Clostridium botulinum and Botulism

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Clostridium botulinumand Botulism

• A
• Caitlin, Farida, Nino, Natalie and Simon
• Presentation

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OUTLINE

• Introduction to C. Botulinum
• Introduction to Botulism
• Infant Botulism
• Food-Borne Botulism
• Wound Botulism
• Bioterrorism

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Clostridium botulinum

• Gram positive rods
• Spore forming
• Anaerobic bacteria
• Produces toxin that causes botulism
• Seven neurotoxic subtypes, labeled
• A-G
• First recognized and isolated in 1896 by Van
  Ermengem

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Botulism

• Botulism is a neuroparalytic disease
• It is caused by the potent protein toxin released
  from C. botulinum
• Once released into the bloodstream it
  irreversibly binds to the acetylcholine receptors
  in the neuromuscular junction
• It alters the mechanism for acetylcholine
  release, making the neuron unresponsive to action
  potentials
• Three major types Infant, food-borne, and wound
• Potential bio-weapon due to its potency

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Infant Botulism

• Most common form
• 2 per 100,000 live births in US
• Afflicts babies from 1 week
• 1 year
• Antigenic variations types A/B
• Caused by
• Ingesting contaminated foodstuff
• Lack of breast milk
• Untreated natural honey and corn syrup
• Household dust containing C. botulinum spores

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Infant Botulism

• Signs and Symptoms
• Poor feeding (weak sucking)
• Weak gag
• Weak cry
• Decreased movement
• Appearing lethargic
• Flat, blunted facial expression
• Trouble swallowing
• Excessive drooling
• Muscle weakness
• Breathing problems
• Ptosis (Drooping eyelids)
• Poor head control
• Decreased anal sphincter tone
• Decreased deep tendon reflexes

• Treatment and Recovery
• New drug BabyBIG, Botulism Immune Globulin
  Intravenous (Human) (BIG-IV)
• Drastically reduces lethargy, IV feeding and
  overall hospital stay
• With early detection, proper treatment, no long
  term effects observed

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Food-borne Botulism

• Second most common form
• Caused by eating food containing
• the toxin produced by C. botulinum
• Antigenic variations types A/E
• Non-commercially canned food is at a higher risk
  for being contaminated
• Dangerous because most contaminated foods cannot
  be detected until too late

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Food-borne Botulism

• Signs and Symptoms
• 12 36 hrs after
• Muscle weakness,
• Diarrhea
• Blurred vision
• Vomiting
• Eventual Paralysis
• Treatment and Recovery
• Equine Botulinum Antitoxin
• Lingering symptoms are fatigue and respiratory
  difficulty
• With early detection, proper treatment, no long
  term effects observed

• Prevention
• Inspect canned food for
• Bulging
• Loose lids
• Mold
• Odor
• Proper home canning procedures
• Hygiene
• Time schedule,
• Proper processing method
• Equipment
• Avoiding home canning or cheaply produced
  commercial food

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Wound Botulism

• Least common, but on the rise
• Occurs when spores inoculate a wound and
  anaerobic conditions allow germination and
  subsequent production of the toxin
• Associated with IV drug use (rise in black tar
  heroine use), and medical equipment
• ex. catheters
• Often misdiagnosed as other
• neurological syndromes

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Bioterrorism

• C. botulinum is one pathogenic microorganism that
  has been researched and developed into a
  biological weapon.
• Many countries, and now terrorists, have
  developed and used botulinum toxin as a
  biological weapon.
• From 1990 to 1995, aerosols were dispersed at
  multiple sites in downtown Tokyo and at US
  military installations in Japan on at least 3
  occasions by Japanese terrorists.
• In 1995, Iraq revealed that it had deployed more
  than 11,000 L of botulinum toxin into specially
  designed SCUD missiles.

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Bioterrorism

• Smallpox and anthrax may be
• getting the most attention, but
• bio-defense researchers have long been concerned
  about botulinum toxin, the deadliest of all
  potential toxic threats gram for gram.
• A biological attack with the botulinum toxin
  would more likely be dispersed in an aerosolized
  form.
• Currently, the US military possesses limited
  quantities of an investigational heptavalent
  antitoxin, which might be available in the event
  of a terrorist attack

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QUESTIONS