Botulism Presentation Gabriela Pontes de Sousa

Botulism Latin: botulus = sausage Is a rare but serious paralytic illness caused by botulinum toxin, which is produced by the bacterium Clostridium botulinium under anaerobic conditions -Gram-positive Bacillus -Spores -Found in soil, vegetables, fruits and animal feces

Pathogenesis The toxin enters the body in one of three ways: Infant botulism Colonization of the digestive tract by the bacterium in children (honey is a known source of bacteria spores) Foodborne botulism Ingestion of toxin from foods (pH above 4.5) Wound botulism Contamination of a wound by the bacterium

Pathogenesis The botulinum toxin is absorbed into the bloodstream; It leaves the circulatory system at the point where a neuron joins a muscle; The toxin prevents the fusion of synaptic vesicles of acetylcholine There is no release of acetylcholine at the neuromuscular junction, with consequent paralysis of the muscle fiber. Botulinum Toxin

Symptoms -Developed in 1 to 3 days; - Nausea, vomiting and stomach pain -Difficulty swallowing and speaking -Double vision or blurred vision -Trouble breathing -Facial Weakness -If untreated, symptoms can progress to respiratory failure Death

Diagnosis ◦ Questioning about the food and drink consumed ◦ Physical exam, including eye and neurological tests. ◦ The diagnosis is confirmed by detection of toxin in blood or stool culture positive for bacteria ◦ The toxin can also be identified in the suspected food

Diagnosed time antitoxin that blocks the action of neurotoxin circulating in the blood Physicians may remove whatever contaminated food is still in the gut by inducing vomiting or by using enemas breathing machine (ventilator) for weeks and may require intensive medical and nursing care BabyBIG (Botulism Immune Globulin, given IV) Treatment

BTX-A or BOTOX® Botulinum toxin type-A - BTX-A Cosmetics temporarily improve the appearance of moderate-to-severe frown lines between the eyebrows less intrusive and/or artificial than other types of plastic surgery

BTX-A or BOTOX® Cosmetics Blepharospasm and strabismus Muscle spasms Upper motor neuron syndrome Sweating Cervical dystonia Chronic Migraine

Prevention Be careful about the canned foods you eat; Make sure any homemade canning was prepared and stored properly; Kill the spores by cooking at 120 °C for 3 minutes; Acidify canned food; Do not feed infants with honey

References CDC/USA. Botulismo in the United States, Handbook for Epidemiologists, Clinicians and Laboratory Workers, Atlanta, 1998.