The most direct way to confirm the diagnosis is to demonstrate the botulinum toxin in the patient's serum or stool by injecting serum or stool into mice and looking for signs of botulism. The bacteria can also be isolated from the stool of persons with foodborne and infant botulism.
How can botulism be treated?
The respiratory failure and paralysis that occur with severe botulism may require a patient to be on a ventilator 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 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 are treated, usually surgically, to remove the source of the toxin-producing bacteria. Currently, antitoxin is not routinely given for treatment of infant botulism.
Are there complications from botulism?
Botulism can result in death due to respiratory failure. However, in the past 50 years the proportion of patients with botulism who die has fallen from about 50 percent to 8 percent. A patient with severe botulism may require a breathing machine as well as intensive medical and nursing care for several months. Patients who survive an episode of botulism poisoning may have fatigue and shortness of breath for years and long-term therapy may be needed to aid recovery.
Are there any medical applications of botulism?
In April 2002, the Federal Food and Drug Administration approved the use of Botox — a highly diluted derivative of Botulinum toxin type A — as a cosmetic treatment to reduce wrinkles. Botox injections, typically given in the forehead, between the eyebrows and at the outside edges of the eyes, reduces wrinkles by temporarily paralyzing muscles.
— Sources: Center for Civilian Biodefense Strategies at Johns Hopkins University, Centers for Disease Control and Prevention.