BOTULISM

General Information

DEFINITION--A serious, non-contagious form of food poisoning caused by eating contaminated food containing a toxin that severely affects the nervous system. Two other types exist: wound botulism and infant botulism.

BODY PARTS INVOLVED--Central nervous system; muscular system.

SEX OR AGE MOST AFFECTED--All ages, but most common in adults.

SIGNS & SYMPTOMS--

The following symptoms usually appear suddenly 18 to 36 hours after eating contaminated food:

• Blurred or double vision.
• Drooping eyelids.
• Dry mouth.
• Slurred speech.
• Swallowing difficulty.
• Vomiting and diarrhea.
• Weakness of the arms and legs, leading to paralysis.
• No fever.
• No disturbance of mental abilities. The following symptoms appear in infants:
• Severe constipation.
• Feeble cry.
• Inability to suck.

CAUSES

• Infection with bacteria, Clostridium botulinum, found in contaminated or incompletely cooked, canned foods. This germ generates a powerful poison (toxin) that is absorbed from the digestive tract and spreads to the central nervous system. Foods likely to cause botulism include home-canned vegetables and fruits, fish, meat, under-cooked sausage, smoked meats and milk products.
• In infants under 1 year, raw honey or other uncooked foods may cause botulism.
• The bacteria also may contaminate a wound and produce the toxin.

RISK INCREASES WITH

• Infants.
• Home-canned foods. Green beans are especially susceptible to spoilage.

HOW TO PREVENT

• If a can of food is bulging, or the contents have a peculiar color or odor, don't taste it.
• Don't eat any foods not definitely known to be properly cooked and canned.
• Don't give infants honey in foods or cough suppressants.
• Boiling can prevent, but call your local home-extension service for details about canning food and cooking it safely. You may get additional information from Center for Nutrition and Dietetics National Consumer Hotline, (800) 366-1655.
• Call your local health department if you suspect botulism. The health department can notify the news media to alert others in danger and require retailers to remove contaminated food from store shelves.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms--especially if several persons eat the same food and become sick.
• Medical history and exam by a doctor.
• Laboratory blood tests; laboratory analysis of suspected food.

APPROPRIATE HEALTH CARE

Doctor's treatment. Hospitalization for intensive care. A respirator may be necessary.

POSSIBLE COMPLICATIONS

• Lung infections as a result of impaired swallowing and choking on food.
• Respiratory failure caused by weak breathing muscles.

PROBABLE OUTCOME--With prompt care, the outlook is good. The larger the toxin dose and the sooner symptoms begin, the more dangerous the condition. The overall death rate is 10% to 25%.

How To Treat

GENERAL MEASURES--

• Induce vomiting if only a few hours have passed since the poisoned food was eaten.
• If you suspect botulism, refrigerate some of the contaminated food for laboratory testing.

MEDICATION--Botulism antitoxin injections prevent the condition from worsening. The antitoxin is available through the Center for Disease Control, Atlanta, Georgia. The antitoxin is derived from horse serum, which may be life-saving, but has serious side effects.

ACTIVITY--Bed rest is necessary during hospitalization. After treatment, resume normal activities gradually.

DIET--Intravenous fluids and foods are usually necessary during hospitalization because of swallowing difficulty. After treatment, no special diet is necessary.

Call Your Doctor If

• You have symptoms of botulism. Call an ambulance immediately. This is an emergency!
• Weakness, blurred vision or slurred speech occur after you return from intensive care.