Botulism

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Overview

Botulism (“BOT-choo-liz-um”) is a rare but serious illness caused by a toxin that attacks the body’s nerves and causes difficulty breathing, muscle paralysis, and even death. This toxin is made by Clostridium botulinum and sometimes Clostridium butyricum and Clostridium baratii bacteria. These bacteria can produce the toxin in food, wounds, and the intestines of infants.


The bacteria that make botulinum toxin are found naturally in many places, but it’s rare for them to make people sick. These bacteria make spores, which act like protective coatings. Spores help the bacteria survive in the environment, even in extreme conditions. The spores usually do not cause people to become sick, even when they’re eaten. But under certain conditions, these spores can grow and make one of the most lethal toxins known. The conditions in which the spores can grow and make toxin are:


Low-oxygen or no oxygen (anaerobic) environment

Low acid

Low sugar

Low salt

A certain temperature range

A certain amount of water

For example, improperly home-canned, preserved, or fermented foods can provide the right conditions for spores to grow and make botulinum toxin. When people eat these foods, they can become seriously ill, or even die, if they don’t get proper medical treatment quickly.


Symptoms

Difficulty swallowing.

Muscle weakness.

Double vision.

Drooping eyelids.

Blurry vision.

Slurred speech.

Difficulty breathing.

Difficulty moving the eyes.

Causes

Foodborne botulism is often caused by eating home-canned foods that have not been canned properly. Commercially canned foods are much less likely to be a source of botulism because modern commercial canning processes kill C. botulinum spores.

Risk factors

Botulism is a rare, but serious disease. Most people will go through their entire lives without getting sick with botulism.


Certain actions can increase your risk of getting sick with botulism.


People who inject certain drugs, such as black tar heroin, put themselves at greater risk of getting wound botulism.

People who drink certain kinds of alcohol they make themselves, such as prisoners who drink “pruno” or “hooch” made in prisons, put themselves at greater risk of getting foodborne botulism.

People who eat home-canned or home-fermented foods that haven’t been prepared safely also have a greater chance of becoming seriously sick. These foods may include many home-canned vegetables and meats, and traditional Alaska Native fermented foods.

People who get botulinum toxin injections for cosmetic reasons (such as for wrinkles) or medical reasons (such as for migraine headaches) may be more likely to get iatrogenic botulism if the dose they receive is too large, if they are children or weigh less than a typical adult, or if they have an underlying problem with their nerves or muscles.


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Complications

Infant botulism has no long-term side effects, but can be complicated by nosocomial adverse events. The case fatality rate is less than 1% for hospitalized infants with botulism.


Important complications of botulism include:[3][1][2]


Respiratory muscle weakness and impending respiratory failure

Long-lasting weakness

Difficult swallowing

Speech difficulties

Fatigue

Death from botulism mainly occurs from a few reasons:

Respiratory failure, possibly due to a delayed diagnosis.

Complications in the hospital such as a nosocomial infection, mostly due to pneumonia.

Prevention

refrigerating leftovers promptly.

using foods that are stored in oil within 10 days of opening.

keeping foods stored in oil, like vegetables and herbs, in the fridge.

making sure products marked 'keep refrigerated' are kept in the fridge.

Refrigerate any canned or pickled foods after you open them.

Always use traditional methods when preparing Alaska Native foods.

Refrigerate homemade oils infused with garlic or herbs and throw away any unused oils after 4 days.