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FAQs about Botulism (Botulinum Toxin)
- What is Botulism?
- Botulism is a rare but serious paralytic illness caused by a nerve toxin that is produced by a bacteria called Clostridium botulinum. There are three main kinds of botulism. Foodborne botulism is caused by eating foods that contain the botulism toxin. Wound botulism is caused by toxin produced from a wound infected with Clostridium botulinum. Infant botulism is caused by consuming the spores of the botulinum bacteria, which then grow in the intestines and release toxin. All forms of botulism can be fatal and are considered medical emergencies. Foodborne botulism can be especially dangerous because many people can be poisoned by eating a contaminated food.
- Is Botulism a biological weapon?
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Botulism toxin is the most potent lethal substance known to man (lethal dose 1ng/kg). Botulism toxin is made by the bacterium Clostridium botulinum. Botulinum toxin has been developed as an aerosol weapon by several countries.
If people have intentionally been exposed, in a bioterrorist attack, breathing in the toxin or ingesting the toxin via contaminated food or water are the most likely routes of exposure that might lead to a serious illness (foodborne botulism).
Spores of Clostridium botulinum are found in soil worldwide. Terrorists with the technical capacity to grow cultures of the bacterium, and harvest and purify the toxin could therefore use it as a bioterrorism agent. Contaminating food with botulism toxin could cause a devastating event. - What are the symptoms of Botulism?
- Symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, muscle weakness which always moves down the body: first shoulders, then upper arms, then lower arms, then thigh, calves, etc. Paralysis of breathing muscles can cause a person to stop breathing and die, unless he/she is assisted by a ventilator.
- What is the incubation period?
- For foodborne botulism, symptoms begin from six hours up to two weeks after eating toxin-containing food; most commonly the delay is about 12-36 hours, but they can occur as early as 6 hours or as late as 10 days. Infants with botulism appear lethargic, feed poorly, are constipated, and have a weak cry and muscle tone.
- Who can get botulism?
- Foodborne botulism can occur in all age groups.
- Is Botulism contagious?
- Botulism is not spread person-to-person.
- What is the treatment for botulism?
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If diagnosed early, foodborne and wound botulism can be treated with an antitoxin which blocks the action of toxin circulating in the blood. This can prevent patients from worsening, but recovery still takes many weeks.
The paralysis and respiratory failure that occur with botulism may require a patient to be on a breathing machine (ventilator) for weeks, plus intensive medical and nursing care. The paralysis slowly improves, usually over several weeks. If diagnosed early, foodborne and wound botulism can be treated with an antitoxin from horse serum which blocks the action of toxin circulating in the blood. This can prevent patients from worsening, but recovery still may take many weeks. - Are there complications from botulism?
- Botulism can result in death due to respiratory failure. However, in the past 50 years the proportion of patients with botulism who die has fallen from about 50% to 8%. A patient with severe botulism may require a breathing machine as well as intensive medical and nursing care for several months. Patients who survive an episode of botulism poisoning may have fatigue and shortness of breath for years and long-term therapy may be needed to aid recovery.
- How can botulism be prevented?
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Because the botulism toxin is destroyed by high temperatures, persons who eat home-canned foods should consider boiling the food for 10 minutes before eating it to ensure safety. Instructions on safe home canning can be obtained the US Department of Agriculture. Because honey can contain spores of Clostridium botulinum and this has been a source of infection for infants, children less than 12 months old should not be fed honey. Honey is safe for persons 1 year of age and older. Wound botulism can be prevented by promptly seeking medical care for infected wounds and by not using injectable street drugs.
State health departments and CDC have persons knowledgeable about botulism available to consult with physicians 24 hours a day. If antitoxin is needed to treat a patient, it can be quickly delivered to a physician anywhere in the country.