Be wary of botulism

Although rare in the UK, botulism can have serious consequences if caught. Up to one in ten people affected with botulism die as a result of the condition, but this risk is greatly reduced if treatment is started as soon as possible, so it is important to know the signs to look out for. (1)

What is botulism?

Botulism is a condition caused by exposure to a type of bacteria called Clostridium botulinum. These bacteria release a toxin called the botulinum toxin, which is one of the most potent toxins known. It is these toxins rather than the bacteria themselves which pose such a threat to health. The toxins attack the cells of the nervous system, leading to paralysis. In cases where the muscles controlling the respiratory (breathing) system are affected, this can prove fatal. (1)

The bacteria which release the toxin can be found in the soil, sea or river sediments, and even dust. Perhaps the best known source is home canning, pickling or other types of preserving involving food in closed containers. If guidelines on safe and hygienic preparation are not followed, the food may become contaminated with Clostridium botulinum, and the low oxygen environment inside the jar or can is perfect for botulinum toxin production. For food preserved in jars, cans and bottles sold in UK shops, the risk of botulism is minute as stringent hygiene practices must be adhered to during their preparation. Nevertheless, be wary of warped or damaged containers and preserved food that smells or tastes ‘off’. (1)

Botulism can also develop as a result of injecting illegal drugs contaminated with the bacteria into muscle. The reason why this risk applies to illegal drugs in particular is because they are not prepared in a sterile environment, unlike prescribed injectable drugs. Whilst the best advice is obviously to refrain from injecting illegal drugs altogether, it is safer to inject into a vein rather than a muscle. (1)

Babies aged one year or younger are also at risk of contracting botulism from ingesting spores (a dormant form) of the causative bacteria. The spores may be found in soil or food, but honey is a particularly risky source. For this reason, honey should not be given to babies until they are at least 12 months old. (1)

What are the symptoms?

Initially, symptoms may be similar to those of a ‘stomach bug’, including feeling and being sick, diarrhoea and abdominal cramps. This may occur hours or days after first exposure. (1)

Symptoms of paralysis include blurred vision, droopy eyelids, problems swallowing, difficulty speaking or making facial expressions, and eventually problems breathing. (1)

Babies may be quieter than normal, struggle to feed and their body may appear floppy. (1)

How is botulism treated?

The aim of treatment for botulism is to deactivate the toxins produced by the bacteria. This is achieved by administering post-exposure vaccines containing botulism antitoxins or antibodies, which work as toxin neutralisers, stopping any further damage from occurring. Additionally, help with breathing and other essential bodily functions should be given until patients recover. Paralysis that has already occurred can’t be undone by treatment, but it should eventually ease off over time regardless. (1)

If you suspect that you or someone else in your presence may have contracted botulism, it is essential to seek emergency medical attention and to begin treatment at the earliest opportunity, as the more time passes, the greater the damage that will be caused by the deadly toxins. In this instance, do not hesitate to call 999 for an ambulance or to visit A&E as soon as possible. (1)

References

1. NHS Choices. Botulism [cited 4 June 2018]. Available at: https://www.nhs.uk/conditions/botulism/

   Author: Gabby Gallagher MPharm

   Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 6/06/18