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| Botulism, Causes, Diagnosis, Treatment, Prevention, Complications |
Botulism is a serious poisoning caused by toxins from the bacterium Clostridium botulinum. Although very rare, botulism is a serious, life-threatening condition. The poison produced by the bacterium Clostridium botulinum is known as one of the most powerful poisons. This poison attacks the nervous system and can cause paralysis or muscle paralysis.
In the vast majority of cases, people with botulism can recover with proper treatment. However, if treatment is delayed, the poison can spread to the muscles that control breathing and cause paralysis. This can lead to death.
Botulism Causes and Risk Factors
Botulism is caused by toxins from the bacterium Clostridium botulinum. These bacteria can be found in soil, dust, rivers, and the seabed.
In fact, the bacterium Clostridium botulinum is harmless under normal environmental conditions. However, these bacteria will release toxins when there is a lack of oxygen, for example if they are under mud and soil, in closed cans, bottles, or the human body.
Each type of botulism is triggered by different factors. Here is the explanation:
Foodborne botulism
This type of botulism occurs due to consumption of food contaminated with C. botulinum bacteria, especially canned foods that are not processed properly. The types of foods that are known to contain this bacteria are:
- Canned low-acid fruit or vegetables
- Canned fish
- Fermented, smoked or salted fish
- Canned meat
Wound botulism
This botulism occurs when the bacteria C. botulinum gets into a wound. This condition often occurs in people who abuse drugs, especially the injection type.
The bacteria that trigger botulism can contaminate illegal substances, such as heroin. When the drug enters the body, the bacteria in the substance will multiply and produce toxins.
Infant botulism
Infant botulism occurs when a baby eats food containing C. botulinum spores (usually honey or corn syrup) or is exposed to soil contaminated with the bacteria.
Bacterial spores that are ingested by the baby will multiply and release toxins in the digestive tract. However, these bacterial spores are harmless in infants over 1 year of age. This is because his body has formed immunity against bacteria.
Symptoms of Botulism
Symptoms of botulism appear within hours or days after a person is exposed to toxins from the bacterium Clostridium botulinum. Early symptoms of botulism include stomach cramps, nausea, vomiting, diarrhea, or constipation.
If not treated immediately, the toxins from these bacteria will interfere with nerve function and cause muscle paralysis. Symptoms that can appear include:
- Dysphagia (difficulty swallowing)
- Difficulty speaking or speech becomes slurred
- Dry mouth
- Weakness in facial muscles
- Double or blurred vision
- Drooping eyelids
- It's hard to breathe
- Paralysis or difficulty moving the body
In foodborne botulism, the above symptoms generally appear 12–36 hours or days after the poison enters the body. Whereas in the case of wound botulism, symptoms usually only appear 10 days after exposure to the poison.
In the case of infant botulism, symptoms appear 18–36 hours after the poison enters the body. Complaints that arise in infant botulism include:
- Constipation or constipation
- Fussy
- Drooling
- Looks sleepy
- Movement looks drooping
- Difficulty controlling head movement
- Seems to have difficulty sucking milk or chewing food
- Weak crying sound
- Weak
- Paralyzed (not moving at all)
When to go to the doctor
Go to the ER immediately if you or your child has symptoms of botulism. Early examination and treatment can increase the chances of recovery and reduce the risk of complications.
Diagnosis of botulism
The doctor will ask the patient's symptoms and what foods were consumed before the symptoms appeared, including honey or corn syrup in infants.
After that, the doctor will perform a physical examination to look for signs of paralysis and look for any wounds on the patient's body that could be an entry point for bacteria.
To ensure that the symptoms that occur are really caused by botulism and not due to another disease, the doctor may perform additional tests, such as:
- Test samples of blood, vomit, or feces, to confirm the presence of toxins produced by the bacteria that cause botulism
- Electromyography, to check nerve and muscle function
- Scan with a CT scan or MRI scan of the head, to rule out the possibility of symptoms being caused by another disease, such as a stroke
- Examination of cerebrospinal fluid (brain and spinal fluid), to check whether symptoms are caused by infection or from injury to the brain and spine.
Botulism Treatment
The main treatment for botulism is the administration of an antitoxin to prevent the toxin from binding to the nerves and damaging them. This therapy can prevent worsening of symptoms and reduce the risk of complications. However, the antitoxin cannot break the already established bond between the nerve and the poison.
Further treatment depends on the type of botulism and the patient's condition. In the case of foodborne botulism, the doctor will prescribe medication to stimulate the patient to vomit and laxatives to flush out toxins in the digestive system. This is done if the food suspected of causing botulism has only been consumed a few hours before.
Especially in wound botulism, the doctor will perform surgery to remove the infected tissue and give antibiotics. Antibiotics should not be used in other types of botulism because they can accelerate the release of toxins.
Based on the symptoms experienced, other treatments that can be done include:
Providing breathing apparatus
A breathing apparatus or ventilator will be placed on patients who have difficulty breathing. The ventilator will be installed for several weeks until the effects of the poison decrease gradually.
Feeding hose installation
Patients who have difficulty swallowing will be given a feeding tube. The goal is to meet the nutritional needs of patients, especially patients who are still children or infants.
Rehabilitation therapy
Rehabilitation therapy is performed on patients whose condition is stable. Its purpose is to aid recovery in speech and swallowing, as well as improve bodily functions affected by botulism.
Complications of Botulism
Botulism can affect all muscles in the body. If not treated immediately, this condition can cause respiratory arrest, which is the most common cause of death from botulism.
Other complications that can occur are long-term disorders, in the form of:
- Difficulty in speaking and swallowing
- Fatigue
- Hard to breathe
Prevention of botulism
There are several steps you can take to prevent botulism, including:
- If you want to eat canned food, preheat the food at a temperature above 120 degrees Celsius for 20–100 minutes, depending on the type of food.
- Avoid eating foods that have been damaged in packaging, preserved foods that have smelled, expired foods, and foods that are stored at inappropriate temperatures.
- Do not give honey to babies under the age of 1 year even a little, because honey is known to contain spores of the botulinum bacteria.
Do not use drugs, especially heroin, either by inhalation or by injection. Please note that the use of sterile syringes cannot prevent botulism, because what is contaminated with botulism-causing bacteria is heroin itself.
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