Botulism

Definition

Botulism is a rare but serious illness caused by the bacteria Clostridium botulinum. The bacteria may enter the body through wounds, or they may live in improperly canned or preserved food.

Causes, incidence, and risk factors

Clostridium botulinum is found in soil and untreated water throughout the world. It produces spores that survive in improperly preserved or canned food, where they produce toxin. When eaten, even tiny amounts of this toxin can lead to severe poisoning.

The foods most commonly contaminated are home-canned vegetables, cured pork and ham, smoked or raw fish, and honey or corn syrup. Botulism may also occur if the organism enters open wounds and produces toxin there.

Infant botulism occurs when living bacteria or its spores are eaten and grow within the baby's gastrointestinal tract. The most common cause of infant botulism is eating honey or corn syrup.

Clostridium botulinum also occurs normally in the stool of some infants.

Approximately 110 cases of botulism occur in the U.S. per year. The majority are in infants.

Symptoms

Symptoms usually appear between 8 - 36 hours after consuming contaminated food.

In adults, symptoms may include:

• Abdominal cramps
• Breathing difficulty that may lead to respiratory failure
• Difficulty swallowing and speaking
• Double vision
• Dry mouth
• Nausea
• Temporary lack of breathing
• Vomiting
• Weakness with paralysis

Symptoms in infants may include:

• Constipation
• Weakness, loss of muscle tone
• Weak cry
• Poor feeding and weak sucking
• Respiratory distress
• Alertness, despite weakness

Signs and tests

The doctor will perform a physical exam. There may be signs of:

• Speech impairment
• Muscle function/feeling loss
• Eyelid drooping
• Absent or decreased gag reflex
• Absent or decreased deep tendon reflexes
• Paralyzed bowel
• Urine retention with inability to urinate

Blood tests can be done to identify toxin. A stool culture may also be ordered. Lab tests can be done on the suspected food to confirm botulism.