RISK ASSESSMENT PROJECT:

BOTULISM

By
Micah Kinney
 DISEASE IDENTIFICATION

• What is Botulism?
• Botulism is a disease where the Bacterium
Clostridium botulinum, Clostridium butyricum, and
Clostridium baratii produces a toxin after entering a
host’s body through food or through an open wound,
when the bacteria dies.
• There are considered 5 different types of Botulism.
 • Foodborne Botulism can happen when eating food
with the bacteria present, or with the toxin present in
the food.
FOODBORNE • Most likely contracted through improperly canned,
BOTULISM preserved and fermented food.
• Very unlikely to protract through store bought food,
but could still happen
 • Wound Botulism occurs when the spores of the
Bacterium enter the host through an open wound
WOUND • More likely among drug users who inject needles
BOTULISM • Can also occur after a traumatic injury from a car
crash to surgery.
 • Infant Botulism can happen after a baby consumes
the bacterium or spores
• The organism reproduces in the young child's
INFANT intestines

BOTULISM • These spores are more common in honey, that’s why

they say never feed a baby honey. (under 12 months)
• Most common type worldwide
 • Like Infant Botulism, Adult intestinal Toxemia is
ADULT when an adult (usually one with a weakened immune
system or serious health problems relating to the
INTESTINAL digestive tract.) consumes the spores or bacteria
TOXEMIA where they reproduce in the adult's intestines, and
produce the toxins.
 • This type of Botulism is associated with cosmetic
LATROGENIC surgery
BOTULISM • Occurs when a patient injects too much of the toxin
for its effects on “freezing” features through Botox.
 • Once the bacterium or toxin is entered in the body,
the toxin, Botulinum toxin (Botox) is released,
causing the prevention of Acetylcholine to be
received at the neuromuscular junction.
WHAT DOES IT DO? • This block causes the muscle to be paralyzed
• If untreated, the paralysis may spread to essential
bodily functions like breathing and movement.
 SYMPTOMS

• Some symptoms are as follows

• Blurred or double vision
• Drooping Eyelids
• Difficulty swallowing or
breathing
• Muscle weakness
• Slurred speech
• Diarrhea
• Nausea and Vomiting
 SYMPTOMS
(INFANTS)

• Symptoms of botulism within

Infants are as follows
• Lethargic
• Constipation
• Weak cry
• Poor muscle tone ( appears
floppy )
 BACTERIU
M
BIOLOGY

Clostridium botulinum is a Gram-positive, rod

shaped, anaerobic, spore forming, motile
bacterium
 TOXIN
BIOLOGY

Name: Botox, Myobloc, Jeuveau

ATC Code: M03AX01
Chemical Formula:
C6760H10447N1743O2010S32
Molar Mass: 149 kg/mol
 HABITAT, RESERVOIR, LIFE
CYCLES, VECTORS

• This bacteria is found within Soil and agricultural products

along with aquatic sediments.
• Can be moved up the food chain through consumption.
• Is not transmitted between person to person, but from a
contaminated source to person.
 • Clinical Description
• Ingestion of botulinum toxin results in an illness of variable
severity. Common symptoms are diplopia, blurred vision, and
bulbar weakness. Symmetric paralysis may progress rapidly.
• Laboratory Criteria for Diagnosis
• Detection of botulinum toxin in serum, stool, or patient's
food, OR
• Isolation of Clostridium botulinum from stool
CASE DEFINITION • Case Classification
OF DISEASE • Probable
• A clinically compatible case with an epidemiologic link (e.g.,
ingestion of a home-canned food within the previous 48 hours)
• Confirmed
• A clinically compatible case that is laboratory confirmed or that
occurs among persons who ate the same food as persons who
have laboratory-confirmed botulism
 • The mortality rate for Botulism is 5-10% when
treated.
• If left untreated, It is fatal in 40-50%.
• Specifically in Infant Botulism while
MORTALITY RATE hospitalized, the case fatality rate is less the
2%.
AND LETHAL • (LD50) of toxins is 1.3–2.1 ng/kg intravenously
DOSE or intramuscularly, 10–13 ng/kg when inhaled,
or 1000 ng/kg when taken by mouth.
• It is considered the Deadliest toxin known to
man.
 PERSON FACTORS

• Everyone is at risk for Botulism, especially those who can/process their own food.
• Intravenous drug users are more susceptible to Wound Botulism.
• Babies are also susceptible to procure Botulism due to their underdeveloped digestive
tract.
• Babies should avoid eating honey or cornstarch because of the likely hood of the Spores
being in them.
 PERSON FACTORS

• In 2017, 182 laboratory-confirmed botulism cases were reported to CDC—141 (77%)

infant, 19 (10%) foodborne, 19 (10%) wound, and three (1%) “other” classified as: two
(1%) iatrogenic, and one (1%) suspected adult intestinal colonization.
• Overall, the worldwide cases of Botulism have decreased over the years to about 1,000 a
year.
• There have been some minor spikes in the U.S in specific states due too food
contamination, like California, Ohio and Mississippi.
 PLACE FACTORS

• Botulism occurs worldwide but is predominantly located in North and South America,
along with Europe.
• Different strains occur East and West of the Mississippi, primarily found among the cost
within, ocean, lake and river sediments.
• Conditions that favor this bacteria are high-moisture, low-salt, low-acid, without oxygen,
because it is Anaerobic.
• Growth of this bacteria is optimized in pH at or near 7.
 RISK MANAGEMENT

• Some ways that you could control, minimize and preventing this
disease are as followed.
• Because it is considered a rare disease, a lot of people might not
know about it so more public awareness about the disease will help
in prevention.
• Making sure that expecting mothers know about the risks of feeding
their child honey would reduce the amount of Infant Botulism.
• In regard to the FDA, properly canning and processing of food and
upholding those standards would reduce the chance of improper
canning, which leads to the bacteria reproducing.
 RISK MANAGEMENT

• Regular testing of at-risk sites like fisheries and canneries would also limit the
spikes of contamination that was seen in places like California, Ohio, and
Mississippi.
• Currently there is work on a vaccine for this disease, but no FDA approved
vaccine for the public.
• Regarding people using intravenous drugs, if admitted to the hospital a quick
screening for the bacteria and/or its toxins might also save lives.
 SOURCES

• https://extension.colostate.edu/topic-areas/nutrition-food-safety-health/botulism-9-305/
• http://www.cfsph.iastate.edu/Factsheets/pdfs/botulism.pdf
• https://www.ncbi.nlm.nih.gov/books/NBK459273/
• https://www.cdc.gov/botulism/surv/2017/index.html
• https://www.cdc.gov/botulism/pdf/bot-manual.pdf
• https://www.ndhealth.gov/Disease/Documents/faqs/Botulism.pdf
• https://www.medicinenet.com/botulism/article.htm
 SOURCES

• https://wwwn.cdc.gov/nndss/conditions/botulism/case-definition/2011/
• http://www.health.gov.on.ca/en/public/publications/disease/botulism.aspx
• https://www.nature.com/articles/nrmicro3295
• https://www2.health.vic.gov.au/public-health/infectious-diseases/disease-information-advice/botulism
• https://kidshealth.org/en/parents/botulism.html
• https://www.cdc.gov/botulism/symptoms.html
• http://www.health.gov.on.ca/en/public/publications/disease/botulism.aspx
• https://www.nicklauschildrens.org/conditions/botulism