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Botulism: Causes, Symptoms & Prevention

Sylvia Rose

Botulism is a serious food-borne illness caused by potent toxin of the bacterium Clostridium botulinum. This neurotoxin can lead to paralysis and may be life-threatening without immediate treatment.



emergency

Botulism is primarily recognized as a foodborne illness acquired by eating food tainted with botulinum toxin. Symptoms emerge 18 - 36 hours after ingesting contaminated food.


This is the most common form. In low-oxygen environments, spores germinate and bacteria multiply, releasing deadly toxin. Clostridium botulinum thrives in environments with little to no oxygen.



bacteria
Clostridium botulinum club & rod shapes (image courtesy of CDC)

Improper home canning and preserves are leading causes of foodborne botulism. Low-acid foods like green beans, corn and meats are especially vulnerable.


Besides foodborne botulism, there are other types. They include wound botulism, infant botulism, and adult intestinal colonization botulism and Botox poisoning.



sick

Wound botulism occurs when spores enter the body through broken skin. This is frequently seen in intravenous drug users who inject contaminated substances.


Spores can also enter wounds which are deep or contaminated with soil, They germinate in the anaerobic conditions and produce toxin. Botulinum toxins are among the most potent known to science



fish
canned fish and other low-acid foods are especially risky

Infant botulism occurs when infants consume spores, usually from sources like honey or contaminated environments. The underdeveloped digestive systems of infants make them particularly susceptible.


Clostridium botulinum spores colonize the intestines and produce the toxin. Honey is a known source of spores and should not be given to infants under one year of age.


Iatrogenic Botulism is a rare form of botulism. It can occur from overdoses of botulinum toxin (Botox) injections used for medical or cosmetic purposes.



honey
honey can be toxic to infants

Adult intestinal toxemia, also called adult intestinal colonization, is an extremely rare form of botulism. It occurs when bacterial spores enter an adult's intestines, develop and generate the toxin, much like in infant botulism.


Clostridium botulinum and Its Toxin


Clostridium botulinum is an anaerobic, Gram-positive, spore-forming bacterium. While the bacterium itself isn't inherently harmful, its production of the botulinum toxin makes it dangerous.


Eight+ distinct types of botulinum toxin have been identified, each with varying degrees of potency. As little as 2 ng/kg of some strains can lead to severe effects. Other strains of Clostridium can mimic botulism symptoms.



copy
just a copy ...

Effects and Symptoms


The botulinum toxin disrupts nerve function by blocking the release of acetylcholine, a neurotransmitter responsible for muscle contraction. This leads to a characteristic descending paralysis.


It usually starts in the head and works its way down the body. Common symptoms include:


  • double or blurred vision

  • drooping eyelids

  • slurred speech

  • difficulty swallowing

  • dry mouth

  • muscle weakness

  • difficulty breathing

  • constipation

  • paralysis

  • respiratory failure

  • death


Symptoms can emerge suddenly.



hospital

The toxin is released from the bacterium as a single chain, then becomes activated when cleaved by its own proteases. Botulinum toxin functions by breaking down essential proteins needed for nerve activation.


The toxin attaches to the surface of neurons which use the neurotransmitter acetylcholine. The neuron internalizes the toxin into a vesicle through receptor-mediated endocytosis.


As the vesicle travels deeper into the cell, it becomes more acidic. This activates a part of the toxin enabling it to penetrate the vesicle membrane and enter the cell's cytoplasm.



cell
human cell

Killing the Pathogen: Heat and Oxygen


The botulinum toxin is heat-labile and can be inactivated by boiling food for several minutes. Heating to 85 °C (185 °F) for at least 5 minutes can neutralize the toxin; spores are highly resistant to heat.


Proper sterilization is essential to eliminate spores when canning or preserving foods. Pressure cookers can destroy spores of C. botulinum. The bacteria are also obligate anaerobes, meaning they can't live in oxygen.


Botulism bacteria and spores are vulnerable to salt. 10% salt will deactivate spores and kill microbes. The typical salt concentration in fermenting brine is less than half that, though in some cases it can go up to 20%.



salt
salt

Unique Survival Skills and Traits


Clostridium botulinum spores are resilient, allowing them to survive in harsh environments for extended periods. They can withstand high temperatures, radiation and chemical disinfectants.


This hardiness makes them strong survivors but a major challenge in food preservation and sterilization. Clostridium botulinum is in soil, sediment, and even intestinal tracts of some animals such as (healthy) fish and pigs.



piglets
cute piglets

Its widespread distribution means contamination is a constant risk in food processing and handling. Spores can persist for many years, waiting for the right environmental conditions.


Clostridium botulinum toxins convey no smell, taste or visual cues. Food looks and tastes normal.



boiling
heat can kill botulism bacteria and most other microbes

Botulinum antitoxin can be administered to prevent symptoms from getting worse, but cannot reverse existing nerve damage. Mechanical ventilation might be needed to prevent respiratory failure. The nerve damage may recover over weeks to months.


In medicine, botulinum toxin is given to treat muscle spasms associated with conditions like cerebral palsy. It's also used in other muscle disorders, migraines and excessive sweating, besides its well-known cosmetic use.



botox

Prevention of Botulism


Preventing botulism is a focus of food safety practices. Some preventative measures include:


  • Proper Canning Techniques: Follow recommended procedures for home canning. Ensure accurate processing times and temperatures to kill Clostridium botulinum spores.

  • Avoid Damaged Cans: Discard any canned goods with bulging lids, leaks, or signs of spoilage. Don't taste food from suspicious looking cans.

  • Refrigeration: Refrigerate leftovers promptly and keep them at a temperature below 4°C (40°F) to prevent growth of C. botulinum.

  • Avoid Honey for Infants: Do not give honey to infants under one year of age due to the risk of infant botulism.

  • Wound Care: Clean wounds thoroughly and get medical attention for deep or heavily contaminated wounds. Tetanus is another concern here if the patient is not vaccinated.

  • Avoid Home Canning Certain Foods: Foods like garlic in oil or asparagus are especially risky.

  • Hygiene: Clean and sterilize equipment and jars during food preparation to minimize contamination hazards.

  • Storage: Keep canned items in a cool, dark location, and be aware of their expiration dates.



preserves
store in a cool dark place

Non-Fiction Books:


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