Botulism is a serious and potentially fatal illness caused by Clostridium botulinum. Food-borne botulism, caused by eating contaminated food, produces gastrointestinal symptoms followed by paralysis. Wound botulism, often the result of injecting illegal drugs, causes paralysis without gastrointestinal effects. Infant botulism, frequently caused by giving honey or corn syrup to a child under the age of 12 months, is characterized by constipation, weakness, poor feeding, weak sucking and respiratory distress. Treatment depends upon the form of the illness, the age and health of the patient and the severity of the symptoms, according to the University of Maryland Medical Center.
Antitoxin
Administering an equine antitoxin early in the course of food-borne or wound botulism can prevent the patient’s symptoms from worsening, according to the Centers for Disease Control and Prevention. For infant botulism, administering botulism immune globulin intravenous helps the patient to recover sooner, according to KidsHealth.
Induced Vomiting
Food-borne botulism is caused by ingesting contaminated food. Often, home-canned food is the source, although commercially prepared products have also been linked to food-borne botulism outbreaks. Inducing vomiting with activated charcoal or administering enemas can benefit patients with food-borne botulism by removing the source of the contamination from the digestive tract, reports the Merck Manual. Because the patient’s reflexes will be poor, vomiting should not be induced at home.
Surgical Treatment
Wound botulism is caused by Clostridium botulinum entering the body through a break in the skin. Often, injecting illegal drugs such as black tar heroin is the source of the contamination, according to the Centers for Disease Control and Prevention. Treatment requires surgical removal of infected tissue and antibiotic therapy in addition to hospitalization.
Hospital Care
Hospitalization is necessary for all forms of suspected botulism, reports the Centers for Disease Control and Prevention, to provide intensive nursing and medical care and monitoring. Patients with severe botulism can die from respiratory failure, so a ventilator—breathing machine—may be needed until the paralysis improves. In fact, notes Dr. Jeremy Sobel in the October 15, 2005 issue of “Food Safety,” in the early part of the 20th century, the mortality rate among patients with botulism was as high as 60 to 70 percent, even with the administration of antitoxin. The mortality rate began to drop in the late 1940s and 1950s when mechanical ventilation and intensive care techniques were developed, and 2010 it is between 3 and 5 percent. In addition to ventilation, patients need intravenous fluids, nasogastric tube feeding and careful monitoring for several weeks or even months.
