Foodborne illness brought about by Clostridium botulinum

by Twinnee M. Baares

Characteristics Clostridium botulinum is an anaerobic, Gram-positive, spore-forming rod that produces a potent neurotoxin. The spores are heat-resistant and can survive in foods that are incorrectly or minimally processed. Seven types (A, B, C, D, E, F and G) of botulism are recognized, based on the antigenic specificity of the toxin produced by each strain. Types A, B, E and F cause human botulism. Types C and D cause most cases of botulism in animals. Animals most commonly affected are wild fowl and poultry, cattle, horses and some species of fish. Although type G has been isolated from soil in Argentina, no outbreaks involving it have been recognized. Foodborne botulism (as distinct from wound botulism and infant botulism) is a severe type of food poisoning caused by the ingestion of foods containing the potent neurotoxin formed during growth of the organism. The toxin is heat labile and can be destroyed if heated at 80C for 10 minutes or longer. The incidence of the disease is low, but the disease is of considerable concern because of its high mortality rate if not treated immediately and properly. Most of the 10 to 30 outbreaks that are reported annually in the United States are associated with inadequately processed, home-canned foods, but occasionally commercially produced foods have been involved in outbreaks. Infant botulism is the most common form of botulism. See below for symptoms specific to infant botulism. Associated foods The types of foods involved in botulism vary according to food preservation and eating habits in different regions. Any food that is conducive to outgrowth and toxin production, that when processed allows spore survival, and is not subsequently heated before consumption can be associated with botulism. Almost any type of food that is not very acidic (pH above 4.6) can support growth and toxin production by C. botulinum. Botulinal toxin has been demonstrated in a considerable variety of foods, such as canned corn, peppers, green beans, soups, beets, asparagus, mushrooms, ripe olives, spinach, tuna fish, chicken and chicken livers and liver pate, and luncheon meats, ham, sausage, stuffed eggplant, lobster, and smoked and salted fish.

Target Populations All people are believed to be susceptible to the foodborne intoxication.

Symptoms of Botulism Botulism neurotoxins prevent neurotransmitters from functioning properly. This means that they inhibit motor control. As botulism progresses, the patient experiences paralysis from top to bottom, starting with the eyes and face and moving to the throat, chest, and extremities. When paralysis reaches the chest, death from inability to breathe results unless the patient is ventilated. Symptoms of botulism generally appear 12 to 72 hours after eating contaminated food. With treatment, illness lasts from 1 to 10 days. Full recovery from botulism poisoning can take weeks to months. Some people never fully recover. In general, symptoms of botulism poisoning include the following:

Nausea Vomiting Fatigue Dizziness Double vision Dry skin, mouth and throat Drooping eyelids Difficulty swallowing Slurred speech Muscle Weakness Body Aches Paralysis Lack of fever Infant botulism takes on a different form. Symptoms in an infant include lethargy, poor appetite, constipation, drooling, drooping eyelids, a weak cry, and paralysis.

Long-Term Effects of Botulism The majority of botulism patients never fully recover their pre-illness health. After three months to a year of recovery, persisting side-effects are most likely permanent. These long-term effects most often include fatigue, weakness, dizziness, dry mouth, and difficulty performing strenuous tasks. Patients also report a generally less happy and peaceful psychological state than before their illness.

Botulism Diagnosis If a patient displays symptoms of botulism, a doctor will most likely take a blood, stool, or gastric secretion sample. The most common test for botulism is injecting the patients blood into a mouse to see whether the mouse displays signs of botulism, since other testing methods take up to a week. Sometimes botulism can be difficult to diagnose, since symptoms can be mild, or confused with those of Guillan-Barre Syndrome. Treatment Of Botulism If found early, botulism can be treated with an antitoxin that blocks circulation of the toxin in the bloodstream. This prevents the patients case from worsening, but recovery still takes several weeks.

Prevention of Botulism Since botulism poisoning most commonly comes from foods improperly canned at home, the most important step in preventing botulism is to follow proper canning procedure. Ohio State Universitys Extension Service provides a useful guide to sanitary canning techniques. Further botulism prevention techniques include:

Not eating canned food if the container is bulging or if it smells bad, although not all strains on Clostridium Botulinum smell Storing garlic or herb-infused oil in the refrigerator Not storing baked potatoes at room temperature To prevent infant botulism, do not give even a small amount of honey to an infant, as honey is one source of infant botulism.