Botulism

Botulism

Clostridium botulinum

*gram positive rod
*strict anearobe
*non-lactose fermenting
*spore forming
*produces neurotoxins (A-G and H)

2-1000 ng/kg based on portal of entry

Botulinum toxin (BTX)

*Botulism neurotoxins (BoNTs) bind to periphercal cholinergic nerve terminals (accepts acetylcholine)
*BoNTs enters cytosol of cell through endocytosis
*once in cell, light chain cleaves SNARE proteins (blocking release of neurotransmitters).

SNARE proteins forma complex that enables synaptic fusion of vesicle containg neurotransmitters (Acetylcholine) to synaptic membrane

Environment (soil)

*digestive tract or open wounds

*eating contaminated foods
*parenteral route (administering liquids through IV)

6 hrs-10 dys

*spores germinate and colonize food
*bacterium enters through intestinal mucosa or tissue
*secreted botulinum toxin enters circulatory system
*BoTX transported to motor neurons, it blocks release of neurotransmitters, results in paralysis

*gastrointestinal
*nervous system

*constipation
*nausea
*vomiting
*dry mouth
*chills
*thick-feeling tongue

*blurred vision
*dilated pupil
*dropping eyelids
*inability to swallow
*speech impairment
*urinary retention
*skeletal weakness

*lethargy
*weak cry

*parlysis
*respiratory failure
*mortality (5%)
*sequelae (pathological consequence resulting from previous disease or injury)
-muscle atrophy
-long lasting weakness
-shortness of breath
-secondary infection

*proper canning procedures
*proper food handling storage
*boil canned foods for 10 min
*dispose contaminated foods
*don't consume suspect foods

*Antitoxin (for Type A, B, E, and H)
-BabyBIG-human IgG for types A and B (infant botulism)
*remove gastrointestinal contents
*life support systems (ventilator)