What are the symptoms of

BOTULISMSymptoms of botulism generally

begin 12 to 72 hours after ingesting the toxin but may begin as early as 2 hours or

as late as 8 days.

Symptoms include:

double vision

blurred vision

drooping eyelids

slurred speech

difficulty swallowing

dry mouth, and

muscle weakness

If untreated, these symptoms mayprogress to paralysis of the arms,legs, and respiratory muscles, and

lead to death. Weakness andparalysis begin with the musclesof the head and neck and then

descend to the upper body, arms,lower body, and legs. Hawaii State Department of Health

www.hawaii.gov/doh

For more information or referral

Call 2-1-1

BOTULISM

The Department of Health provides access to its programs and activities without regard

to race, color, national origin (including language), age, sex, religion, or disability.

Write or call our Affirmative Action Officer at Box 3378, Honolulu, HI 96801-3378 or

at (808) 586-4616 (voice) within 180 days of a problem.

11/03

For more information, call

www.hawaii.gov/dohor

www.cdc.gov

Linda Lingle, Governor

Chiyome L. Fukino, M.D., Director of Health

What is botulism?

Botulism is a serious muscle-paralyzing illnesscaused by a nerve toxin that isproduced by the bacteriaClostridium botulinum.Three forms of botulismoccur naturally.

• Foodborne botulismoccurs when a person eatsfood contaminated with thetoxin produced by the botulism bacteria. Thisleads to severe illness that occurs within a fewhours or several days. Foodborne botulism is apublic health emergency because the contam-inated food may be eaten by a number ofpeople before being identified.

• Infant botulism occurs in a small number ofinfants each year who have C. botulinum intheir intestinal tract from ingesting botulismspores. These spores are quite common andare usually found in food such as honey.

• Wound botulism occurs when wounds areinfected with soil containing C. botulinum thatproduces the toxin.

A fourth man-made form of botulism can occurif the toxin is inhaled into the lungs.

How is botulismspread?

Botulism is most commonly foundin contaminatedfood. Heating offood will inacti-

vate the toxin. Botulism is not contagious; itdoes not spread from person to person.

What are the symptoms of botulism?

Symptoms of botulism generally begin 12 to 72hours after ingesting the toxin but may begin asearly as 2 hours or as late as 8 days. Symptomsinclude double vision, blurred vision, droopingeyelids, slurred speech, difficulty swallowing, drymouth, and muscle weakness. If untreated, thesesymptoms may progress to paralysis of the arms,legs, and respiratory muscles, and can lead todeath. Weakness and paralysis begin with themuscles of the head and neck and then descendto the upper body, arms, lower body, and legs.

How can botulism be treated?An antitoxin to botulismexists but must be givenas soon as possible afterthe diagnosis is made.The antitoxin can preventprogression of the disease,but does not reverseparalysis that has alreadyoccurred. Antibiotics arenot effective in treatingbotulism.

Good supportive care in ahospital is the mainstay oftherapy for all forms ofbotulism. A patient with severe botulism mayrequire a breathing machine as well as intensivemedical and nursing care for several months.Patients who survive an episode of botulismpoisoning may have fatigue and shortness ofbreath for years and long-term therapy may beneeded to aid recovery.

Why is there concern about botulism as a bioweapon agent?Botulism is a very serious illness. The bacteriathat cause the disease are readily available andcould be used to contaminate food or water supplies.

What should you do if you were exposed to botulism?

Seek prompt medicalattention. All foods suspected of being contaminated with botulinum toxin shouldbe removed and storedaway from any otherpossible consumers and

given to the Department of Health for testingwhen possible. If toxin came in contact withclothing or skin, clothing should be removedand skin washed with soap and water.

What is the public health communitydoing to prevent and control botulism?

State health departments and CDC have personsknowledgeable about botulism available to con-sult with physicians 24 hours a day. If antitoxin is needed to treat a patient, it can be quicklydelivered to a physician anywhere in the coun-try. Suspected outbreaks of botulism are quicklyinvestigated, and if they involve a commercialproduct, the appropriate control measures arecoordinated among public health and regulatoryagencies. Physicians should report suspectedcases of botulism to a state health department.

Can pets and other animals get botulism?

Yes. Your pet or farm animals could get botulismfrom eating contaminated food or inhaling toxin.If you think your pet hasbeen exposed, seekprompt veterinary attention for the animal.Animals cannot transmitthe disease to humans.

Photomicrograph of Clostridium botulinum type Acourtesy Public Health Image Library,

Center for Disease Control and Prevention.