A severe, sometimes fatal food poisoning caused by ingestion of food containing botulin's toxin or botulin's spores, and characterized by nausea, vomiting, disturbed vision, muscular weakness, and fatigue.
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CARRIERS OF INTOXICATION
- jams and confections;
- handmade sausages;
- oiled or tinned vegetables;
- raw or not enough cooked food;
The incubation period ,together with the consecutive symptoms appearance, depends on infection pathway.
- By inhalation , the real incubation period isn't known, but in three clinical cases it was about 72 hours.
- By bowel the incubation go on from 6 to 8 hours.
- By wound from 4 to 18 hours after the contact.
(there are 7 different toxin types ,from A to F they causes the same clinical effect. The Gs don't cause patology in human.)
Botulism could be:
- light with subclinical symptoms;
- fatal and take to death in 24 hours;
(In general earlier the symptoms apper , more serious is the disease .)
THE FIRST SYMPTOMS are:
- double vision
- ptosis ;
- progressive difficulty in speaking and dryness of mouth and troath, caused by muscles and glands paralisis ;
(Special feature is the absence of anomalies in clinical analisis.)
CLINICAL EXAMINATION (second phase)
- problem in swallowing and talking;
- dilated and rigid pupils;
- crusted and dried mucosa;
As the disease go on, neck and arms' muscles became affected by the toxin.
THE CLASSIC TRIAD of symptoms in botulism :
- flaccid descendent paralisis (starting froma neck's muscles affects facial muscles, swallowing control and muscle of breating , in the end it affects the rest of body);
- no temperature;
- the patient is always conscious.
Foodborne Botulism is not the only form. There are three other forms luckly not so frequent as the foodborne one.
- Wound botulism: it's the rarer , caused by penetration inbody of bacteria's spores from the ground or from ashes in wound.
- Infant botulism: this form affect more chidren from 2 weeks and 3 years of life. It's caused by intaking of contaminated food. The ingested spores colonize the bowel and produce the toxin. Symptoms : weakness, fatigue, inability in moving the head.
- Botulism by unknown causes:includes cases not classified of botulism, actually cases when the bacteria colonize the adult's bowel.
Clostridium botulinum has three modes of entry into the human body: wound contamination, foodborne, and inhalation. After toxin is absorbed, it enters the bloodstream and travels to peripheral cholinergic synapses, primarily the neuromuscular junction. Once at these sites, botulinum toxin is internalized and enzymatically prevents the release of acteylcholine. Recovery of neuromuscular function requires new synapses to form. Symptoms of botulism typically develop 12 to 72 hours after exposure. This incubation period depends on the amount of toxin absorbed and the rate of absorption. Person-to-person transmission of botulism does not occur.
Clinical ManifestationsBotulism is an acute symmetrical descending flaccid paralysis that often begins in the bulbar musculature. Prominent bulbar palsies typically include diplopia, dysarthria, dysphonia, and dysphagia (the so-called 4 Ds). Pupillary dilatation and subsequent blurry vision may also be present. The symmetric descending paralysis usually begins in the upper extremities and then progresses down the trunk and to the lower extremities, highlighted by the loss of deep tendon reflexes. Finally, respiratory muscle paralysis occurs.
- intravenous injections of equine antitoxins (two types, one trivalent and one eptavalent covering awhole the toxin types). The treatment doesn't solve immediatly, but decelerate and slowly arrests the progress of paralisis.
- induce vomiting the patient or treat with enema.
- penicillin, effictive in stopping the bacteria replication, due to the bacterial spores, and so in blocking the rise of poisoning in whole the body.
- artificial respiration when toxin interess the breathing muscles.
- surgery sif the poisoning started from wounds,due to remove the contaminated portion,followed by a treatment based on antibiotics.
Wikipedia's link about spores
[patients that survive the poisoning could present problem breathing and short breath for years and they must have long recovery therapies.]