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Botulism is arare but seriousconditioncaused bytoxins frombacteria calledClostridium
botulinum.
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Botulism comes in three main forms:
Infant botulism Food-bornebotulism. Wound Botulism
This most commonform of botulism
begins afterClostridiumbotulinum bacterialspores grow in ababy's intestinal
tract. It typicallyoccurs between theages of 2 and 6months.
The harmfulbacteria thrive
and produce thetoxin inenvironmentswith little
oxygen, such asin canned food.
If these bacteria getinto a cut, they can
cause a dangerousinfection thatproduces the toxin.Because all types ofbotulism can
potentially causedeath, all types ofbotulism areconsidered medical
emergencies
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Infant botulism Food-bornebotulism.
Wound Botulism
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SIGNS AND SYMPTOMSFood-borne and wound botulism
Difficulty swallowing orspeakingFacial weakness on both sides
of the faceBlurred visionDrooping eyelidsTrouble breathingNausea, vomiting andabdominal cramps (only infood-borne botulism)Paralysis
Infant botulism
Constipation (often the firstsign)Floppy movements due to
muscle weakness, and troublecontrolling the headWeak cryIrritability
DroolingDrooping eyelidsTirednessDifficulty sucking or feedingParalysis
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Certain signs and symptoms usually aren't present
with botulism, including no elevation in bloodpressure or heart rate, no confusion and no fever.However, fever is sometimes present with woundbotulism.
When to see a doctorSeek urgent medical care if you suspect that youhave botulism. Early treatment increases yourchances of survival. Seeking medical care promptlymay also serve to alert public health authorities, whocan keep other people from eating contaminatedfood.
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CAUSESInfant botulism Food-borne
botulism.
Wound Botulism
Babies get infant botulismafter consuming spores ofthe bacteria, which thengrow and multiply in theintestine and make toxins.The source of infantbotulism may be honey,but is more likely to beexposure to soilcontaminated with the
bacteria
The source of food-bornebotulism is often home-canned foods that are lowin acid, such as greenbeans, corn and beets. Acommon source of theillness in Alaska isfermented seafood.However, the disease hasalso occurred from chili
peppers, baked potatoesand oil infused with garlic.When you eat foodcontaining the toxin, itdisrupts nerve function,causing paralysis.
Wound botulismWhen C. botulinumbacteria get into a wound possibly caused by aninjury you might not notice
they can multiply andproduce toxin. Woundbotulism has increased inrecent decades in peoplewho inject heroin, which
can contain spores of thebacteria. Some peoplehave also gotten botulismfrom inhaling the sporesfrom cocaine
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Are there benefits to botulinum
toxin? You might wonder how something so toxic could ever be
beneficial, but scientists have found that the paralyzing effectof botulinum toxin makes it useful in certain circumstances.
Botulinum toxin (Botox, Myobloc) can be an effectivemedication when used in very small amounts.
Botulinum toxin has been used to reduce facial wrinkles bypreventing contraction of muscles beneath the skin, and formedical conditions, such as eyelid spasms and severe
underarm sweating. However, there have been rareoccurrences of serious side effects, such as muscle paralysisextending beyond the treated area, with the use of botulinumtoxin for medical reasons
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Tests and diagnosis
To diagnose botulism, your doctor will check you forsigns of muscle weakness or paralysis, such asdrooping eyelids and a weak voice. Your doctor will
also ask about the foods you've eaten in the past fewdays, and ask if you may have been exposed to thebacteria through a wound. A blood test can confirmthe presence of the toxin.
.
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Test and Diagnosis In cases of possible infant botulism, the doctor may ask if the
child has eaten honey recently and has had problems such asconstipation and sluggishness.
Analysis of stool or vomit for evidence of the toxin may helpconfirm an infant or food-borne botulism diagnosis, butbecause these tests may take days, your doctor's clinicalexamination is the primary means of diagnosis
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Treatments and drugs
To diagnose botulism, your doctor will check you for signs ofmuscle weakness or paralysis, such as drooping eyelids and aweak voice. Your doctor will also ask about the foods you'veeaten in the past few days, and ask if you may have been
exposed to the bacteria through a wound. A blood test canconfirm the presence of the toxin.
In cases of possible infant botulism, the doctor may ask if thechild has eaten honey recently and has had problems such asconstipation and sluggishness.
Analysis of stool or vomit for evidence of the toxin may helpconfirm an infant or food-borne botulism diagnosis, butbecause these tests may take days, your doctor's clinicalexamination is the primary means of diagnosis.
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For cases of food-borne botulism, doctors sometimesclear out the digestive system by inducing vomiting andgiving medications to induce bowel movements. If youhave botulism in a wound, a doctor may need to removeinfected tissue surgically
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Antitoxin If you're diagnosed early with food-borne or wound
botulism, injected antitoxin reduces the risk ofcomplications. The antitoxin attaches itself to toxin that's
still circulating in your bloodstream and keeps it fromharming your nerves. The antitoxin cannot, however,reverse any damage that's already been done.
Antitoxin is not, however, recommended for cases of
infant botulism, since it doesn't affect the disease-causing germs in the baby's digestive system. Atreatment called botulism immune globulin is used totreat infants.
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Breathing assistance If you're having trouble breathing, you will probably need
a mechanical ventilator. The ventilator forces air intoyour lungs through a tube inserted in your airwaythrough your nose or mouth. You may remain on theventilator for up to several weeks as the effects of thetoxin gradually lessen.
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Rehabilitation As you recover, you may also need therapy to improve
your speech, swallowing and other functions affected bythe disease.
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Prevention Use proper canning techniquesBe sure to use proper techniques when canning foods at home to
ensure that any botulism germs in the food are destroyed: Pressure cook these foods at 250 F (121 C) for at least 30 minutes. Consider boiling these foods for 10 minutes before serving them.
Prepare and store food safely Don't eat preserved food if its container is bulging or if the food
smells spoiled. However, taste and smell won't always give awaythe presence of C. botulinum. Some strains don't make food smellbad or taste unusual.
If you wrap potatoes in foil before baking them, eat them hot orstore them in the refrigerator
not at room temperature.
Store oils infused with garlic or herbs in the refrigerator.
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Infant botulismTo reduce the risk of infant botulism, avoid giving honey even a tiny taste to babies under the age of 1 year.
Wound botulismTo prevent wound botulism and other seriousbloodborne diseases, never inject or inhale street drugs.