What is botulism?

Botulism is a serious muscle-paralyzing illness caused by clostridium botulinum, a bacterium commonly found in the soil. When botulinim enters the blood stream, it produces a nerve toxin that prevents muscles from contracting.  This leads to paralysis and, in some cases, inability to breathe naturally. Botulism is a serious but rather rare illness in the United States, where only about 110 cases are reported each year. 

There are three types of naturally occurring botulism. Foodborne botulism is caused by the consumption of food containing the toxin and rapid identification of the contaminated food is important in order to protect public health.  Infant botulism (intestinal botulism) occurs when the spores of the botulinum bacteria are ingested, then grow in the intestines and release the toxin.  Wound botulism occurs when a wound produces a toxin after it has become infected with Clostridium botulinum bacteria. Of the cases that affect the U.S. each year, about 25% are foodborne botulism, 72% are infant botulism, and the rest are wound botulism.

A fourth form of the disease, inhalational botulism, is a man-made disease that results from inhaling aerosolized botulinum toxin.
The Botulinum toxin is an attractive agent for individuals interested in producing bioterrorism agents. It is easy to produce, transport and misuse, and it has the potential to produce permanent, costly damage to those infected.

What are the symptoms of botulism?
Botulism's symptoms include blurred and/or double vision, difficulty speaking, muscle weakness, and difficulty swallowing. Symptoms for infants are similar, but may also include constipation, sluggishness, and trouble with feeding.  If these signs are ignored and left untreated, they may progress into muscle paralysis. 

Foodborne botulism can occur at any age, and anyone who consumes foods that are not cooked or cleaned properly can become a target. 
Even children under one year old have developed botulism after ingesting honey containing Clostridium botulinum spores.    

How is botulism treated?

If foodborne and wound botulism is discovered early, adult patients may take an antitoxin that keeps their condition from becoming worse.  Infants usually do not receive the antitoxin, and they may need to be connected to a ventilator or fed intravenously until the toxins wear off. 

Physicians may fight foodborne botulism by inducing vomiting or using enemas to remove the source producing the toxin.  In a case of wound botulism, the wound may have to be surgically removed.

Researchers have developed an experimental botulism vaccine, which is given primarily to certain military personnel and lab workers. Because botulism is so rare, the vaccine is not available to the public.

How can I protect myself from botulism?

Foodborne botulism can be prevented by hygienic food preparation practices. Cases of the disease have come from home-canned foods like asparagus, green beans, garlic in oil, tomatoes and fermented fish, so if you practice home canning, be sure to reduce contamination of foods and consider boiling the food before serving it. Refrigerate oils that contain herbs or garlic, and keep potatoes baked in aluminum foil hot until they're served or refrigerated.

You can avoid infant botulism away by refusing to give honey to any child under hone year of age.  Honey contains spores of the botulinum bacteria; it won't make older children and adults sick, but it does pose a danger to infants.

The best ways to avoid wound botulism are avoiding street drugs and seeking immediate medical care for infected cuts.

To find out more about botulism, talk with your doctor or check out the following web sites:

Centers for Disease Control, http://www.cdc.gov/ncidod/dbmd/diseaseinfo/botulism_g.htm

WebMD, http://www.webmd.com/content/article/6/1680_53320.htm