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What is botulism?
Botulism is a rare but potentially deadly condition caused by a toxin produced by the bacteria Clostridium botulinum which is present in the natural environment. It attacks the nervous system, causing paralysis and other severe health complications.
How is botulism transmitted?
Botulism can spread in the following ways:
Foodborne botulism: Occurs when people consume food that has been contaminated with pre-formed botulism toxin. The risk is particularly high in improperly home-canned, preserved, or fermented foods such as fruits, vegetables, and fishes.
Infant botulism: Occurs when babies ingest bacterial spores that colonise their digestive system and produce the toxin. These spores can come from the environment (e.g. dust and soil), or from food (e.g. honey which may contain C. botulinum spores).
Wound botulism: Occurs when spores get into a wound and produce the toxin. People who inject illicit drugs have a greater chance of getting wound botulism.
Inhalational botulism: Occurs when tiny particles of botulinum toxins are inhaled. While extremely rare, this form of botulism could occur through accidental laboratory exposure or in rare scenarios, used as a biological weapon.
Iatrogenic botulism: Occurs when excessive amounts of botulism toxin are administered, typically during cosmetic procedures like wrinkle treatments. This risk is especially high when treatments are performed by unlicensed practitioners or when non-approved products are used.
There is no person-to-person transmission.
What are the symptoms of botulism?
Symptoms of botulism may include:
Visual impairment
Speaking, swallowing, and breathing difficulties
For foodborne botulism, people may experience gastroenteritis symptoms such as vomiting, nausea, stomach pain, diarrhoea or constipation.
For infant botulism, babies may experience constipation, weakness, loss of head control, low muscle tone, difficulty in swallowing, poor feeding, poor gag reflex, and accumulation of saliva in the mouth.
What are the risk factors?
Risk factors of botulism include:
Botulism poisoning: Persons who consume improperly canned (whether home-canned or commercially canned), preserved, or fermented foods such as low-acid vegetables (including green beans, spinach, mushrooms, and beets), fish (including canned tuna, fermented, salted, or smoked fish) or meat products (including ham and sausage).
Infant botulism: Infants younger than 1 year who are fed honey.
Wound botulism: Persons who use injection drugs.
Iatrogenic botulism: Persons who receive very high dose of botulinum toxin for cosmetic purposes.
How is botulism treated?
Treating botulism involves botulinum antitoxin treatment and supportive care, including prompt intubation and mechanical ventilation for respiratory distress if necessary. For wound botulism, doctors may also use antibiotics and clean the wound to help treat the infection.
How to prevent botulism?
To prevent foodborne botulism:
Do not taste or eat food from cans or jars that are leaking, swollen, damaged, or look unusual. Avoid products that squirt liquid or foam when opened
Store opened canned food in the fridge or keep it warm above 60°C if you’re not eating it right away
Keep raw and cooked foods separate to avoid cross-contamination. Throw away any swollen or spoiled canned goods. Double bag the cans or jars in plastic, and store them out of reach of people and pets
Boil home-canned food for at least 10 minutes before eating
For wound botulism, make sure to keep wounds clean and get medical help rightaway if the wound shows signs of infection.
Infants should not be given honey to prevent infant botulism.
To prevent iatrogenic botulism, only use botulinum toxin products approved by the Health Sciences Authority (HSA) and have them administered by a qualified healthcare professional.