Botulism: definition, symptoms and treatments

Botulism: definition, symptoms and treatments

Botulism is a paralytic disease caused by a toxin produced by the bacterium Clostridium botulinum. It is caught in particular by consuming contaminated foods such as canned goods, honey or flavored oils. Symptoms, diagnosis, food and infant botulism and treatments with Dr Christelle Mazuet.

Botulism is a crippling disease linked to a toxin produced by the Clostridium botulinum bacteria. Foodborne botulism is caused by the ingestion of contaminated food. A cause of infant botulismwhich affects children under 12 months, the consumption of honey is not recommended for infants. The canned “homemade”, if they are not prepared according to a strict hygiene protocol, can cause botulism. What is botulism? What are the symptoms botulism? How to heal him ?

Definition: what is botulism?

Botulism is a crippling disease due to a toxin (botulinum toxin) produced by a bacterium (Clostridium botulinum). “It’s the toxin that makes you sick, not the bacteria itself.” emphasizes Christelle Mazuet, head of the National Reference Center for Anaerobic Bacteria and Botulism at the Institut Pasteur. This toxin is extremely powerful and targets nerve endings. This disease affects both humans and animals, especially birds and cattle. .

Foodborne botulism is the most common type of botulism in France

What is foodborne botulism?

Foodborne botulism is the most common type of botulism in France. It is caused by ingestion of food contaminated with botulinum toxin.

What is infant botulism?

Infant botulism is much less common. It occurs in children under one year old when they ingest the bacteria, which then implant themselves in the digestive tract and produce their toxin. “It is a colonization of the digestive tract“says Christelle Mazuet. It is because of the risk of botulism that honey is not recommended before the age of 12 months in children. It should never be added to infant food, nor used on finger or pacifier to calm an agitated infant suffering from colic. As ANSES points out, the spores of the bacterium Clostridium botulinum can be contained in honey, which remains the only identified source of dietary exposure to this bacterium, in the current state of knowledge. L’child under one year old is particularly susceptible to this infection because its immune system is not quite ready to defend itself against germs. After a year, the child’s defenses are more effective and allow him, by himself, to eliminate the spores.

There are other types of botulism:

  • wound botulism which develops on the occasion of a deep wound or a fracture: the bacterium then enters the wound to produce the toxin and contaminate the person
  • iatrogenic botulism caused by misuse or accidents in the injection of treatments based on botulinum toxin used in particular in aesthetic medicine. However, there has never been a confirmed case in France.

What are the causes of botulism?

Food-borne botulism is caught byingestion of contaminated products by botulinum toxin. It is most often linked, in France, to the consumption of foods in home-made or artisanal preservesmore rarely of industrial manufacture. These include low-acid plant preserves (green beans, olives, asparagus). All “homemade” charcuterie products (ham, raw ham) are also at risk. More rarely, there are cases of contamination with seafood products such as artisanal smoked/salted-dried fish.

What are the symptoms of botulism?

Botulism is a descending flaccid paralysis“explains Christelle Mazuet. It starts with vision problems (the person sees double, has drooping eyelids). Then come slurred speech and swallowing and impaired salivation. Then, depending on the quantity and type of toxin ingested, the paralysis can extend to the respiratory muscles and to the upper and lower limbs. Thus, the most serious forms can lead to a tetraplegia and respiratory insufficiency or even incapacity. Without medical care, the prognosis is therefore lethal.

Who are the people at risk of botulism?

“There is no one at risk” emphasizes Christelle Mazuet. Indeed, everyone is likely to consume contaminated products. On the other hand, the susceptible populations (children and the elderly) are susceptible to developing severe forms of the disease and will naturally have more difficulty recovering.

The progression of symptoms can go very quickly and it is best to go to the emergency room : “In severe forms, patients can be in intensive care within a few hours of the onset of the first symptoms..” emphasizes Christelle Mazuet. The examinations are generally carried out by neurologists in order to rule out other neurological conditions (stroke, autoimmune neuropathy, etc.). We practice a number of samples and analysis as well as electromyograms. A blood sample and a stool collection will be sent to the National Reference Center for Anaerobic Bacteria and Botulism at the Institut Pasteur to confirm the diagnosis.

Antibiotics have no action on botulinum toxin

Can botulism be cured?

The treatment is basically symptomatic” explains Christelle Mazuet. “intensive respiratory care with assisted ventilation will be put in place in the most serious cases to allow people to breathe“. There is a serum that neutralizes botulinum toxins but it is only effective if injected within 24 hours of the onset of symptoms. The vast majority of patients treated quickly recover without sequelae, but the duration of treatment and recovery can sometimes last several months. Antibiotics have no action on botulinum toxin, and are therefore not prescribed.

The prevention of botulism is based on basic food hygiene rules:

  • wash food very carefully before canning them – “it only takes a few grams of soil to cause botulism” emphasizes Christelle Mazuet.
  • respect the cold chain and expiration dates
  • keep the refrigerator at a temperature between 3 and 5°C
  • There is a botulinum vaccinehowever, it is reserved for exposed people, and can generate significant side effects. It is not used in France.

Thanks to Dr Christelle Mazuet, head of the National Reference Center for Anaerobic Bacteria and Botulism at the Institut Pasteur.

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