Monday, November 14, 2011

Broader Scale Botulism



It has been repeatedly said in this blog and sites everywhere that botulism poisoning is a rare but lethal disease. However true, it's bu micro-liter lethal dosage and potential to wipe out millions would be irresponsible to overlook. China, Germany, Iran, Japan, North Korea, and Syria have been reported to have experimented with botulism toxins as weapons of mass destruction. Since the events of September 11, 2001, there has been heightened surveillance and mandatory reporting of actual or suspected cases of infectious diseases such as botulism. Emphasis on botulism reporting is also for epidemiological purposes such that the report of one case may prevent several other cases from worsening by creating modes of contact.  Surveillance experts may be able to identify an outbreak source or common contaminated food item.

The Centers for Disease Control and Prevention has a supply of antitoxins ready to be administered to anyone in the country. The antitoxin is not a cure for botulism but rather a means to deactivate the toxin to prevent further damage. If the victim survives the first couple of days, it may still take months to years of healing and rehabilitation. Secondly, unlike other toxins like tetanus, botulinum cannot be vaccinated against, thereby leaving the entire population as vulnerable.

Knowledge is power.
Although citizens have no control over intentional release of the lethal toxin, they do have control over the foods they eat and the ways they prepare them.

Here are some tips from University of California, Los Angeles:


Preventive measures

1) Ensure effective control of processing and preparation of commercially canned and preserved foods.
2) Educate those concerned with home canning and other food preservation techniques regarding the proper time, pressure and temperature required to destroy spores, the need for adequately refrigerated storage of incompletely processed foods, and the effectiveness of boiling, with stirring, home canned vegetables for at least 10 minutes to destroy botulinum toxins.
3) C. botulinum may or may not cause container lids to bulge and the contents to have "off-odors." Other contaminants can also cause cans or bottle lids to bulge. Bulging containers should not be opened, and foods with off-odors should not be eaten or "taste tested." Commercial cans with bulging lids should be returned unopened to the vendor.


Sources:http://www.upmc-biosecurity.org/website/our_work/biological-threats-and-epidemics/fact_sheets/botulinum.html
http://www.ph.ucla.edu/epi/bioter/botapha_control.html



Monday, November 7, 2011

What to do with Botulism: Treatment

Once it is suspected someone has botulism, it is important to seek medical attention or else it can be fatal. The sooner the antitoxin can be delivered, the more effective it can be by preventing damage to the nerve endings. This antitoxin is derived from horse serum and induces passive immunity to the toxin.

Another major complication with botulism is the difficulty breathing. Victims with severe botulism require respiratory support so that they do not suffocate.

Treatment
Procedures
Efficacy

Antitoxin
"Equine"


Delivered intravenously (10ml)

Derived from horse serum

Attaches to the botulin toxin that has not attached to nerve endings/inactivates toxin


Cannot reverse existing damage

Administered as soon as possible (minimize damage from circulation of toxin)

Respiratory Support

Mechanical ventilator that forces air into the lungs through a tube (nose or mouth)

Severe cases of botulism are especially life-threatening when the respiratory system is compromised

Required in 20% of infected adults

The antitoxin is available from the Centers for Disease Control and some local health departments. No serious adverse effects have been reported, even from children, immune-compromised, and pregnant women. Common side effects of the antitoxin are serum sickness, urticaria (welts), hypersensitivity, and anaphylaxis.
Sources: