toxin into the bloodstream.
- Mostly associated with frequent drug users (who use needles to inject drugs into their veins), particularly when injecting black tar heroin or in people with surgery or a serious injury.
- Adult intestinal toxemia or adult intestinal colonization
- Spores reach the intestines and they grow, spread, and produce toxins in a similar way they do in infants.
- Adults with serious health conditions, affecting the digestive system are at risk.
- Iatrogenic botulism
What are the signs and symptoms of botulism?
Symptoms may range from mild to severe and may develop from three to 30 days after exposure to Clostridium botulinum spores.
Symptoms of infant botulism and adult intestinal toxemia
- Drooping eyelids (ptosis)
- Loss of facial expression
- Slow or poor feeding
- Reduced gag reflex
- Weakness or floppiness
- Weak cry (in infants)
- Difficulty breathing
Symptoms of botulism in older children and adults
- Weakness on both sides of the face, eyes, and throat
- Drooping eyelids
- Double or blurred vision
- Xerostomia (dry mouth)
- Slurred speech
- Dysphagia (difficulty swallowing)
- Difficulty breathing
- Weakness or paralysis of arms or legs
- Nausea and vomiting
Symptoms of wound botulism
These are similar to other types of botulism but may take about two weeks to appear and may include:
- Skin redness, swelling, and other signs of infection
Symptoms of iatrogenic botulism
Mostly the same as those seen in other types of botulism along with:
- Eye muscle weakness
- Difficulty speaking
- Facial paralysis
- A thick and weak tongue
How is botulism diagnosed?
To distinguish, the healthcare provider may need to do further testing, such as:
- Physical examination: To look for signs of botulism, such as muscle weakness, a weak voice, or drooping eyelids, and may interrogate about foods you (or your baby) have eaten.
- Blood test: Blood counts, serum electrolytes, and inflammatory markers.
- Brain scan: MRI or CT scan of the brain helps rule out other reasons for the symptoms, such as a stroke.
- Spinal fluid examination: A cerebrospinal fluid study or a spinal tap may show a slight increase in the level of protein.
- Nerve and muscle function tests: Electromyography can help confirm a diagnosis of botulism.
- Tensilon test: To rule out myasthenia gravis, which can cause similar symptoms.
How is botulism treated?
There are a variety of treatment options available depending on the cause and severity of botulism, which may include:
- Antitoxins: The primary treatment for botulism is a medication called an antitoxin that helps block the toxin’s activity in the bloodstream.
- Antibiotics: In cases of wound botulism, surgical removal of the contaminated part of the wound along with antibiotics are recommended.
- Breathing aid: A mechanical ventilation machine (ventilator) helps breathe if the illness is severe.
- Therapy: To help with speech, swallowing, and other body functions post-recovery.
What are the complications of botulism and can you prevent it?
In severe cases, health issues that may result from botulism include:
- Extreme tiredness (fatigue)
- Long-term weakness
- Shortness of breath (dyspnea)
- Aspiration pneumonia and infection
- Nervous system issues
Steps to prevent the most common types of botulism.
- Cook food thoroughly by using clean hands, containers, and utensils
- Refrigerate foods within two hours after cooking
- Avoid food containers that appear damaged
- Throw away foul-smelling preserved foods
- Boil home-canned foods in a pressure cooker at 250 °F for 30 minutes
- Avoid giving honey to babies younger than one year
- Breastfeed your baby to slow the onset of illness if botulism develops
- Do not abuse injectable drugs
- Seek medical help for a wound with signs of infection, including redness, tenderness, swelling, or pus
- Clean wounds contaminated by dirt and soil thoroughly
- Ensure that Botox injections are administered only by licensed medical professionals
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