Infectious Disease Botulism



botulism Clostridium botulinum botulism is a rare but serious paralytic illness caused by a nerve toxin that is produced by the bacterium Clostridium botulinum there are three main kinds of botulism foodborne botulism is caused by eating foods that contain the botulism toxin wound botulism is caused by toxin produced from a wound infected with Clostridium botulinum infant botulism is caused by consuming the spores of the botulinum bacteria which then grow in the intestines and release toxin all forms of botulism can be fatal and are considered medical emergencies foodborne botulism can be especially dangerous because many people can be poisoned by eating a contaminated food symptoms the classic symptoms of botulism include double vision blurred vision drooping eyelids slurred speech difficulty swallowing dry mouth and muscle weakness infants with botulism appear lethargic feed poorly are constipated and have a weak cry and poor muscle tone these are all symptoms of the muscle paralysis caused by the bacterial toxin if untreated these symptoms may progress to cause paralysis of the arms legs trunk and respiratory muscles in foodborne 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 treatment the respiratory failure and paralysis that occur with severe botulism may require a patient to be on a breathing machine for weeks plus intensive medical and nursing care after several weeks the paralysis slowly improves if diagnosed early foodborne and wound botulism can be treated with an equine antitoxin which blocks the action of toxin circulating in the blood this can prevent patients from worsening but recovery still takes many weeks physicians may try to remove contaminated food 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 followed by administration of appropriate antibiotics good supportive care in a hospital is the mainstay of therapy for all forms of botulism a human derived antitoxin is used to treat cases of infant botulism and is available from the California Department of Public Health botulism family guide to home care in the event of an intentional release of the toxin that causes botulism many people will need to be hospitalized treating botulism requires supportive care in addition to antitoxin if you or any member of your family has any of the following symptoms go to the nearest hospital or treatment center now double vision blurred vision drooping eyelids slurred speech difficulty swallowing dry mouth or muscle weakness foods associated with botulism low acidic foods with a pH greater than 4.6 home canned foods sausages meat products canned vegetables seafood products salsa potatoes cooked in aluminum foil honey some commercially prepared foods yogurt cream cheese and jarred peanuts food and cooking precautions botulism toxin is inactivated by heat exposure to heat equal to or greater than a hundred and eighty-five degrees Fahrenheit for at least five minutes will detoxify contaminated food or drink heat foods thoroughly before eating foods suspected of contamination should be removed immediately from potential consumers and given to public health authorities for testing protection from aerosol release awareness of an intended release of the botulism toxin into the air would probably be too late to prevent exposure however when exposure is anticipated covering the mouth and nose with an undershirt shirt scarf painters or surgical mask or hand kerchief will provide some protection decontamination after exposure to botulinum toxin clothing and skin should be washed with soap and water exposed surfaces need to be cleaned with a ten percent household bleach solution if the patient with botulism also has meningitis droplet precautions need to be taken those around patients with meningitis should cover the mouth and nose when in close contact use everyday sanitation techniques while botulism is not contagious it still makes sense to use common sense sanitation techniques wash hands frequently especially after eating or drinking after using the bathroom and after every contact with those who are sick wash the hands of those who are sick especially after helping them use the bathroom and before eating and drinking care for those who are sick follow all medical instructions carefully be sure that those who are sick take all medication exactly as prescribed take care of yourself patients with botulism will most likely be cared for in the hospital however hospitalization also requires support and care from the family for those who are sick you will not be able to help care for others if you do not also care for yourself get plenty of rest drink lots of liquids and maintain a healthy diet where to get more information stay tuned to your local media for ongoing updates Centers for Disease Control and Prevention public response hotline for English call 888 to 4-6 2-6 7-5 for spanish call eight eight eight two four six two eight five seven tty users can call eight eight eight eight seven four to six four six you

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