Botulism

Background
Clostridium botulinum (C. botulinum) is a spore-forming bacterium that produces a very powerful neurotoxin that causes botulism. The toxin is among the most toxic of all naturallyoccurring substances. Botulism is usually associated with consumption of the toxin in food. However, in rare cases the toxin can be produced in infected wounds or in the intestinal tracts of young infants.C. botulinum spores can be found in soil and are very resistant to heat and other treatments. Because naturally occurring levels of spores are low, growth is required to produce toxin. C. botulinumgrows under anaerobic (no oxygen) conditions.

Symptoms and disease process
Symptoms usually develop within 12 to 36 hours after consumption of contaminated food. They include double or blurredvision, slurred speech, muscle weakness and flaccid paralysis that progresses down from the head, affecting the rest of the body. Paralysis of the respiratory system may eventually cause death if nottreated.

Infant botulism progresses in a different manner. The initial sign is constipation, followed by lethargy, inability to feed, floppiness and ultimately, respiratory failure. Infant botulismis rare and symptoms often take weeks to occur after consumption of spores, which grow and produce toxin in the infant’s intestine. As infants get older, they develop “healthy” bacteria in theirintestine that prevent the growth of the organism. Wound botulism occurs when C. botulinum cells infect a wound and grow, producing toxin, which is carried to other parts of the body in the bloodstream.Treatment includes removal of the toxin from the body through clearing contents of the stomach and intestine and administering antiserum. Prolonged supportive care, including artificial breathing withuse of a ventilator, is required in about 80 percent of cases. Botulism has a mortality rate usually less than 10 percent, assuming treatment is promptly administered. Recovery takes weeks to...