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Food-Borne Botulism

Intoxication Botulism


Presentation

  • Most cases first presented with gastrointestinal symptoms followed by neurological symptoms, the most striking of which being difficulty in swallowing.[ncbi.nlm.nih.gov]
  • In this study, we present the features of eleven cases of food-borne botulism admitted to our hospital in 2001. All of the cases were caused by home-prepared foods; green beans.[ncbi.nlm.nih.gov]
  • Case Presentation A 32-year-old female presented to the emergency department with a few hours' history of shortness of breath and weakness associated with chest tightness, congestion, hoarseness of voice, and difficulty swallowing.[cureus.com]
  • Botulism classically presents as acute symmetrical descending flaccid paralysis. Its diagnosis is based on the detection of botulinum toxins in the patient's serum or stool specimens.[ncbi.nlm.nih.gov]
  • Patients may initially present with gastrointestinal distress, nausea and vomiting preceding neurological symptoms.[jhsph.edu]
Fatigue
  • 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.[foodborneillness.com]
  • Sometimes fatigue and shortness of breath can last for years.[drugs.com]
  • Signs and symptoms Symptoms in adults may include: an initial short period of diarrhoea and vomiting, followed by constipation blurred vision difficulty in speaking, swallowing and breathing dry mouth weakness, fatigue and ultimately paralysis of the[healthywa.wa.gov.au]
  • These are followed by neurological symptoms: visual impairments (blurred or double vision), loss of normal throat and mouth functions (difficulty speaking and swallowing; dry mouth, throat, and tongue; and sore throat), general fatigue, lack of muscle[fsis.usda.gov]
  • Torres tells the Sacramento Bee that within hours on consuming nacho cheese from a gas station on the way home from work, Kelly felt fatigued and she complained of double vision. She went to the hospital, but was sent home hours later.[self.com]
El Salvador
  • International locations: Bahamas, Barbados, Belize, Bermuda, El Salvador, Haiti, Guyana, Uruguay, Aruba, Panama, Saint Lucia, Suriname.[botulismblog.com]
Sputum
  • Extremely thick, tenacious sputum probably contributed to the high nosocomial pneumonia rate. Empirical antibiotic use to eliminate persistent C. botulinum was associated with unacceptably high nosocomial infection rates (p less than .01).[ncbi.nlm.nih.gov]
Hoarseness
  • Case Presentation A 32-year-old female presented to the emergency department with a few hours' history of shortness of breath and weakness associated with chest tightness, congestion, hoarseness of voice, and difficulty swallowing.[cureus.com]
Nausea
  • Of the 41 botulinal toxin-positive persons, 38 (93%) had at least three of the commonly recognized pentad of signs or symptoms--nausea and vomiting, dysphagia, diplopia, dilated and fixed pupils, or dry mouth and throat--and 20 (49%) required respiratory[ncbi.nlm.nih.gov]
  • 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[foodborneillness.com]
  • In rare cases, you may also experience nausea and vomiting. Infants with botulism may show signs such as weak cries, constipation, a flat facial expression, and difficulty breathing.[everydayhealth.com]
  • Symptoms: Muscle weakness Vision problems Dry mouth Difficulty speaking Nausea or vomiting, sometimes accompanied by diarrhea Trouble breathing/Respiratory failure Heart failure/Cardiac failure Paralysis starting from the top of the body, moving downwards[hnhu.org]
  • After botulinum toxins are ingested, the symptoms generally start with nausea, vomiting and dizziness.[lsuagcenter.com]
Abdominal Pain
  • Results: A 36 years-old patient “A”, a 49 years-old patient “B” and a 17 years-old patient “C” have abdominal pain, vomiting, difficulty swallowing and speaking, dyspnea, asthenia and xerostomia at day 1.[jle.com]
  • Gastrointestinal symptoms may include abdominal pain, diarrhea, or constipation. Death is usually caused by respiratory failure and airway obstructions.[fsis.usda.gov]
  • Early or mild symptoms, which may go away on their own, include: Abdominal pain, nausea, vomiting or diarrhea (not usually present in wound botulism) Double vision, blurred vision (especially when viewing close objects) or drooping eyelids Dryness of[drugs.com]
  • Symptoms of botulism can include fatigue, weakness and dizziness; blurred or double vision; dryness in the mouth, throat and nose and difficulty in swallowing and speaking; headache; nausea, vomiting, abdominal pain and, less commonly, diarrhea; and paralysis[canada.ca]
Proximal Muscle Weakness
  • Common clinical features included ptosis, ophthalmoplegia, proximal muscle weakness, pupillary abnormality, and respiratory failure.[ncbi.nlm.nih.gov]
Pupillary Abnormality
  • Common clinical features included ptosis, ophthalmoplegia, proximal muscle weakness, pupillary abnormality, and respiratory failure.[ncbi.nlm.nih.gov]
Withdrawn
  • The product, which was sold in Slovakia and the Czech Republic, was withdrawn from the market and a warning was issued immediately through the European Commission's Rapid Alert System for Food and Feed (RASFF).[ncbi.nlm.nih.gov]
  • The product, which was sold in Slovakia and the Czech Republic, was withdrawn from the market and a warning was issued immediately through the European Commission’s Rapid Alert System for Food and Feed (RASFF).[eurosurveillance.org]
Fixed Pupils
  • Of the 41 botulinal toxin-positive persons, 38 (93%) had at least three of the commonly recognized pentad of signs or symptoms--nausea and vomiting, dysphagia, diplopia, dilated and fixed pupils, or dry mouth and throat--and 20 (49%) required respiratory[ncbi.nlm.nih.gov]
  • Difficulty in breathing, moderate to severe ptosis, and dilated and fixed pupils were associated with respiratory failure.[ncbi.nlm.nih.gov]
Headache
  • Symptoms of botulism can include fatigue, weakness and dizziness; blurred or double vision; dryness in the mouth, throat and nose and difficulty in swallowing and speaking; headache; nausea, vomiting, abdominal pain and, less commonly, diarrhea; and paralysis[canada.ca]
Muscular Fasciculation
  • Rogers, Medicine [Baltimore] 43:517-545, 1964), and muscular fasciculations, which have been rarely reported.[ncbi.nlm.nih.gov]
Motor Symptoms
  • The patient's motor symptoms started ameliorating several days after the antitoxin injection.[ncbi.nlm.nih.gov]
Meningism
  • After Hours Emergencies For public health emergencies or hazards, such as outbreaks, food poisoning, meningitis or rabies, please call our after hours emergency phone number at 1-877-298-5888.[hnhu.org]

Workup

  • The general workup, including biochemical and hematological investigations, came out to be normal except for a mildly decreased serum calcium (7.9 mg/dl). The magnetic resonance imaging (MRI) scan of the brain was also normal.[cureus.com]
Listeria Monocytogenes
  • ., Staphylococcus aureus, Campylobacter Infections, Listeria monocytogenes, Salmonella spp., Shigella spp., Escherichia coli, Clostridium botulinum, Clostridium perfringens and Bacillus cereus.[books.google.com]
  • ., Listeria monocytogenes, Cronobacter sakazakii) are often treated by public health and regulatory agencies as being equally pathogenic; however, this is not necessarily true and is an overly conservative approach to ensuring the safety of foods.[books.google.de]
Clostridium Perfringens
  • ., Escherichia coli, Clostridium botulinum, Clostridium perfringens and Bacillus cereus.[books.google.com]
  • Along with the botulism bacteria, the recall notice mentioned Clostridium perfringens. That bacteria, according to the Centers for Disease Control and Prevention, causes “one million cases of foodborne illness in the United States each year.”[botulismblog.com]
Fusarium
  • Topics include: * Arcobacter/Helicobacter * Aspergillus * Bacillus cereus * Campylobacter * Clostidium perfringens * Clostridium botulinum * Escherichia coli * Fusarium * Listeria * Salmonella * Shigella * Staphylococcus aureus * Vibrio * Yersinia enterocolitica[books.google.de]

Treatment

  • This report provides a reminder to public health professions of the occurrence, diagnosis, treatment and control of this rare but serious food-borne disease.[ncbi.nlm.nih.gov]
  • Diagnosis and treatment are reviewed.[ncbi.nlm.nih.gov]
  • Recovery with this type of treatment can take weeks or months. Death can occur from respiratory failure if diagnosis and treatment are delayed. Those suspected of having food-borne botulism should seek medical treatment at a hospital immediately.[hnhu.org]
  • Management consisted of supportive measures, symptomatic treatment, and nursing care. Equine antitoxin was not administered and assisted ventilation was unnecessary.[ncbi.nlm.nih.gov]
  • Early diagnosis of the condition is essential for effective treatment. We report a case of food-borne botulism in identical twins characterized by severe initial oral involvement and a review of the literature about the condition.[ncbi.nlm.nih.gov]

Prognosis

  • A long incubation time was associated with a better prognosis. Although botulism is a potentially fatal disease, there was no mortality in this outbreak.[ncbi.nlm.nih.gov]
  • The prognosis depends on early diagnosis and administration of the antitoxin, which may reduce the further deterioration of muscle weakness and the severity of the disease [5].[cureus.com]
  • The patient’s respiratory vital capacity is closely monitored and a ventilation machine is provided for breathing support, if required Prognosis Botulism tends to occur in small outbreaks.[news-medical.net]
  • […] in the USA: Prompt treatment of infant botulism type A or type B was found to be safe and effective in shortening the length and cost of the hospital stay and the severity of illness. [ 6 ] Further evaluation has supported the initial findings. [ 7 ] Prognosis[patient.info]
  • An earlier diagnosis will result in better prognosis of foodborne botulism [10]. An infected person, in some cases, will not be able to breathe, which is the most common cause of death in botulism [14].[microbewiki.kenyon.edu]

Etiology

  • Foodborne botulism accounted for 2 illnesses, or 1 percent of all cases, with 1 death, infant botulism for 135 illnesses, or 88 percent of all cases, wound botulism for 14 illnesses, or 9 percent of all cases, and botulism of unknown or other etiology[foodsafetynews.com]
  • Of these, 20 were foodborne, 102 infant, 13 wound, and 5 of unknown or other etiology (CDC 2013). Then, in 2014 there were 161 confirmed and 16 probable cases of botulism reported.[edis.ifas.ufl.edu]

Epidemiology

  • Even though since the mid-1990s the number of food-borne botulism cases has systematically decreased and it now occurs in Poland relatively rarely, it is still a real epidemiological problem.[ncbi.nlm.nih.gov]
  • It discusses the nature of illnesses; the epidemiology of pathogens; and current detection, prevention, and control methods. It also features chapters on the globalization of the food supply, seafood toxins, and other miscellaneous agents.[books.google.de]
  • His research interests include the epidemiology of bacterial enteric infections with a special focus on botulism. Top References Shapiro R , Hathaway C , Swerdlow DL . Botulism in the United States: a clinical and epidemiologic review.[wwwnc.cdc.gov]
  • Contact your doctor or the Southern Nevada Health District, Office of Epidemiology at (702) 759-1300.[southernnevadahealthdistrict.org]
  • Food was identified as the transmission vehicle by lab testing or epidemiological investigations in 41.4% (118/285) and 30.7% of confirmed incidents, respectively.[foodqualitynews.com]
Sex distribution
Age distribution

Prevention

  • 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.[foodborneillness.com]
  • The only way to ensure prevention of foodborne botulism is to prevent the neurotoxin production within those foods.[microbewiki.kenyon.edu]
  • And they were already taking rather extreme measures to try to prevent it (like very long processing times, which were probably at least somewhat effective in decreasing the incidence of botulism, even if not preventing it entirely).[cooking.stackexchange.com]

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