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Cause:
Bacterial toxin from
Clostridium botulinum,
mainly Types A, B, and E.
Illness and treatment:
Forms are
foodborne botulism (ingested toxin), wound botulism
(toxin production in an infected wound), infant
botulism (toxin produced in the intestine of a
child under a year of age), adult colonization botulism
(toxin produced in the intestine of an adult), and
inhalational botulism (inhaling toxin, which does
not happen naturally). Paralysis starts with facial muscles
and often progresses to involve the breathing muscles.
Infants may have a weak cry, difficulty feeding leading to
weight loss, and weakness. Treatment is supportive care plus
either human-derived botulism hyper-immune globulin (BIG-IV)
for infants or botulism antitoxin for older children and
adults. Antibiotics are given for wound botulism.
Sources:
C. botulinum
spores are common in soil.
No consistent exposure is known for infants. Inadequately
processed home-canned foods are implicated in food botulism.
Wound botulism is associated with subcutaneous black-tar
heroin injection (“skin popping”).
Additional risks:
Infant botulism cases
usually occur in babies under 3 months old (almost always
under 6 months), both breast fed and formula fed.
Prevention:
Follow safe home canning
procedures. Boil risky home-canned foods (i.e., low acidic,
non-pickled foods) before consumption.
Recent Washington trends:
Each year there
are 0 to 2 reports of foodborne botulism, 0 to 9 reports of
infant botulism and 0 to 7 reports of wound botulism.
2008:
One case of infant botulism
and 2 cases of wound botulism were reported. No cases of
foodborne botulism were reported. All were type A botulism.
Purpose of Reporting and
Surveillance
- To assist in the diagnosis of
potential cases and facilitate prompt administration of
either antitoxin or botulism immune globulin when indicated.
- For foodborne botulism, to
identify contaminated food(s) and to prevent further
exposures.
- For foodborne botulism, to
identify and assure the proper evaluation and care of other
persons who may be at immediate risk of illness because they
have already eaten the implicated food.
- For wound botulism, to alert
others at risk regarding the importance of promptly
identifying illness and obtaining medical care.
Legal Reporting Requirements
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Health care providers: immediately notifiable to local health jurisdiction.
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Hospitals: immediately notifiable to
local health jurisdiction.
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Laboratories: immediately notifiable
to local health jurisdiction. Specimen submission is
required.
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Local health jurisdictions:
suspected and confirmed cases are immediately notifiable to
the Washington State Department of Health Communicable
Disease Epidemiology Section (1-877-539-4344).
Last
update
November 2009 |
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