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The most common causative agent of Botulism is Clostridium botulinum. This bacterium is gram-positive, rod-shaped, anaerobic and spore-forming.

It can secrete botulinum neurotoxin (BoNT), the most potent of toxins, that can cause paralysis and/or death to those who have been infected.

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Botulism is not known to be communicable (spread person to person or be contagious).

Can be contracted through:

1. Food-borne: consumption of contaminated food

2. Contaminated wounds: can infect deep subcutaneous lacerations that provide a great environment for the toxin to proliferate

3. Air-borne: Inhaling the toxin can interact with the respiratory system to infect an individual

4. Botox: usually means patient has been injected with too much of the toxin

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Most common symptoms include:

Paralysis (present in all ages)

Trouble swallowing or speaking

Facial weakness on both sides of the face

Blurred or double vision

Drooping eyelids (present in all ages)

Trouble breathing

Infant botulism symptoms:

Constipation (the 1st symptom)

Floppy movement due to muscle weakness

Trouble sucking or feeding

Weak cry and irritability

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The most important virulence factor of botulism is that it is spore forming. This means the bacteria is highly resistant to extreme environments and remains dormant in order to protect its genetic material for later use.

It also contains a neurotoxin (BoNT) that directly targets the nervous system (our nerves, brain and spinal cord) to cause extreme muscle weakness.

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A definite diagnosis would be through any serum, vomit, gastric aspirate and stool.

Other tests include:

Checking symptoms

Cerebrospinal fluid testing

Urine tests

Brain imaging, electromyography

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May experience fatigue and shortness of breath even years after survival

May need long-term therapy / ventilators

Death from respiratory failure

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There are currently no vaccines

Practicing proper processing, storing, washing, cleaning and sterilization of canned items

Avoid giving infants (younger than a year) honey

Keeping wounds clean

Getting injections from ONLY licensed, trained practitioners

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Antibody therapy

Trivalent antitoxin contains botulinum toxin types A, B and E; this antitoxin develops antibodies which provide protection. It also neutralizes the free toxin molecule that have entered the body so that it can not bind to any nerve ending, thus preventing the spread of paralysis but not reversing it.

An antibiotic such as penicillin is given to destroy the Clostridium bacteria as well.

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According to the CDC the most confirmed number of cases were in California with 71 and the second most was Washington with 8 cases.

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EPIDEMIOLOGY OF CONFIRMED LABORATORY BOTULISM CASES (2018)

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EPIDEMIOLOGY OF CONFIRMED LABORATORY BOTULISM CASES (2018)

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Botulinum toxin is called "miracle poison" because though very dangerous it can be used to treat many medical conditions such as spasms, overactive smooth muscles, hypersalivation, hyperhidrosis, headaches, etc.

Important to note that doses should be infrequent and at the lowest effective dose possible.

Can be used cosmetically to fix lines, creases and wrinkling.

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It is rare, however with proper therapy many people fully recover (this can also be credited to our nerves repairing themselves throughout the healing process).

There are 7 serotypes of Clostridium botulinum (A to G); type A has the highest death rate and therefore is thought to be likely used as a biological weapon.

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In the 1930s, it is documented that C. botulinum was used by a Japanese warfare group as a bioweapon. Prisoners were fed the lethal bacterium.

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Shukla, H. D., and S. K Sharma. “Clostridium Botulinum: A Bug with Beauty and Weapon.” Login.tccd.idm.oclc.org, web-s-ebscohost-com.tccd.idm.oclc.org/ehost/detail/detail?vid=2&sid=8b41e231-f010-45c5-a918-f4a9f758cf37%40redis&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=16358279&anchor=AN0016358279-14.

Zhang, Jiu-Cong, et al. “Botulism, Where Are We Now?” Login.tccd.idm.oclc.org, web-p-ebscohost-com.tccd.idm.oclc.org/ehost/detail/detail?vid=6&sid=45a1979e-4526-4314-a6ed-472a957d96a0%40redis&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#anchor=AN0056474992-8. Accessed 21 Nov. 2022.

Nigam PK, Nigam A. Botulinum toxin. Indian J Dermatol. 2010;55(1):8-14. doi: 10.4103/0019-5154.60343. PMID: 20418969; PMCID: PMC2856357.

“Botulism - Diagnosis and Treatment - Mayo Clinic.” Mayoclinic.org, 2018, www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266.

“Botulism.” Centers of Disease Control and Prevention, 2019, www.cdc.gov/botulism/prevention.html.

Moawad, Heidi. “Why You Should Throw Away Dented Cans of Food.” Verywell Health, 25 Aug. 2022, www.verywellhealth.com/what-is-botulism-4142153.