Botulism

GENERAL INFORMATION:

What is it? Botulism is the most poisonous natural substance known. It is a bacteria (bak-TEER-e-uh) (germ) found naturally in soil. When the botulism bacteria finds a place to grow, it makes a toxin. It is the toxin that makes people sick. Botulism toxin can get into your body in 3 ways:

• Foodborne botulism comes from eating food that has the botulism toxin in it. Foodborne botulism usually comes from eating home-canned food. Any food may have botulism. Botulism is tasteless, odorless, and has no color.
  
  
• Wound botulism comes from having a sore, a cut, or a skin opening. Wound botulism usually comes from injecting street drugs.
  
  
• Infant botulism attacks babies under 1 year old. Infant botulism is the most common type of botulism.

• Inhalational (in-huh-LA-shun-ull) botulism is a pure form. It can be breathed in through the mouth or nose into the lungs.
  
  
• Intestinal botulism is a toxin that can be sprayed onto food.

Is botulism contagious? Natural botulism is not contagious. It cannot be passed from one person to another in the same way as colds or flu. Botulism cannot pass through skin that has no cuts or sores. You can get botulism by eating or breathing something that has the toxin in it. You can also get botulism from injecting street drugs, especially black tar heroin.

What are the signs and symptoms of botulism? Signs and symptoms may begin from 2 hours to 8 days after eating food with botulism in it. Signs and symptoms usually begin 12 to 72 hours after eating food with botulism in it. There are 2 kinds of signs and symptoms of botulism:

• Intestinal (in-TES-tin-ul):
  
  
  • Nausea (feeling sick to your stomach).
    
    
  • Vomiting (throwing up).
    
    
  • Cramps.
    
    
  • Diarrhea (loose, watery BMs).
  
  

• Neurological (nur-uh-LOJ-ih-kul): Caregivers will be able to tell that you have botulism and not another disease because: Neurological means in the nerves. These symptoms usually begin at the top of the body and move toward the feet.
  
  
  • Droopy eyelids.
    
    
  • Seeing double and having blurry vision.
    
    
  • It may be hard to talk or hard to understand other people.
    
    
  • Dry mouth and throat. Your throat may even be sore from being dry.
    
    
  • It may be hard to breathe.
    
    
  • You may not be able to stand or walk.
  
  
  
  • You will not have a fever (high temperature) from having botulism. If you have a fever it will be caused by another germ.
    
    
  • You may be unable to move, but you will know who you are, what time it is, and where you are.
    
    
  • You will not lose your ability to feel by touch. You will feel when other people touch you. You will feel the bed and the medical equipment touching you.
  
  

How is botulism treated? Botulism is treated with antitoxin and supportive care. Infants are only treated with supportive care.

• Antitoxin.
  
  
  • The antitoxin can keep you from getting more symptoms. It does not take away symptoms you already have. Caregivers may choose to give the antitoxin to everyone who ate a suspected food. They may also choose to watch you and wait to see if symptoms begin.
    
    
  • The antitoxin may cause allergy symptoms in some people. If you know you are sensitive or allergic to horse serum, tell your caregiver. They can give you medicine for your allergy before giving you the antitoxin.
  
  
• Supportive care. How you are treated depends on how bad your symptoms are. Symptoms can range from almost none at all, to death within 24 hours. Severe symptoms are treated in the hospital in an ICU. Botulism can paralyze your body. You may not be able to move, but you will still feel. You may be put on a machine that helps you breathe for days, weeks, or months. You will be on the machine until you can breathe on your own.

Is there a vaccine for botulism? A vaccine will keep the person vaccinated from getting sick, even if they are directly exposed to the botulism toxin. There is a vaccine available.

• Botulism is very rare. Only people who may, or will, be directly exposed to botulism are given the vaccine. This includes laboratory workers and military people who may be exposed to botulism during warfare.
  
  
• The vaccine must be given months before the person may be exposed to botulism to work.
  
  
• The vaccine does not work for someone who already has botulism.

What should I do if I am exposed to botulism? The two ways you are most likely to be exposed to botulism are by eating a home-canned food or eating food with botulism in a restaurant. If you have symptoms of botulism, call your caregiver immediately. If the symptoms are sudden and severe beginning with droopy eyelids, blurred and double vision, this is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself!

What is the risk of a botulism outbreak?

• Natural botulism is very rare. About 100 people get botulism each year in the U.S. Outbreaks happen more often west of the Mississippi River. More than half of the outbreaks happen in 5 states: California, Washington, Oregon, Colorado and Alaska.
  
  
• Botulism as a weapon has been used in the past to kill large groups of people.

Prevention hints:

• In the store:
  
  
  • Inspect packaging. Do not buy packages or containers that have holes, are torn, partially opened, or damaged in any other way.
    
    
  • Do not buy frozen food that looks like it was thawed and refrozen.
    
    
  • Do not buy spoiled food, or food in containers that are swollen or gassy.
    
    
  • Buy food from stores with a good reputation for handling food well.
    
    
  • Read and follow any use-by or sell-by dates on the package.
  
  
• At home:
  
  
  • Do not give honey to babies under 1 year old. Infant botulism is often caused by giving babies honey.
    
    
  • When you open a container, inspect the food inside. If the food is not the right color, is moldy or smells bad, throw it away.
    
    
  • Follow preparation directions on the label.
    
    
  • Do not taste any food you think may be contaminated (foods that may have botulism in them).
  
  
• Handling possibly contaminated (kun-TAM-ih-na-ted) food:
  
  
  • If you buy food and think it may be contaminated call your local health department. Or call the USDA Meat and Poultry hotline (1-800-535-4555; TDD/TTY: 1-800-256-7072) for further instructions.
    
    
  • If you open any food in your kitchen you think is contaminated:
    
    
    • Thoroughly scrub the can opener or other utensils, containers, counters, that may have touched the food or its container.
      
      
    • Throw away any sponges or cloths used in the cleanup.
      
      
    • Wash your hands carefully and completely. Wash any clothes that may have been splattered with the contaminated food.

Should I worry about botulism toxin type A (Botox®)? Many valuable medicines are made of natural substances that can also kill. Scientists find a dose that is helpful, and not harmful, to make a medicine work. Botox® was approved for use in April 2002 by the FDA as a safe and effective treatment.

Where can I get more information about botulism?

• Centers for Disease Control and Prevention
  National Center for Infectious Diseases
  Phone: 1-888-4437232
  Web Address: http://www.cdc.gov/ncidod/
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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