Botulism
Botulism (or botulism poisoning) is a rare but very serious illness that transmits through food, contact with contaminated soil, or through an open wound. Without early treatment, botulism can lead to paralysis, breathing difficulties, and death.
Types –
• Infant botulism
If babies swallow botulinum spores, the spores can germinate into bacteria.It typically occurs in babies between the ages of 2 months and 8 months. For example, they can swallow it from dust and soil, which is most common, or from honey. The bacteria can then release the toxin.
• Wound botulism
Botulinum spores can get into open wounds and slowly reproduce, eventually releasing the toxin. This type of botulism is associated with drug users who inject black tar heroin into their skin rather than their veins.
• Inhalation botulism
Breathing in the toxin is rare, though some nations have tried to make biological weapons that would spread a deadly form of the toxin into the air.
• Adult intestinal toxemia
This very rare kind of botulism is similar to infant botulism. Bacteria spores get into your intestines, where they grow and spread. It’s also called adult intestinal colonization. Adults with serious health conditions of the gut are at most at risk.
• Iatrogenic botulism
You can get this form of botulism if you have too much of the Botox toxin injected during a cosmetic or medical procedure; for example, when treating migraines or wrinkles.
Symptoms –
• Foodborne botulism
Signs and symptoms of foodborne botulism typically begin between 12 and 36 hours after the toxin gets into your body. But, depending on how much toxin was consumed, the start of symptoms may range from a few hours to a few days. Signs and symptoms of foodborne botulism include:
• Difficulty swallowing or speaking
• Dry mouth
• Facial weakness on both sides of the face
• Blurred or double vision
• Drooping eyelids
• Trouble breathing
• Nausea, vomiting and abdominal cramps
• Paralysis
• Wound botulism
Signs and symptoms of wound botulism appear about 10 days after the toxin has entered the body. Wound botulism signs and symptoms include:
• Difficulty swallowing or speaking
• Facial weakness on both sides of the face
• Blurred or double vision
• Drooping eyelids
• Trouble breathing
• Paralysis
The wound may or may not appear red and swollen.
• Infant botulism
If infant botulism is related to food, such as honey, problems generally begin within 18 to 36 hours after the toxin enters the baby’s body. Signs and symptoms include:
• Constipation, which is often the first sign
• Floppy movements due to muscle weakness and trouble controlling the head
• Weak cry
• Irritability
• Drooling
• Drooping eyelids
• Tiredness
• Difficulty sucking or feeding
• Paralysis
Certain signs and symptoms usually don’t occur with botulism. For example, botulism doesn’t generally increase blood pressure or heart rate, or cause fever or confusion. Sometimes, however, wound botulism may cause fever.
Causes –
The botulinum toxin, a poison produced by the bacterium Clostridium botulinum (C. botulinum), is common in soil and exists in untreated water. It can survive in these environments as a resistant spore.
C. botulinum produces spores that can survive in poorly preserved or canned foods. Here, they produce a toxin. When consumed, even minimal amounts of the toxin can cause severe poisoning.
Clostridium botulinum is the name of bacteria commonly found in soil all over the world. The bacteria are considered to be anaerobic, which means these organisms grow best in low or absent oxygen levels. Clostridium bacteria are gram-positive rod-shaped bacteria that form spores that allow the bacteria to survive in a dormant state until exposed to conditions that can support growth.
• There are seven types of botulism neurotoxin designated by the letters A through G.
• Only types A, B, E, and F cause illness in humans.
Complications –
Because it affects muscle control throughout your body, botulinum toxin can cause many complications. The most immediate danger is that you won’t be able to breathe, which is the most common cause of death in botulism. Other complications, which may require rehabilitation, may include:
• Difficulty speaking
• Trouble swallowing
• Long-lasting weakness
• Shortness of breath
Diagnosis –
If the patient’s history and physical examination suggest botulism, a doctor may consider it, but as other conditions share similar symptoms, a test will be needed to rule these out. Conditions with similar symptoms to botulism include stroke, myasthenia gravis, and Guillain-Barre syndrome.
Diagnostic tests may include:
• a brain scan
• cerebrospinal fluid examination
• electromyography
• edrophonium chloride test for myasthenia gravis
If the toxin is identified in the food, stomach, vomit, feces, or intestinal contents, a definitive diagnosis can be made.
In very acute cases the toxin might be detected in the blood.
Diagnosis of infant botulism is confirmed after testing a stool or specimen of enema.
Treatment –
For cases of foodborne botulism, doctors sometimes clear out the digestive system by inducing vomiting and giving medications to induce bowel movements. If you have botulism in a wound, a doctor may need to remove infected tissue surgically.
• Antitoxin
If you’re diagnosed early with foodborne or wound botulism, injected antitoxin reduces the risk of complications. The antitoxin attaches itself to toxin that’s still circulating in your bloodstream and keeps it from harming your nerves.
The antitoxin cannot, however, reverse the damage that’s been done. Fortunately, nerves do regenerate. Many people recover fully, but it may take months and extended rehabilitation therapy.
A different type of antitoxin, known as botulism immune globulin, is used to treat infants.
• Antibiotics
Antibiotics are recommended for the treatment of wound botulism. However, these medications are not advised for other types of botulism because they can speed up the release of toxins.
• Breathing assistance
If you’re having trouble breathing, you’ll probably need a mechanical ventilator for as long as several weeks as the effects of the toxin gradually lessen. The ventilator forces air into your lungs through a tube inserted in your airway through your nose or mouth.
• Rehabilitation
As you recover, you may also need therapy to improve your speech, swallowing and other functions affected by the disease.
Some Ayurvedic Formulations –
• Kaishor Guggulu
• Capsule Ashwagandha
• Tablet Shallaki
• Capsule Turmeric
• Vrihat Vatachintamani Ras
• Chandraprabha Vati
• Punarnava Mandoor
Prevention –
To reduce the risk of wound botulism, people are advised to seek urgent medical attention for any infected wounds and also to avoid injecting street drugs. It is important to practice good hygiene to ensure food safety.
• Follow any instructions carefully when canning food at home, or avoid canning food at home
• Boil home-processed foods for at least 10 minutes before eating, even if no signs of food spoilage are evident
• Do not taste canned food items to see if they are still good. Throw away any cans that are bulging, leaking, or appear damaged
• Keep potatoes that have been baked in foil hot until eaten
• Not give honey or corn syrup to infants under 12 months of age
• Ensure all foods are well-cooked
• Keep oils infused with garlic or herbs in a refrigerator
Boiling can destroy both the vegetative, or non-spore, form of the bacterium, and the toxin it produces.
To prevent wound botulism:
• Don’t abuse injectable drugs.
• Seek medical treatment for a wound with signs of infection.
• Clean and bandage any open wounds.
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