Botulism is a rare but serious foodborne disease. It is caused by contamination of certain foods by the botulism bacterium commonly found in the soil. There are two different illnesses: adult botulism and infant botulism. An adult may become ill by eating spoiled food containing the botulism toxin. This toxin is produced when the bacteria grow in improperly canned foods and occasionally in contaminated fish. Infant botulism is caused by eating the spores of the botulinum bacterium. For infants one source of these spores is honey.
When contaminated food is eaten by adults, toxin is absorbed from the intestines and attaches to the nerves causing the signs and symptoms of botulism. Early symptoms include blurred vision, dry mouth, difficulty in swallowing or speaking, general weakness, and shortness of breath. The illness may progress to complete paralysis, respiratory failure, and death. When infants eat contaminated food, the spores grow in the intestines and release toxin.
Diagnosis is made by the presence of appropriate neurologic symptoms and by laboratory tests that detect toxin or by culture of Clostridium botulinum bacterium from the patient's stool.
Although there are very few cases of botulism poisoning each year, prevention is extremely important. Home canning should follow strict hygienic recommendations to reduce contamination of foods. In addition, because the botulism toxin is destroyed by boiling for 10 minutes, people who eat home- canned foods should consider boiling the food before eating it to ensure safety. A county extension home economist can provide specific instructions on safe home canning techniques. To help prevent infant botulism, infants less than 12 months old should not be fed honey.
Treatment for adults requires care in an intensive care unit; botulism antitoxin can be helpful if given soon after symptoms begin. Treatment for infants requires hospitalization and possibly care in an intensive care unit. Antitoxin is not recommended for infants.
Reprinted with permission from the Centers for Disease Control and Prevention
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