Botulism, a paralytic illness, is rare, but it can cause serious, paralyzing symptoms and may be fatal. The disease is caused by a nerve toxin formed from a bacterium (germ), called Clostridium botulinum, which is found in soil.
There are seven known botulism toxins (poisons), but only toxins type A, B, E, and F are harmful to humans.
On average, only 110 cases of botulism are reported in the United States each year. Of these:
- 25% are foodborne botulism
- 72% are infant botulism
- 3% are wound botulism
Infant botulism is a very rare disorder in the Chicago area.
Botulism is treated by the specialists in Lurie Children's Division of Infectious Diseases. Learn more.
There are three kinds of botulism, characterized differently on the basis of their means of exposure:
This type of botulism is caused by eating food contaminated with a botulism toxin. Foodborne botulism can affect a great number of people who eat contaminated food. The World Health Organization (WHO) considers botulism one of the four most likely agents to be used in biological warfare (a state in which infectious agents or toxic chemicals are being used as a weapon of mass destruction).
This type of botulism is caused by a botulism toxin that is produced from a wound that was contaminated with Clostridium botulinum.
This type of botulism occurs when infants consume spores of Clostridium botulinum, which then release toxins in the intestines.
Diagnosis & Treatment
The patient's history and physical examination may lead to a diagnosis of botulism. However, since botulism resembles other diseases, other diagnostic testing may be necessary, including the following:
Computed tomography scan (Also called a CT or CAT scan)
This diagnostic procedure that uses a combination of x-rays and computer technology to produce cross-sectional pictures of the body. A CT scan can show detailed images of any part of the body, including the brain, bones, muscles, fat, and organs. CT scans are more detailed than routine x-rays.
Spinal tap (Also called a lumbar puncture)
A small amount of fluid can be removed and sent for testing to determine if there are signs of an infection or other problems.
This test measures the electrical activity of a muscle or a group of muscles. An EMG can detect abnormal electrical muscle activity.
Test for botulism toxin poisons in the patient's serum or stool.
The symptoms of foodborne botulism usually occur 18–36 hours after eating contaminated food. However, symptoms may occur as early as six hours or as late as 10 days following exposure. The following are generally the most common symptoms of botulism. However, individuals may experience symptoms differently.
Symptoms may include:
- Double vision or blurred vision
- Drooping eyelids
- Slurred speech
- Difficulty swallowing
- Dry mouth
- Muscle weakness
Infants with botulism may seem lethargic, feed poorly, experience constipation, and have a weak cry and appear floppy. If left untreated, symptoms may progress to paralysis of the arms, legs, trunk, and breathing muscles.
The symptoms of botulism may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
Specific treatment for botulism will be determined by your physician based on:
- Your child's age, overall health and medical history
- Extent of the condition
- Your child's tolerance for specific medications, procedures or therapies
Treatment may include:
- Antitoxin treatment for foodborne and wound botulism (when diagnosed early)
- Removal of contaminated food in the gut through induced vomiting or enemas in food botulism
- Surgical treatment for infected wounds (to remove the source of the toxin) in wound botulism
- Respiratory assistance (ventilator) for patients who need this
- Intensive medical and supportive care including antibiotics
Recovery from botulism may take many weeks. Fatigue and shortness of breath may persist for years.