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Part A
BOTULISM
TEXT A
Botulism is a rare but serious condition caused by a toxin that attacks the body's nerves. Botulism may cause
life-threatening symptoms. A type of bacteria called Clostridium botulinum produces the toxin. Botulism
can occur as the result of food or wound contamination. The condition can also occur when bacterial spores
grow in the intestinal tract of infants. In rare cases, botulism can also be caused by medical treatment or
bioterrorism.

Three common forms of botulism are:

 Foodborne botulism. The harmful bacteria thrive and make the toxin in environments with little
oxygen, such as in home-canned food.
 Wound botulism. If these bacteria get into a cut, they can cause a dangerous infection that makes
the toxin.
 Infant botulism. This most generic form of botulism begins after spores of C. botulinum bacteria
grow in a baby's intestinal tract. It typically occurs in babies between the ages of 2 months and 8
months. In rare cases, this form of intestinal botulism also affects adults.

Occasionally, botulism happens when too much botulinum toxin is injected for cosmetic or medical reasons.
This rare form is called iatrogenic botulism. The term "iatrogenic" means an illness caused by medical exam
or treatment.

Another rare form of botulism can occur from inhaling toxins. This may happen as the result of bioterrorism

TEXT B
To diagnose botulism, a doctor will complete a physical exam, noting any signs or symptoms of botulism
poisoning. They’ll ask about foods eaten within the past several days as possible sources of the toxin, and if
anyone else ate the same food. They’ll also ask about any wounds.

In infants, a doctor will also check for physical symptoms, and will ask about any foods that the infant ate,
such as honey or corn syrup.

Your doctor may also take blood or stool samples to analyse for the presence of toxins. However, results for
these tests may take days, so most doctors rely on a clinical observation of symptoms to make a diagnosis.

Some symptoms of botulism can mimic those of other diseases and conditions. Your doctor may order
additional tests to rule out other causes. These tests may include:

 electromyography (EMG) to evaluate muscle response.

 imaging scans to detect any internal damage to the head or brain.
 spinal fluid test to determine if infection or injury to the brain or spinal cord is causing symptoms.

TEXT C
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The CDC reports that 65 percent of botulism cases occur in infants or children younger than 1 year of age.
Infant botulism is typically the result of exposure to contaminated soil, or by eating foods that contain
botulism spores. Honey and corn syrup are two examples of foods that can have contamination. These
spores can grow inside the intestinal tract of infants, releasing the botulism toxin. Older children and adults
have natural defences that prevent the bacteria from growing.

According to the CDC, around 15 percent of botulism cases are foodborne. These can be home-canned foods
or commercially canned products that didn’t undergo proper processing. The World Health Organization
(WHO) reports that botulism toxin has been found in:

 preserved vegetables with low acid content, such as beets, spinach, mushrooms, and green beans
canned tuna fish
 fermented, smoked, and salted fish
 meat products, such as ham and sausage

Wound botulism makes up 20 percent of all botulism cases, and is due to botulism spores entering an open
wound, according to the CDC, the rate of occurrence for this type of botulism has risen in recent years due
to drug use, as the spores are commonly present in heroin and cocaine.

TEXT D

Treatment

 Gastric lavage to remove residual toxin from the stomach (first with boiled water to collect
material – then 2.5% solution of soda); introduction of enterosorbents through the probe.
ENZYMES DO NOT GIVE!
 Intestinal dialysis (2.5% solution soda);
 Antitoxic serum (type A, C, E each 10,000 ME, type B 5,000 ME, type F 3 – thousand); in severe
cases, a double dose. Cover glucocorticoids…i/ m or i/v by frequently.
 Parenteral administration of infusion media for the purpose of detoxification, correction of water-
electrolyte and protein disorders.
 Antibiotic therapy (chloramphenicol)
 Hyperbaric oxygenation as a remedy hypoxia.
 Treatment of complications

Promising – homologous plasma and human anti-botulinum immunoglobulin

Time: 15 minutes

• Look at the four texts, A-D, in the separate Text Booklet

• For each question, 1-20, look through the texts, A-D, to find the relevant information.
• Write your answers on the spaces provided in this Question Paper.
• Answer all the questions within the 15-minte time limit.
• Your answers should be correctly spelt.
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Botulism: Questions

Questions 1 - 7

For each question 1 – 7, decide which text (A, B, C or D) the information comes from. You may use any
letter more than once.

In which text can you find information about

1. How protein disorders are managed? ___________

2. How symptoms are related to brain and spinal cord? ___________

3. Cases of intestinal botulism in adults? ___________

4. Eatables of infants that usually get contaminated? ___________

5. Complications are treated by? ___________

6. Improper processing of food may lead to? ___________

7. Most reliable method for the doctors? ___________

Questions 8 – 14

Answer each of the questions, 8 – 14, with a word or short phrase from one of the texts. Each answer may
include words, numbers or both.

8. Growing ground of spores in infants?

__________________________
9. Remedial measure for hypoxia?
_____________________________
10. Type of botulism that has got upsurged in the recent past?
___________________________
11. Double dosage is recommended for?
__________________________
12. Botulism formed out of injecting toxins?
___________________________
13. What shouldn’t be given as a medication option?
_________________________
14. Reason for the increased occurrence of wound botulism?
___________________________
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Questions 15 – 20

Complete each of the sentences, 15 – 20, with a word or short phrase from one of the texts. Each answer
may include words, numbers or both.

15. It is because of the _________________________, the growth of bacteria is prevented in older

children and adults.

16. Inhalation of toxins which results from ________________________, forms a rare type of botulism .

17. ___________________ of the blood or stools to detect the presence of toxins is also done by the

doctor.

18. ______________________________ solution soda is used for intestinal dialysis.

19. This is the condition where the ______________________________ is attacked by the toxins.

20. ____________________________ are clinically observed to make a diagnosis.

END OF PART A

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