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botulism(bŏch`əlĭz'əm), acute poisoning resulting from ingestion of food containing toxins produced by the bacillus Clostridium botulinum. The bacterium can grow only in an anaerobic atmosphere, such as that found in canned foods. Consequently, botulism is almost always caused by preserved foods that have been improperly processed, usually a product canned imperfectly at home. The toxins are destroyed by boiling canned food for 30 min at 176°F; (80°C;). Once the toxins (which are impervious to destruction by the enzymes of the gastrointestinal tract) have entered the body, they interfere with the transmission of nerve impulses, causing disturbances in vision, speech, and swallowing, and ultimately paralysis of the respiratory muscles, leading to suffocation. Symptoms of the disease appear about 18 to 36 hr after ingestion of toxins. Botulinus antiserum is given to persons who have been exposed to contaminated food before they develop symptoms of the disease and is given to diagnosed cases of the disease as soon as possible. Developments in early detection have reduced the mortality rate from 65% to 10%.
See food poisoningfood poisoning,
acute illness following the eating of foods contaminated by bacteria, bacterial toxins, natural poisons, or harmful chemical substances. It was once customary to classify all such illnesses as "ptomaine poisoning," but it was later discovered that ptomaines, the
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Medicinal Use of Botulin Toxin
In a technique pioneered by Alan B. Scott, an ophthalmologist, and Edward Schantz, a biochemist, in the late 1970s, botulin toxin has been purified and used in the treatment of debilitating muscle spasms caused by the excessive firing of certain nerves. The treatment utilizes the same process that paralyzes the muscles in botulism poisoning. Injected in tiny amounts into the affected tissue, the botulin blocks the release of acetylcholine, a neurotransmitter that controls muscle contraction, and temporarily relieves the spasms. Botulin was approved by the Food and Drug Administration in 1989 for treatment of blepharospasm (uncontrolled rapid blinking) and strabismus (crossed eyes). The toxin is also injected to treat other conditions, such as neck muscle spasms, and to provide short-term (three to four months) cosmetic treatment of facial wrinkles.
An illness produced by the exotoxin of Clostridium botulinum and occasionally other clostridia, and characterized by paralysis and other neurological abnormalities. There are seven principal toxin types involved (A–G); only types A, B, E, and F have been implicated in human disease. Types C and D produce illness in birds and mammals. Strains of C. barati and C. butyricum have been found to produce toxins E and F and have been implicated in infant botulism. See Virulence
The three clinical forms of botulism are classic botulism, infant botulism, and wound botulism. Classic botulism is typically due to ingestion of preformed toxin, infant botulism involves ingestion of C. botulinum spores with subsequent germination and toxin production in the gastrointestinal tract, and wound botulism involves production of toxin by the organism's infecting or colonizing a wound. The incubation period is from a few hours to more than a week (but usually 1–2 days), depending primarily on the amount of toxin ingested or absorbed.
There is classically acute onset of bilateral cranial nerve impairment and subsequent symmetrical descending paralysis or weakness. Commonly noted are dysphagia (difficulty in swallowing), dry mouth, diplopia (double vision), dysarthria (a neuromuscular disorder affecting speech), and blurred vision. Nausea, vomiting, and fatigue are common as well. Ileus (impaired intestinal motility) and constipation are much more typical than diarrhea; there may also be urinary retention and dry mucous membranes. Central nervous system function and sensation remain intact, and fever does not occur in the absence of complications. Fever may even be absent in wound botulism. See Toxin
In food-borne botulism, home-canned or home-processed foods (particularly vegetables) are commonly implicated, with commercially canned foods involved infrequently. Outbreaks usually involve only one or two people, but may affect dozens. In infant botulism, honey and corn syrup have been implicated as vehicles. Therapy involves measures to rid the body of unabsorbed toxin, neutralization of unfixed toxin by antitoxin, and adequate intensive care support. See Food poisoning
an acute toxic and infectious disease of the food toxemia group, caused by anaerobic bacteria and their toxins, and characterized by the overwhelmingly severe affection of the nuclei of the cranial nerves. Botulism is found in all parts of the world but more often in countries where the population uses many home-canned products. Mortality due to botulism among those affected in 1965 was 76.5 percent in England, 65 percent in the USA, 40.6 percent in Denmark, 31.9 percent in Japan, and 24.5 percent in the USSR.
The causative agent of botulism is a spore-forming rod, Clostridium botulinum, that belongs to the group of anaerobic microorganisms. There are six types of causative agents of botulism—A, B, C, D, E, and F—each of which produces a specific exotoxin which affects the nervous system. The spores of the causative agent of botulism are found in soil, from which they enter water and food products (fodder), and through them, the intestines of man and animals; they multiply in the intestines and are then dispersed on the earth’s surface in feces.
In humans Man is infected with botulism when the botulism rods and their toxins enter the digestive tract with food. Infection occurs through canned meat and fish (with unsanitary conditions of animal slaughter and processing of carcasses), vegetables, fruits, and canned mushrooms that have not been subjected to proper processing and sterilization. The exotoxin absorbed in the intestine circulates in the blood and affects the nuclei of the cranial nerves and of intracardial nerve ganglia. The incubation period—from the moment of infection to the appearance of the first symptoms of disease—varies from two hours to ten days; it is usually 18–24 hours. Botulism begins suddenly with the onset of weakness, frequent repeated vomiting, and constipation; the stomach is often distended. Body temperature may be slightly elevated or remain normal. After 3–4 hours dizziness appears, vision is disturbed; the patient sees all objects as though in a fog; there is often double vision and strabismus. The patient’s mouth feels dry and he is thirsty; swallowing food and even water becomes difficult; breathing disturbances are possible. Speech becomes indistinct and the voice very weak. Sometimes convulsions are observed. Death may result from paralysis of the heart or respiratory center.
A reliable diagnosis of botulism is made upon discovery of the toxins or microbes in the blood, vomitus, and so on of the patient. He must be hospitalized as soon as possible. Treatment requires specific antitoxic serum and artificial ventilation of the lungs in respiratory disturbances. Prophylaxis of botulism calls for the observance of sanitary hygienic rules in the preparation of canned foods and in the processing, transportation, and storage of raw foods.
In animals Botulism in animals is food poisoning characterized by paralysis of the pharyngeal musculature, tongue, and lower jaw. Horses, poultry, less frequently cattle, and, among fur bearers, mink are susceptible to botulism. Spores of the causative agent, entering fodder from the soil, germinate under favorable conditions. The botulism toxin, entering the intestine with fodder, is absorbed in the body. Treatment in the initial stage requires purgatives—for instance, arecoline, pilocarpine, and physostigmine—and at a later stage by heart medicines. Prophylaxis calls for the observance of hygiene in the feeding of animals. When the disease occurs on animal-breeding farms, the healthy population is vaccinated.
REFERENCESBunin, K. V. Diagnostika infektsionnykh boleznei. Moscow, 1965.
Matveev, K. I. Botulizm. Moscow, 1959.
Lukashev, I.I. “Botulizm.” In Veterinarnaia entsiklopediia, vol. 1. Moscow, 1968.
K. V. BUNIN