Botulism

WHAT YOU SHOULD KNOW

Botulism is a rare, life-threatening illness caused by an invasion of bacteria named Clostridium botulinum. These germs produce a toxin that interferes with the transmission of nerve impulses to the muscles and salivary glands.

Causes

There are three types of botulism:

• Foodborne is the most common form. It is caused by eating contaminated foods that haven't been thoroughly cooked. C. botulinum is most commonly found in improperly prepared home-canned foods, but may also lurk in meat products, fish, and shellfish. The contaminated food may have a foul odor, but sometimes gives no warning.
• Wound botulism accounts for only about three percent of the botulism cases treated in the United States annually. C. botulinum thrives in the absence of air. It can live in soil and invade the body when an uncovered wound comes in contact with it.
• Infant botulism can strike babies given raw honey or corn syrup that contains botulinal spores. Once inside the digestive tract, the spores develop and give off their toxin. This differs from foodborne botulism, in which the toxin is already present in the contaminated food. Honey and corn syrup are generally considered safe to feed young children after the age of one year.

Signs/Symptoms

Symptoms typically develop within 18 to 36 hours after the toxin enters the body. Early warnings include nausea, vomiting, abdominal cramps, and muscle weakness. Left untreated, the condition can quickly progress to paralysis and respiratory failure.

Other possible symptoms include dry mouth, droopy eyelids, double vision, and an inability to focus on nearby objects. Infants may experience difficulty breathing, trouble swallowing, abnormal drooling, constipation, a weak cry, and loss of appetite. Symptoms have been known to appear as soon as four hours or as long as eight days after eating the spoiled food.

Care

The primary treatment for botulism is botulin antitoxin, a drug that blocks the toxin from working its mischief. Treatment is most effective if rendered within 72 hours of the onset of symptoms. Any suspicion of botulism should always be considered a medical emergency.

Risks

If you don't seek treatment as soon as the symptoms appear, this disorder can be fatal. Death usually comes through an inability to breath caused by disruption of nerve impulses to the respiratory system. Paralysis is also a concern in severe cases. Fortunately, with the advent of botulin antitoxin treatment, less than 10 percent of botulism cases are now fatal. Most people recover completely, although for some it may take several months. In extreme cases, however&#151as when treatment is delayed, some nerve damage may remain.

WHAT YOU SHOULD KNOW

Seek Care Immediately If...

• You develop any symptoms that lead you to suspect botulism.

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

You may encounter the following procedures and equipment during your stay.

• Taking Vital Signs: These include your temperature, pulse, blood pressure, and respirations. A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by a cuff wrapped around your arm. These tests may be performed hourly.
• IV: A tube placed in a vein for giving medications, liquids, or food. The primary medication to treat botulism, antitoxin, is administered via this route. You may also be given other fluids through your IV to prevent dehydration.
• Medicines: In addition to the antitoxin, the following medications may be used to help rid your body of the toxin:
  • Ipecac syrup: To induce vomiting.
  • Laxative: To speed the passage of intestinal contents.
• Gastric lavage: This procedure washes the contaminated food from your stomach.
• Ventilator: This artificial breathing machine may be a life-saver if respiratory failure sets in.
• Blood Tests: Samples taken from a vein in your hand or the bend in your elbow will be needed to confirm your diagnosis. The amount of oxygen in your blood will also have to be evaluated. Samples for these tests are drawn from the wrist, elbow, or groin.
• EMG (Electromyography): This procedure measures the condition of your nerves. Electrodes inserted into certain muscle fibers record the electrical activity of the nerves within the tissue. The test is used to help confirm your diagnosis and rule out other disorders with similar symptoms, such as Guillain-Barré) syndrome, stroke, and myasthenia gravis.
• Activity: Depending upon the severity of your condition, you may be required to stay in the hospital for a few days. As your body rids itself of the toxin, you will slowly recover and your symptoms will improve. You may resume your normal activities as soon as you feel up to them.

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