Botulism

Definition

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

Causes, incidence, and risk factors

Clostridium 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 minute 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 is a special type in which living bacteria or its spores are ingested and grow within the infant's gastrointestinal tract. The most common cause of infant botulism is ingestion of honey or corn syrup.

Clostridium 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. Respiratory failure caused by weakness in the muscles that control breathing can cause death in up to 7% of food-related illness.

Symptoms

• difficulty swallowing and speaking
  
• progressive weakness with paralysis
  
• nausea, vomiting
  
• abdominal cramps
  
• dry mouth
  
• double vision
  
• breathing difficulty that may lead to respiratory failure
  
• breathing, absent temporarily
  
• no fever, usually
  
• in infants:
  o constipation
  o weakness, loss of muscle tone
  o weak cry
  o poor feeding and weak sucking
  o respiratory distress
  o appears alert but weak
  

Note: Symptoms usually appear between 8 to 36 hours after consuming contaminated food.

Signs and tests

• speech impairment
  
• muscle function/feeling loss
  
• eyelid drooping
  
• absent or decreased gag reflex
  
• absent or decreased deep tendon reflexes
  
• paralyzed bowel
  
• severe constipation
  
• urine retained in bladder with inability to urinate