Facts About Botulism

Botulism is a rare muscle-paralyzing illness caused by a nerve toxin. Here are some facts about the illness.

What is botulism?

There are three main kinds of botulism. Foodborne botulism is caused by eating foods that contain the botulism toxin,Clostridium botulinum. 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.

Can Clostridium botulinium be used as a bioweapon?

Botulinum toxin poses a major bioweapons threat because of its extreme potency and lethality; its ease of production, transport and misuse; and the potential need for prolonged intensive care in affected persons.

Have people tried developing the toxin as a bioweapon?

A number of states named by the U.S. State Department as "state sponsors of terrorism" have developed or are developing botulinum toxin as a biological weapon. Members of the Japanese cult, Aum Shinrikyo, tried but failed to use botulinum toxin as a biological weapon.

What kind of germ is Clostridium botulinum?

Clostridium botulinum is the name of a group of bacteria commonly found in soil. These rod-shaped organisms grow best in low oxygen conditions. The bacteria form spores which allow them to survive in a dormant state until exposed to conditions that can support their growth. There are seven types of botulism toxin designated by the letters A through G; only types A, B, E and F cause illness in humans.

Can botulism be spread person to person?

Botulism is not spread person to person.

How common is botulism?

In the United States an average of 110 cases of botulism are reported each year. Of these, approximately 25 percent are foodborne, 72 percent are infant botulism, and the rest are wound botulism. Outbreaks of foodborne botulism involving two or more people occur most years and are usually caused by eating contaminated home-canned foods. The number of cases of foodborne and infant botulism has changed little in recent years, but wound botulism has increased because of the use of black-tar heroin, especially in California.

What are the symptoms of botulism?

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, 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.

How is botulism diagnosed?

Physicians consider the diagnosis if the patient's history and physical examination suggest botulism. However, these clues are usually not enough to allow a diagnosis of botulism. Other diseases such as Guillain-Barré syndrome, stroke, and myasthenia gravis can appear similar to botulism, and special tests may be needed to exclude these other conditions.

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