Q: What is botulism?
Botulism is a rare but serious paralytic illness caused by a nerve toxin ("botulinum toxin") that is produced by the bacterium Clostridium botulinum. There are three forms of botulism - foodborne, infant, and wound.
Q: Who is at risk?
Foodborne botulism can affect anyone who eats food containing the toxin. Infant botulism almost exclusively affects children under 1 year of age, but can rarely affect adults. Wound botulism - though rare - can affect anyone.
Q: How is botulism spread?
Foodborne botulism is acquired by ingestion of foods in which toxin has been formed, predominantly after inadequate heating during canning or subsequent inadequate cooking (of the canned foods). Other less common sources of spread have been reported, including minced garlic in oil, improperly handled baked potatoes wrapped in aluminum foil, and homecanned or fermented fish. Infant botulism is acquired by ingestion of botulinum spores that then grow in the intestine and produce toxin. Possible sources of spores include foods (including honey) and dust. Wound botulism is often acquired from contamination of wounds, but can also be due to injection drug use.
Q: Is botulism contagious?
There have been no reports of person-to-person spread of botulism.
Q: What are the symptoms of botulism?
Symptoms of botulism are due to the paralyzing effect of the toxin, and may include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. These symptoms may progress to include paralysis, respiratory failure and death. In foodborne botulism, symptoms generally begin 12 to 36 hours after eating contaminated food, but can occur as early as 6 hours to as late as 10 days.
Q: How is botulism diagnosed?
Foodborne botulism is diagnosed by finding botulinum toxin in blood, stool, stomach contents or incriminated food; or by culture of Clostridium botulinum from stomach contents or stool. Infant botulism is diagnosed by finding Clostridium botulinum organisms and/or toxin in patient's stool. Wound botulism is diagnosed by demonstration of toxin in serum or by culture of Clostridium botulinum from the wound.
Q: How is botulism treated?
Good supportive care in a hospital is the mainstay of treatment for all forms of botulism. Specific treatment includes administration of botulinum antitoxin. In foodborne botulism, other treatment may be warranted, including the removal of contaminated foods still in the gut by induction of vomiting or by use of enemas. In wound botulism, the wound should be thoroughly cleansed and may need surgical debridement.
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Q: How can botulism be prevented?
Persons who do home canning or other food preservation techniques should follow strict hygienic practices and observe proper canning techniques. In addition, those eating home canned-foods should consider boiling foods for at least 10 minutes before eating, as this will destroy the toxin. Because honey can contain spores of Clostridium botulinum, and this has been a source of infection for infants, children less than 12 months should not be fed honey. Wound botulism can be prevented by promptly seeking medical care for infected wounds.
