Though it’s a rare chance you will witness botulism symptoms, recognizing and understanding the toxin’s effects could mean life-saving treatment.
A byproduct of the bacteria C. botulinum, botulism toxin is a paralyzing nerve agent. In minuscule doses, it’s injected into muscles as Botox, as a cosmetic or therapeutic treatment. It doesn’t take much to harm or kill a human. Botulism symptoms should be recognized and treated fast because effects can be long-lasting if they aren’t fatal.
Botulism is most often associated with improper water bath canning, since failure to follow safety guidelines may create the perfect environment in which bacteria thrive and produce the toxin. Certified chefs and food handlers receive microbe training that home cooks don’t, so most states have written laws regarding selling homemade food. Pickles may be legal while canned vegetables are prohibited.
In addition to knowing botulism causes, recognizing botulism symptoms involves understanding how the neurotoxin works.
Homesteaders most often focus on foodborne botulism, though doctors also face latrogenic (from too much injected toxin), wound (when spores enter an open wound and reproduce within the body), and inhalation botulism (often caused by bioterrorism). All of those are rare; the most common is infant botulism, with foodborne following afterward.
Tragically, up to 75 percent of confirmed botulism cases are with infants. Unlike foodborne botulism, which occurs when bacteria produce the toxin before food is consumed, infant botulism comes from spores which turn to bacteria within the child’s digestive tract.
Botulism spores are prolific in honey. Since spores survive up to 240 degrees, pasteurization cannot destroy them. Honey is acidic enough that it suppresses transition from spore to bacteria. And, once it is consumed, stomach acids ensure bacteria never forms.
Infant digestive systems aren’t acidic enough to suppress C. botulinum growth.
Though infant botulism can come from several sources, it is most often traced to honey which was given to infants under six months of age. Parents and caretakers are warned to never give honey or orange juice to children under one year.
Constipation is often the first sign of infant botulism. Next, comes drooping eyelids, weak cries, difficulty sucking and floppy movements. If you suspect botulism symptoms in infants, seek urgent medical care to avoid the risk of death or complications.
Foodborne Botulism Symptoms
Do not expect fever as a symptom. Though a rise in body temperature accompanies bacterial infection, botulism poisoning is from the toxin, not the bacteria itself.
As a neurotoxin, botulism interrupts signals telling muscles what to do. Botulism symptoms often start at the top and work their way down. Fatigue, weakness and vertigo may come first, followed by difficulty swallowing or speaking. Vision may blur and eyelids may droop. Soon muscle failure moves down into the abdomen, causing vomiting, diarrhea, swelling, and constipation. Arms and neck weaken. Then legs and the respiratory system stop working
Botulism symptoms usually appear 12 to 36 hours after consumption but can take as long as eight days. The World Health Organization stresses that prompt diagnosis and treatment is necessary to avoid high mortality.
Diagnosis and Treatment
If you suspect botulism and think food is involved, bring a sample to your checkup.
Botulism symptoms are often confused with stroke or Guillan-Barré syndrome, so a laboratory confirmation usually follows clinical examination. Labs test serum and food; sometimes, physicians require a stool sample as well.
After labs confirm the presence of C. botulinum bacteria or toxin, the antitoxin is administered as soon as possible. Antibiotics are rarely effective because the illness is caused by a toxin, not the bacteria itself. Severe cases may require mechanical intervention, such as ventilators, for several weeks to months. Survivors of severe botulism poisoning may need years of physical therapy to overcome nerve damage. Some patients experience permanent paralysis.
Because of modern testing and quick intervention, the disease is only fatal in five to 10 percent of cases.
Even the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). Commercial pasteurization is often inadequate to kill spores so refrigerators must be set at 37 degrees or below. Acidic conditions and high salt content also inhibit growth.
The WHO lists five important keys to preventing food poisoning:
- Keep areas and containers clean.
- Separate raw from cooked food.
- Cook food thoroughly.
- Keep food at safe temperatures.
- Use safe water and raw materials.
Even with all the scary facts and figures, botulism causes fewer deaths than bee stings. The CDC confirmed 199 cases in 2015, with 14 more probable cases. 141 (71 percent) were infant botulism, often from babies consuming honey. Of the 39 foodborne cases, 27 were from potato salad at a single church potluck; four were from fermented seal flipper, and two from beets that were roasted then kept at room temperature several days before being made into soup.
Whether you are a commercial chef, parent of an infant, home canner, cottage food seller, or just someone who wants trustworthy food, knowing botulism symptoms and causes can make prevention easy. Follow a few simple rules. Seek immediate help if you suspect botulism symptoms.
And remember that knowledge is the most powerful factor in botulism prevention.
World Health Organization http://www.who.int/mediacentre/factsheets/fs270/en/
Centers for Disease Control and Prevention https://www.cdc.gov/botulism/index.html