Botulism: understand what it is, symptoms and main risks

Two people died in the state of Bahia as a result of the botulism a serious disease caused by the ingestion of contaminated food. According to the Health Department, six cases of the infection have been confirmed this year alone, and of these, three patients remain hospitalized and one has been discharged.

Botulism is a rare disease that is not contagious from one person to another. It is caused by the action of a toxin produced by the bacteria Clostridium botulinum (C. botulinum), which can be found in contaminated foods that are not produced and/or preserved properly. In addition, the microorganism can enter the body through skin wounds.

According to the Ministry of Health, all forms of botulism can lead to death if not treated properly and, therefore, these cases are considered medical and public health emergencies. This is because the bacteria that causes botulism produces a toxin that, even if ingested in small quantities, can cause serious poisoning in a matter of hours.

How is botulism transmitted?

The main form of transmission of the disease is food contamination, which involves the ingestion of toxins present in contaminated food. According to the ministry, the most common foods involved in contamination are:

• Vegetable conversations (such as hearts of palm, pickles and pequi);
• Cooked, cured or smoked animal products (such as sausages, ham and “corned meat”);
• Smoked, salted and fermented fish;
• Cheeses and cheese spreads;
• Industrialized canned foods (however, cases related to the consumption of these foods are rare, according to the Ministry of Health).

In this case, the incubation period (time between consumption and the onset of symptoms) can vary from 2 hours to 10 days, with an average of 12 to 36 hours.

However, there are other ways in which the bacteria that causes botulism can be transmitted. These are:

• Intestinal botulism : spores contained in contaminated food can multiply in the intestine, where the toxin is produced and absorbed. Risk factors in adults include intestinal surgery, Crohn’s disease and/or prolonged use of antibiotics. The incubation period is not known;
• Wound botulism : one of the rarest forms of botulism and is caused by the contamination of wounds by the bacteria. The main entry points are chronic ulcers with necrotic tissue, fissures, crushed limbs, wounds in deep areas with poor vascularization, or even needlestick injuries. The incubation period varies from 4 to 21 days, with an average of 7 days;
• Infant botulism : This is the most common intestinal form of the disease in children between 3 and 26 weeks of age. According to the Health Ministry, the main cause is the consumption of honey in the first weeks of life. According to the Ministry, this form of the disease may be responsible for 5% of cases of sudden death in infants.

Symptoms of botulism

The most common symptoms of botulism include:

• Headaches;
• Vertigo;
• Dizziness;
• Diarrhea or constipation;
• Nausea and vomiting;
• Blurred or double vision;
• Difficulty breathing;
• Cranial nerve involvement;
• Paralysis of the respiratory muscles, arms and legs.

Symptoms may vary depending on the type of botulism (foodborne, intestinal or wound botulism), and may present common or specific symptoms. For example, in wound botulism, fever is common, but gastrointestinal symptoms are not common (more common in foodborne and intestinal botulism). In some cases, symptoms may be mild, making diagnosis difficult.

Complications related to botulism

Botulinum toxin, released by the bacteria that causes botulism, affects the motor system and can therefore lead to serious health complications. This includes difficulty speaking, difficulty swallowing, weakness and fatigue, aspiration pneumonia and problems with the nervous system in general. In addition, it can lead to respiratory failure, which is usually the main cause of death from botulism.

How is diagnosis and treatment performed?

Botulism is identified through a physical examination by the doctor and analysis of symptoms. During the consultation, the professional may request neurological, imaging and laboratory tests to confirm the diagnosis.

The disease is then treated, based on supportive measures — such as the use of medication to alleviate symptoms and cardiorespiratory monitoring — and specific measures, such as the use of antibotulinum serum and antibiotics to eliminate the toxin circulating in the body. The serum is provided exclusively by the Unified Health System (SUS) upon notification of the suspected case on a specific form.

How to prevent botulism?

According to the Ministry of Health, prevention includes taking care with the preparation, consumption, distribution and marketing of food, as well as hand and food hygiene. The ministry also lists the following guidelines to prevent botulism:

• Do not consume preserved foods that are in swollen cans, fogged up windows, damaged or expired packaging or with changes in smell or appearance;
• When preparing homemade preserves, it is essential to strictly adhere to hygiene and storage precautions and ensure that these measures have been adopted by the establishment/seller who prepared the food;
• Prevent children under 2 years of age from consuming honey, as there is a risk of it containing spores of the botulism bacteria;
• Heat food by cooking for 10 minutes at a temperature above 80ºC to eliminate botulism toxins.

More than 3,000 toxins from food manufacturing contaminate the body

This content was originally published in Botulism: understand what it is, symptoms and main risks on the CNN Brasil website.

Source: CNN Brasil