Most people know that botulism is dangerous, but many are confused about whether it’s an infection or a case of poisoning. In fact, it can be both. Clostridium botulinum is a worldwide bacterium that inhabits rivers, soil, and the guts of mammals, fish, and shellfish. It’s not an organism that normally makes its living by attacking humans. We most often encounter C. botulinum by accident.
C. botulinum secretes a neurotoxin (nerve poison) that can weaken or paralyze muscles and can even cause death. This is botulin toxin, one of the most dangerous substances known. Botulism is the condition of having been poisoned with C. botulinum toxin.
Botulism is rare, but there are still cases every year.
There are 6 ways to get botulism:
Rarely, toxins can be inhaled or absorbed through the eyes.
Botulism can cause death due to paralysis of muscles used in breathing. However, advancements in supportive care have greatly reduced the death rate, and now less than 10% of people who get botulism die from the condition.
Supportive care is provided to anyone with botulism. This may include hospitalization, use of a ventilator to help with breathing, and nursing care. Recovery can take many weeks as paralysis slowly improves.
While there is a botulism antitoxin and immune globin therapy, they are not approved for sale in Canada and are currently only available through Health Canada’s Special Access Program.
The antitoxin works by neutralizing botulin. However, the antitoxin needs to be administered as soon as possible after diagnosis. The medication can’t repair nerve endings already damaged. This means that while you may survive, you will be temporarily left in the state you were in at the time the medication was administered. That may mean paralysis, sometimes to the point of being unable to talk or even swallow.
The good news is that you’ll recover, because new nerves can grow to replace those that were killed. However, this is a slow recovery process and it may take weeks or months, even up to a year, for this to occur.
For wound botulism, antibiotics are given in addition to supportive care.
Preventing botulism is usually possible. However, if you prepare and store a lot of your own food, you may be creating unnecessary risk. The C. botulinum bacterium is anaerobic, meaning it likes airless environments. This is why you can get foodborne botulism out of a can. Very few cases of botulism arise from commercially canned food. Most occur when individuals can their own products.
Botulin toxin has been found in North America in these foods:
Only highly acidic foods are safe from C. botulinum. Freezing will shut down toxin production, but a fridge isn’t cold enough. The following food handling procedures can help you to prevent foodborne botulism:
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