Botulism poisoning is a serious condition that is caused by the ingestion of foods with toxin produced by a bacteria---Clostridium botulinum---or by the contamination of wounds with the toxin. The symptoms begin 12 to 36 hours after exposure and the common signs include difficulty swallowing or speaking, blurred vision, troubled breathing, nausea, vomiting and abdominal cramps. Since botulism poisoning can be potentially fatal, the condition is considered a medical emergency and the treatment is usually administered in a hospital.
Antitoxin
Botulinum antitoxin is injected intravenously to control the progression of the disease. Although the antitoxin cannot reverse the neuro-muscular damage that has already taken place, it binds to the circulating toxin in the patient's bloodstream and prevents further damage of the nerve cells. A skin test should be performed before administering the botulinum antitoxin to ensure that the patient is not allergic to the serum. According to the U.S. Centers for Disease Control and Prevention, a single dose of the antitoxin is sufficient as the antitoxin can remain in the bloodstream for almost 10 days.
The antitoxin is often available at the local health department and can be ordered by the physician after reporting to the case to the health department. The local health department, in turn, has to report the case to the CDC. Due to the severity of the condition, the 24-hour emergency phone number of the health agencies can be used for the purpose.
Ventilator
Respiratory impairment is one of the common life-threatening complications of botulism poisoning and may require close management of the patient's vital capacity in the intensive care unit. A mechanical ventilator, which is a machine that can mechanically help the lungs to breath in and breath out air, is used to ease the troubled breathing. The device is inserted through a tube through the patient's nose or mouth, and according to MayoClinic.com, the patient may remain on the ventilator for several weeks until the effects of the toxin reduce.
Parentral Nutrition
The extensive neuro-muscular damage that occurs due to botulism poisoning can lead to swallowing difficulties and may prevent the patient from eating food. Fluids rich in nutrients such as glucose, amino acids, lipids, salts and vitamins are given to the patient intravenously, using a tube that is inserted through the nose.
Physical Therapy
Botulism toxins can cause extensive paralysis of the muscles. In fact, very small doses of the toxin can be used to relieve muscle spasms and to reduce wrinkles. An article in the June 2009 edition of the journal "Hand Therapy" states that a surprising number of hand and upper limb conditions have been successively treated with botulinum toxin.
For patients with botulism poisoning, however, this effect of the toxin can mean long-term disability and extensive physical therapy to improve speech and other functions affected by the toxin. Early diagnosis and prompt treatment often limit the damage and, hence, determine the type and the duration of the physical therapy required.
References
- U.S. Centers for Disease Control and Prevention: Botulism
- MayoClinic.com: Botulism
- MedlinePlus: Botulism
- "Hand Therapy"; Role of botulinum toxin in hand and upper limb disorders relevant to hand therapy; James Keir and Henk P Giele; June 2009
