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Botulism in Adults and Children

Overview, Causes, & Risk Factors

Botulism is a rare but potentially fatal disorder. It is caused by a toxin, or poison, produced by the bacteria Clostridium botulinum.

What is going on in the body?

Botulinum toxins are among the most powerful poisons known. There are three forms of botulism:

  • Foodborne botulism can occur when a person eats food containing Clostridium botulinum bacteria.
  • Clostridium botulinum. This toxin triggers sudden, progressive weakness and paralysis. Infant botulism is usually seen in babies younger than 6 months old. ',CAPTION,'Botulism in Infants');" onmouseout="return nd();">Infant botulism occurs when a baby ingests the spores of the bacteria. The spores then grow in the baby's intestine and produce toxin.
  • Wound botulism can be acquired when a wound becomes infected with the bacteria. Black-tar heroin injections are a modern source of wound botulism.
  • What are the causes and risks of the condition?

    Botulism is caused by a toxin made by the Clostridium botulinum bacteria. Foodborne botulism in adults and children is acquired by eating improperly preserved or stored food that contains the toxin. Home canned food is a major source of foodborne botulism.

    Infant botulism can be caused by eating honey, which may contain botulism spores. It can also be caused by eating food containing the toxin.

    Wound botulism occurs when the bacteria enter a wound, grow, and produce the toxin. Black-tar heroin injections are a prime source of wound botulism.

    Symptoms & Signs

    What are the signs and symptoms of the condition?

    Symptoms of foodborne botulism in adults and children usually begin within 18 to 36 hours of eating the contaminated food. However, symptoms can occur as early as 6 hours after eating the food, or as long as 10 days later. The symptoms include the following:

  • diarrhea
  • difficulty swallowing
  • difficulty talking, including slurred speech
  • dizziness
  • double or blurred vision
  • drooping eyelids
  • dry mouth
  • muscle weakness
  • paralysis
  • vomiting
  • Symptoms of wound botulism usually begin 4 to 14 days after the bacteria is introduced into the wound. The wound may be reddened and painful and may drain pus.

    Symptoms of infant botulism include:

  • constipation
  • lethargy, or not moving very much
  • poor feeding
  • poor muscle tone
  • weak crying

  • Diagnosis & Tests

    How is the condition diagnosed?

    The bacteria can be detected in stool samples and in foods. The toxin also can be found in serum, which is the watery portion of blood. Electromyography, or EMG, is measurement of a muscle's electrical activity. This test may be ordered to measure the electrical activity of the muscles. Brain scans and spinal fluid exams can also be helpful in making the diagnosis.

    Prevention & Expectations

    What can be done to prevent the condition?

    Foods should be preserved or home canned only by those who know how to prevent food contamination. Strict hygienic procedures should be followed when preparing and storing food. Pressure cooking at 116 degrees Centigrade (240.8 degrees Fahrenheit) can destroy the bacteria. Food containers that bulge should be discarded.

    Infants under twelve months of age should never be fed honey, which can contain botulism spores.

    Wounds should be carefully washed with antibacterial soap to prevent Clostridium botulinum infection. Injectable street drugs should not be used.

    What are the long-term effects of the condition?

    If botulism is untreated, individuals can suffer paralysis or respiratory failure. Even with treatment, recovery can be long, especially with infant botulism. Individuals can suffer complications from the paralysis, such as pneumonia or other infections.

    What are the risks to others?

    Botulism is not spread from person to person.

    Treatment & Monitoring

    What are the treatments for the condition?

    Early diagnosis and treatment of botulism is important. It is important to remove any remaining contaminated food from the digestive system. The healthcare provider may order enemas, or induce vomiting.

    Foodborne and wound botulism can be treated with an antitoxin. This medicatiion blocks the action of toxin in the blood. Antitoxin doesn't undo the damage already done, but it can slow or prevent further damage. Intravenous fluids can be given if a person can't swallow. A ventilator, or artificial breathing machine, is often used to treat breathing difficulties.

    Antibiotics should only be used to treat secondary infections. Use of antibiotics kill botulism spores in the intestine. This can result in the absorption of even more toxin.

    What are the side effects of the treatments?

    Many people experience allergic reactions to the antitoxin derived from horse serum. There is a human-derived antitoxin that does not cause as many reactions.

    What happens after treatment for the condition?

    With proper treatment, the body is often able to repair the damage over a period of several months. An individual may have fatigue and shortness of breath for several more years.

    How is the condition monitored?

    Botulism is monitored with periodic visits to the healthcare provider. Any new or worsening symptoms should be reported to the healthcare provider.

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