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Botox and Botulism? Beauty and the Beast?

Botox is not just a treatment for wrinkles

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Updated December 16, 2008

A note about Botox (botulism toxin) The botulism toxin has been called “the most poisonous substance known” and is associated with paralytic diseases. While there are approved medical uses for the toxin, such as muscle disorders in the eye, the FDA has denounced the use of Botox as a wrinkle remedy.

There are three main forms of botulism: foodborne, infant, and wound botulism. The first two are caused by consuming either the bacteria themselves or the toxin. All three forms of botulism are caused by the botulism toxin. Although the disease is relatively rare, there is a high risk for death from infections and therefore require immediate emergency care.

Species Name: Clostridium botulinum

Type of Microbe: Gram-positive bacteria found in soil. They produce spores that are resistant to heating.

How it spreads: Food-borne botulism is caused by consuming the botulism toxin in foods. These bacteria and their toxins are often found in home-canned non-acidic foods. Because the bacteria prefer low oxygen environments, they can grow in canned foods, as well as in foods that are submerged in oil.

Infant botulism occurs when infants under 12 months consume the bacterial spores (which can be found in honey), which grow in the intestines and produce the toxin.

Who’s at risk? All people are susceptible to food-born botulism, but the majority of cases are infant botulism. A few outbreaks of foodborne botulism occur most years usually from eating contaminated home-canned foods. Other food-borne outbreaks have involved commercially canned salmon, onions, bottled garlic, baked potatoes, and smoked or salted fish. Over 100 cases of infant or foodborne botulism are reported each year in the US.

Symptoms: Symptoms occur as a consequence of the botulism neurotoxin, and may include double or blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Infected infants will appear weak, eat poorly, are constipated, and have poor muscle tone. Symptoms of foodborne botulinum appear between 18 to 36 hours after eating the contaminated food, but may occur as early as 4 hours and up to 8 days.

Diagnosis: Identification of the botulinum toxin in patient serum or stool and culturing stool samples and foods for the bacteria.

Prognosis: Left untreated, paralysis of the arms, legs, and torso may occur. Severe botulism may be accompanied by difficulty breathing and paralysis.

Treatment: Early diagnosed infections may be treated with antitoxins. Contaminated foods may be removed by inducing vomiting or using enemas. Severe cases which result in difficulty breathing may require the use of a ventilator.

Prevention: Use strict hygienic procedures during home canning. Because the toxin can be destroyed by high temperatures, boil canned foods for at least 10 minutes before eating. Don’t feed honey to babies less than 1 year of age.

How it causes disease: The botulism neurotoxin attacks the nerve cells and causes paralysis.

Complications: Severe botulism that leads to respiratory failure can be fatal, but the risk of death has decreased significantly in the past 50 years.

Sources:

Vangelova, L. Botulinum Toxin: A Poison That Can Heal. FDA Consumer Magazine. US FDA. 1995.

Botulism. Division of Foodborne, Bacterial and Mycotic Diseases. Centers for Disease Control and Prevention.

Clostridium botulinum. USFDA Bad Bug Book. Center for Food Safety and Nutrition.

Clostridium Botulinum. International Programme on Chemical Safety. Poisons Information Monograph 858. Bacteria. World Health Organization.

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