The source of botulism is Clostridium botulinum, an organism found in soil and untreated water that produces a strong neurotoxin, or nerve poison. An average of 145 cases of botulism are reported each year in the United States, notes the Centers for Disease Control and Prevention. Botulism occurs in three forms: food-borne, wound and infant botulism. All forms are potentially fatal, but the percentage of patients who die from botulism has dropped in the past 50 years from 50 percent to 3 to 5 percent. The recovery period is lengthy, and patients who survive may suffer long-term fatigue and shortness of breath.
Contaminated Food
Approximately 15 percent of all botulism cases are caused by eating food contaminated with C. botulinum. Home-canned, low-acid foods such as green beans, corn and beets are often the source, but commercially prepared foods, including seafood, baked potatoes, garlic-infused oil and chili peppers, are responsible for about 10 percent of food-borne botulism cases. Early symptoms, beginning about 18 to 36 hours after ingestion, include nausea, vomiting, diarrhea and abdominal cramps, according to the Merck Manual. Later, when the toxin begins to disrupt nerve function, the patient experiences bilateral weakness, paralysis, double vision and difficulty swallowing and speaking. Food-borne botulism, which can affect any age group, is treated with an antitoxin and hospitalization.
Wound Infection
When C. botulinum enters the body through a wound or injection with a contaminated needle, the bacteria multiply and produce a toxin that causes similar neuromuscular symptoms to those that occur in food-borne botulism. However, the patient does not experience gastrointestinal symptoms with this form of the illness. Wound botulism, which currently accounts for approximately 20 percent of botulism cases in the United States, has become more prevalent among users of black tar heroin, which can contain spores of the bacteria, reports the Merck Manual. Wound botulism requires surgical removal of the infected tissue in addition to administration of an antitoxin and hospitalization of the patient.
Infant Botulism
Infant botulism occurs when a child ingests spores of C. botulinum, which grow and multiply in the large intestine. Sometimes the source is honey or corn syrup, but environmental exposure may also cause the illness, according to the Mayo Clinic. In contrast to food-borne botulism, the toxin is not preformed before ingestion and is not caused by contaminated food. Infant botulism symptoms include constipation, weakness without loss of consciousness, poor muscle tone, weak cry, respiratory distress, poor feeding and weak sucking in a child up to the age of 12 months. Botulism immune globulin is used to treat infant botulism.
