Clostridium botulinum is a bacterium that produces neurotoxins, which at very low doses cause muscle paralysis. Clostridium botulinum contamination can cause foodborne, infant and wound botulism. According to the Centers for Disease Control and Prevention, approximately 145 cases of botulism are reported each year in the United States, and about 15 percent are foodborne, 65 percent are infant botulism, and 20 percent are wound botulism. Also, the CDC reports that the incidence of mortality from botulism is between 3 and 5 percent of reported cases.
Foodborne Botulism
Foodborne botulism is caused by the ingestion of foods containing botulinum neurotoxin. Most cases of foodborne botulism result from the consumption of inadequately processed home-canned foods. Symptoms manifest 18 to 36 hours after consuming the contaminated food. Initially, optical and facial muscles are impaired. causing drooping of the eyelids, double vision, problems chewing and swallowing and slurred speech. Muscle paralysis may progress to the arms and legs, and in severe cases the breathing muscles are compromised, causing breathing difficulties and possibly coma and death.
Infant Botulism
Infant botulism is a rare disorder that was not recognized as an illness until 1976. Infants under the age of 12 months may be infected with spores of Clostridium botulinum, which colonize the intestinal tract and produce the botulinum neurotoxin. Normally colonization of the intestinal tract by Clostridium botulinum is prevented by other intestinal flora, but infants take a little while to develop this defense. The neurotoxin is absorbed into the bloodstream and can cause constipation, drooling and general muscle weakness. The most notable symptom in infants is the loss of head control. If left untreated, symptoms can progress to respiratory failure and death. The Food and Drug Administration approved a human-derived botulism antitoxin for treatment of infant botulism in 2003.
Wound Botulism
Wound botulism until recently was the rarest form of botulism. The illness is contracted when Clostridium botulinum infects a wound and during its growth produces the neurotoxin, which enters the bloodstream and causes the symptoms of muscle paralysis. A review article published in the November 2008 issue of “Current Neurology and Neuroscience Reports” reported that the incidence of wound botulism markedly increased in drug users in the western United States after the introduction of black tar heroin.
References
- Centers of Disease Control and Prevention: Botulism
- Food and Drug Administration: BBB Clostridium Botulism
- Food and Drug Administration: December 9, 2003 Correction Letter for October 23, 2003 Approval Letter – BabyBIG
- “Current Neurology and Neuroscience Reports”; Wound Botulism from Heroin Skin Popping
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