Brief Description
Botulism is a rare condition that causes serious paralytic illness to a patient. The illness is caused by a nervy toxin produced by a bacterium known as clostridium botulinum. According to ANR Communication Services (2005), there are three major types of Botulism. These are;
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(a) Foodborne botulism- this is produced by consumption of food that has botulism contamination.
(b) Infant botulism- the cause of this is the consumption of bacteria of botulinum bacteria which breed in the bowels and produce the toxin.
(c) Wound botulism- this infection is caused by infections of clostridium botulinum in an open wound.
All types of botulism may be deadly and the medics refer to them as medical emergencies. For instance, foodborne botulism can cause a major threat to public health due to the level of exposure of patient to other people. There are high chances that more people can be at the risk of being poisoned from consuming the same polluted food.
The bacteria clostridium botulinum is commonly found in soil and survive in a condition where there is low supply of oxygen. These microorganisms form spores that enhance their survival in a latent state until the condition necessary for their growth are provided. The organisms may also grow in immature gastrointestinal track of foals or human infants, or human gastrointestinal track of people with certain abnormalities or anaerobic wounds. The botulinum toxins that can cause illnesses to human are seven and designated by letters A to G (Leclair, 2008).
Intermittent outbreaks and cases of botulism have previously been reported from both human and beasts. The infection is a major source of death to unvaccinated ranched horses and it can result to an epidemic in wild birds and ducks. Livestock an also be fed accidentally with feeds that are contaminated with the toxin and reports indicates that the toxin has continued to increase in cattle, perhaps due to increase in the use of plastic-packed fodder. These outbreaks can result to serious loss of human and livestock (Anderson, 2006). In other cases, cattle from regions that have phosphorus deficient soils may chew carcasses and that are infected with the toxin.
In America, an average of there is around 110 infections that are reported per year. Among these cases, wound botulism is roughly 3%, foodborne 25%, and infant botulism is the most rampant at 72%. According to The Centre for Public Health and Food Security (2010), most of the outbreaks that have been reported are basically caused by ingestion of contaminated home canned foodstuffs. In recent years, the number of cases for infant and foodborne botulism has reduced but wound infection is on the rise. This is due to increase in drug abuse such as injection of heroin specifically in California. In the US, California has the highest experience of this type of botulism and the WHO as reported this as the worst case in the world. Would botulism cases comprise to nearly ¾ of all cases diagnosed in the US.
In Senegal, the research indicates that it is comprised of soil favorable for the breeding of botulinum bacterium (ANR Communication Services, 2005).the infection is believed to be disastrous than any other known livestock disease. In addition, the bacteria has is reported in other different species of animals including dogs, cats, fowl, foxes, captive, farmed fish, and turtles. Patients and Infected animals by can be successfully treated but they may be required to take some few weeks under medication or months of intensive care. At times, they may be kept in isolation so as to ensure the patients are in an environment that is mechanically ventilated while the nerve endings continue to regenerate. Treatment for adult livestock may be unrealistic unless mild cases.
Causes of the Disease
Botulism is caused by the botulinum toxin. This is a potential neurotoxin that generated by C. botulinum and other species like C. butyricum and C. baratii. These are the most recently classifies species of C. argentinense. The toxin was formerly known as the G toxin and it can grow in a warm moist condition even in absence of oxygen. This growth takes place commonly in gram-positive spore making rods.
There are diverse bacteria that cause the toxin and may lead to seven different types of toxins A to G. according to (Leclair, 2008), the research describes a medley C/D toxic outbreak in birds and all these toxins produce the same medical symptoms in patient though some differences may be observed depending on the spread of the infection.
Therefore, if the physician is able to identify the type of toxin that caused the infection, it can be easy to administer the right antiserum for treatment. This is because one antiserum that may prove effective on one type of infection may not be perfect on the other. In addition, different toxins are responsible for producing botulism in different kinds of species. In human, the major cause of botulism is types A, B and E though there are rare epidemics caused by other types. In animals and birds, C and D types are the leading causes but in intermittent cases, while A, B and E may also be involved. In birds, stallions and minks, the known cause is type C toxin as reported in most parts of the world. Dogs that have ingested contaminated bird carcasses and livestock fed on poultry litter are found to be infected with type C and D.
Transmission of the Disease
All the species of the infection causing bacteria can produce spores; the latent forms of the bacterium are highly resilient to the common sterilizers, heat and atmospheric conditions that destroy the cells of the vegetables. The spores are able to survive perpetually until there environment provide a favorable condition that can allow it to grow and germinate. The organism lives in the intestinal tracts of birds, mammals, healthy fish, gills and viscera of crabs. The contaminant has been spotted in earthworms, snails, nematodes and worms ingesting on contaminated cadavers. Since the amphibians are vulnerable to the poison, they can be essential transmitters of the infection to species like birds.
Signs and Symptoms
According to The Center for Food Security and Public Health (2010), the initial systems are recurrent double blurred vision, loose eyelids, and dehydrated tender throats. Descending paralysis usually descending and symmetrical may also be experienced. After the infection affects the cranial nerve functions by slurring the speech, problematic swallowing and inability for the vertebral muscle to support the head, the respiratory muscled and extremities can then be paralyzed at times. Children suffering from the disease may appear lethargic, show poor feeding signs and constipation, weak crying power and poor muscle tone. The most common signs and symptoms of muscle paralysis are due to the bacterial toxin. The symptoms in foodborne botulism generally begin in the second day after ingesting contaminated food but they may show in as early as half a day or as late as over one week after ingestion.
Effects of Botulism to Healthy Body Functions
When botulism infection strikes, the neurotoxin paralyses the body to an extent that the muscles do not contract.
1. Cells
The toxin enters the nerve cells and interferes with the normal release of acetylcholine, a fluid that stimulates muscle contraction. Without the generation of new axon, the neuromuscular system is interfered with permanently.
2. Tissue organ
All the organs related to the neuron systems are also affected. This is the reason it takes long to recover from the illness.
3. Organ System
Apart from the neuron system, the respiratory organs are also interfered with to an extent that they may not perform their normal body functions (Heritage, Evans & Killington, 2001).
Available Diagnostic and Therapeutic Tools
The doctor should consider diagnosis of a patient if there are physical and historical information of examination that suggest botulism. However, the clues may not be enough to provide a ultimate analysis of botulism. There may be other diseases like Guillain-Barre Syndrome myasthenia gravis and stroke which may present similar signs like botulism where special tests may be required to distinguish the diseases from botulism.
Additional tests may include examination of the spinal fluid, brain scan, electromyography with tedious nerve shock and tension tests for myasthenia gravis. The more direct way of confirming the diagnosis is to check the patient’s stool, serum and wound by injecting the right clinical samples into mice and checking for observable botulism in mice. The California Department of Health services are one of the most reliable laboratories for diagnosis of botulism (CDC, 2002). In treatment, wound and food-borne botulism can be treated with antitoxin derived from horse serum which stops the circulation of toxin in the blood.
BOTOX has become one of the most common therapeutic tools to treat dystonia disorders and produce involuntary muscle contraction. The FDA approved the use of this injection in treatment of chronic migraines to adults who report a persistent headache for more than two weeks.
Prevention of Botulism
This helps in preventing the patient’s case from worsening but may not reverse paralysis. The doctor may attempt to remove the contaminated food in the food pipe by using enemas of inducing vomiting. Wounds may be treated through surgery or eliminating the source of the contaminant causing bacteria. In infant botulism, Botulism Immune Globulin, a drug commonly known as BIG is administered to infant botulism patients.
Potential Recovery
Most deaths that are botulism related generally result from the failure of respiratory system. Through improved supportive care especially on respiration, the chances of patient’s survival increases by 50%. A patient suffering from botulism may require ventilation and intubation support as well as exhaustive nursing and medical care for a number of months in the severe cases. Despite these efforts, the worse of cases tend to recover although the recovery period can be protracted and the patients experience easy fatigue and breathe shortness for a considerable amount of time.
People are advised to avoid consuming meat without proper examination by a qualified health practitioner. If one has an open would, it is advisable to keep it covered as a way of preventing botulism infection. Avoid eating lake meat from botulism prone regions to avoid ingesting on infected animals. Those who live in Botulism prone areas should seek medical advice whenever botulism signs and symptoms are felt.
Minimizing the spread of Botulism
In order to remove the botulism toxin in canned food, home canned foodstuff should be heated before consumption. A patient should seek emergency assistance immediately the signs of infection are detected. Early diagnosis and treatment essentially minimize the probable great risk of death. The government should also prompt epidemiological investigations as a critical way of preventing further cases of occurrence especially if the contaminated food is still available for consumption. Healthcare attendants who suspect any case of botulism infection should inform the epidemiology health offices immediately in order to provide support services to the affected.
Possible Outcomes of the Disease
Infant botulism does not have long term effects but there can be complications through nosocomial adversarial activities. The fatality rate per case is usually less than 1% for all recorded infants with botulism. In adverse cases, botulism can result to death due to failure in respiration.
Current Research and Future on Botulism
In 2011, the UCSF embarked on a research of the microorganism to access the safety of the vaccine. This study also involved the military in order to establish the possibilities of existence and use of the microbe as a bio weapon. This was the first recombination of researchers and human therapy in targeting the lethal neurotoxin (Bole, 2011).
According to Bole (2011), the scientist at the Institute of Food Research have developed a computerized model for predicting the possibilities of the bacteria’s growing under different combination of environmental factors like ph., temperature and salt concentration. The data may be useful to the food industry to formulate the best way of heating to prevent growth of microorganisms. This can be an important development in food research as in its possible advancement; the scientists may come up with a better food preservation and treatment method to kill the toxins.
