21. New York City Department Of Health - Communicable Disease - Botulism, July 2000 Medical Treatment and Response to Suspected botulism Information forHealth Care Providers During Biologic Emergencies. July 2000 Draft http://www.nyc.gov/html/doh/html/cd/botmd.html

New York City Department of Health Bureau of Communicable Disease Medical Treatment and Response to Suspected Botulism: Information for Health Care Providers During Biologic Emergencies July 2000 Draft Key Summary Points Introduction/Epidemiology Significance as a Potential Bioterrorist Agent Clinical Manifestations ... References ALL SUSPECT CASES OF BOTULISM MUST BE REPORTED IMMEDIATELY TO THE BUREAU OF COMMUNICABLE DISEASE: During Business Hours: After Hours (Nights, Weekends and Holidays): 212-POISONS KEY SUMMARY POINTS Epidemiology: Botulinum neurotoxins (A-F) could be transmitted by aerosol or contamination of food and water supplies Botulism is NOT transmitted from person to person Clinical: Incubation period is 12-36 hours (can be several days) Early symptoms include blurred vision, diplopia, and dry mouth Later symptoms include dysarthria, dysphagia, dysphonia, ptosis and the development of a symmetrical, descending progressive paralysis and respiratory failure Patients are usually alert and afebrile Diagnosis: Diagnosis is primarily based on a compatible clinical presentation Spinal fluid protein is normal and characteristic findings are seen on EMG (facilitation of the compound muscle action potential on repetitive nerve stimulation) Toxin can be detected in serum and stool (foodborne botulism) by mouse neutralization bioassay Treatment: Supportive care is the mainstay of therapy; prolonged ventilatory support is often required for severe cases

22. Vm.cfsan.fda.gov/cgi-bin/bbbglos?Botulism http://vm.cfsan.fda.gov/cgi-bin/bbbglos?Botulism

23. Botulism Infant botulism The controversial. It is clear that many infants whoare diagnosed with infantile botulism are primarily breastfed. http://home.coqui.net/myrna/botu.htm

Infant Botulism The infant botulism syndrome is an infectious neuroparalytic disease resulting from the ingestion of spores of Clostridium botulinum which germinate, multiply and produce botulinal toxin within the infant’s large intestine. First described in 1976 it has now been reported from all inhabited continents except Africa. The clinical features include constipation, poor feeding, weakness, hypotonia, dysphagia and in severe cases, flaccid paralysis and respiratory failure. The pediatrician should keep in mind this rare entity, for prompt treatment. Back to PB Index Back to PB Homepage

24. Aktuellt Om Botulism botulism. Bearbetning och aktualisering av 'Farsoter under förhistorisk tid' Copyright© Magdalena Stjernberg. Förstasida . Engelska botulism. Franska http://www.e-interman.com/botulism.html

BOTULISM Bearbetning och aktualisering av 'Farsoter under förhistorisk tid' Magdalena Stjernberg Förstasida Engelska: Botulism Franska: Botulisme Tyska: Botulismus Synonymer: Korvförgiftning Sjukdomsagens: Bakterie: Clostridium botulinum, Bacillus botulinus Smittreservoar: d jur, jord, havsslam, människa, vatten Mottagliga djur: fågel, get, häst, ko, mollusk, strömming, svin, säl Smittöverföring via: m at, vatten En födoämnesförgiftning som inte i första hand ger symptom från matsmältningsorganen utan från nervsystemet Historik Sjukdomen fick sin ofta använda benämning ”botulism” i slutet av 1800-talet när man började förmoda att köttprodukter kunde vara orsak till utbrott av sjukdomen (lat. botulus = korv). Det är rimligt att anta att redan samhällen under tidig stenålder kommit i kontakt med denna sjukdom. Geografisk förekomst Botulism förekommer över hela jorden. Sjukdomsagens Clostridum botulinum är en anaerob sporbildande bakterie som alstrar ett exotoxin som är det giftigaste ämne man känner till. Denna mycket vanliga bakterie som framförallt påträffas i jord är inte sjukdomsalstrande i sig, utan det är toxinet som orsakar sjukdom. Det bildas vid förökning i framförallt kött och fisk.

25. Botulism Fact Sheet - Public Health - Seattle & King County King County Navigation Bar (text navigation at bottom). CommunicableDisease Fact Sheet botulism. What is botulism? It is poisoning http://www.metrokc.gov/health/prevcont/botulism.htm

Communicable Disease Fact Sheet Botulism What is botulism? Symptoms How is it spread? Diagnosis and treatment ... Prevention What is botulism? It is poisoning from eating a toxin formed in food contaminated with the spores of a bacteria called Clostridium botulinum. These spores are widespread in the environment, but are harmless when oxygen is present. They may produce the toxin if they are an environment that contains no oxygen, such as inside a can or jar of improperly canned food. Symptoms Symptoms start 12-36 hours and sometimes several days after eating a contaminated food and include: blurred vision dry mouth paralysis of the muscles, especially those muscles that control the face, swallowing, and breathing. vomiting constipation or diarrhea How is it spread? Clostridium botulinum spores are common in the soil and can often be found on agricultural products. Poorly prepared, home canned vegetables and fruits are the most common source. Toxins are formed when foods are inadequately heated during canning. Illnesses have also occurred with commercial products such as potpies, baked potatoes, and sauteed onions and cured foods in airtight packaging.

26. Botulism - Iowa State Food Safety Project What is botulism? Sausages, meat products, canned vegetables and seafoodproducts have been the most frequent vehicles for human botulism. http://www.extension.iastate.edu/foodsafety/botulism.html

27. Botulism As A Biological Weapon. botulism As Disinformation. botulism Toxin is Impossible to use. botulismwill never be used successfully as a terrorist or military weapon. http://nov55.com/botu.html

NOV Gary Novak nov Botulism As Disinformation A Biologist's Perspective Propaganda on biological weapons including botulism originates in the dark cellars of government for the purpose of swaying the public for increased police powers. Botulism Toxin is Impossible to use. Botulism will never be used successfully as a terrorist or military weapon. It is a toxin which is fragile, unstable and impossible to purify in significant quantities or apply to a purpose. A Protein is not for the Air. Botulism toxin is a protein, which is a chain of amino acids. It targets the nerve system disrupting neurotransmitter function resulting in paralysis and death. When proteins are concentrated, they coagulate becoming gummy like cheese. So botulism toxin would have to be kept very dilute in water. When proteins desiccate, they lose complex biological properties becoming like shoe leather. So botulism would not be practical as an airborne toxin, not to mention the fact that proteins do not stay suspended in air like nerve gas. Journalists claim that biological weapons such as botulism can be produced in a five gallon bucket in someone's back yard. There are biological reasons why their claims are absurd.

28. Tetanus And Botulism Type G toxin is thought to be plasmid encoded. Pathogenesis of botulism. Foodbornebotulism. However, symptomatic CNS involvement is rare. Infant botulism. http://www.bact.wisc.edu/Bact330/lecturetetbot

Bacteriology at UW-Madison Bacteriology 330 Home Page The Pathogenic Clostridia The Genus Clostridium Left. Stained pus from a mixed anaerobic infection. At least three different clostridia are apparent. Right. Electron micrograph of Clostridium tetani cells. The clostridia are relatively large, Gram-positive, rod-shaped bacteria. All species form endospores and have a strictly fermentative mode of metabolism. Most clostridia will not grow under aerobic conditions and vegetative cells are killed by exposure to O2, but their spores are able to survive long periods of exposure to air. The clostridia are ancient organisms that live in virtually all of the anaerobic habitats of nature where organic compounds are present, including soils, aquatic sediments and the intestinal tracts of animals. Clostridia are able to ferment a wide variety of organic compounds. They produce end products such as butyric acid, acetic acid, butanol and acetone, and large amounts of gas (CO2 and H2) during fermentation of sugars. A variety of foul smelling compounds are formed during the fermentation of amino acids and fatty acids. The clostridia also produce a wide variety of extracellular enzymes to degrade large biological molecules in the environment into fermentable components. Hence, the clostridia play an important role in nature in biodegradation and the carbon cycle. In anaerobic clostridial infections, these enzymes play a role in invasion and pathology. Most of the clostridia are saprophytes but a few are pathogenic for humans. Those that are pathogens have primarily a saprophytic existence in nature and, in a sense, are opportunistic pathogens.

29. Harrison's Online: Chapter 144 Part 7 Infectious Diseases Section 5 Diseases Caused By GramPositiveBacteria Chapter 144 botulism Author Elias Abrutyn. Definition. http://www.mheducation.com/HOL2_chapters/HOL_chapters/chapter144.htm

Reproduced from Harrison's Online ( www.harrisonsonline.com as given at the website. Part 7: Infectious Diseases Section 5: Diseases Caused By Gram-Positive Bacteria Chapter 144: Botulism Author: Elias Abrutyn Definition Botulism is a paralytic disease that begins with cranial nerve involvement and progresses caudally to involve the extremities. It is caused by potent protein neurotoxins elaborated by Clostridium botulinum . The toxins' high potency has led to consideration of their use in bioterrorism or biological warfare. Cases may be classified as (1) food-borne botulism , from ingestion of preformed toxin in food contaminated with C. botulinum wound botulism , from toxin produced in wounds contaminated with the organism; (3) infant botulism , from ingestion of spores and production of toxin in the intestine of infants; or (4) adult infectious botulism , a group that includes some cases in older children and adults in which disease is produced by a mechanism similar to that described for infant botulism. Etiologic Agent C. botulinum

30. Botulism How to prevent botulism food poisoning. Proper methods of canning low acid homecanned foods. Causes, symptoms, diagnosis, treatment. Infant botulism. http://hgic.clemson.edu/factsheets/HGIC3680.htm

HGIC 3680 http://hgic.clemson.edu Botulism WHAT IS BOTULISM? Botulism is a food poisoning caused by a toxin produced by the bacteria, Clostridium botulinum C. botulinum and its spores are everywhere. It is prevalent in soil and water worldwide. The bacteria and spores themselves are harmless; however, when they grow, they create a highly toxic poison that can lead to extreme illness and even death. The spores must have an oxygen-depleted, low-acid environment in which to grow, and prefer temperatures between 40 °F and 120 °F. This organism can easily grow in improperly stored home-cooked or commercial foods, as well as in canned foods that have not been prepared with proper canning procedures. During the canning process, oxygen is removed from the container and if the proper temperatures to destroy the spores are not reached, the spores now have the proper environment to grow into vegetative cells and eventually produce the deadly toxin. WHO GETS BOTULISM? Foodborne botulism is due to ingestion of a toxin formed in food. One of the most common culprits in foodborne botulism is home canned foods, especially low-acid foods such as asparagus, corn, green beans, lima beans, mushrooms, peppers, sauces, soups, meats, fish and poultry. More than 90 percent of foodborne botulism outbreaks between 1976 and 1985 were due to home-processed foods. Commercial foods have also been involved in botulism outbreaks. Some outbreaks have been attributed to improperly handled food, such as potato salad, served in restaurants. But many commercial food outbreaks are due to consumer mishandling, such as disregarding labels that indicate the food should be refrigerated. Some food companies acidify their products or lower their moisture content as an extra precautionary measure in case the refrigeration warning is not heeded. Consumers can best protect themselves by reading the labels and following the storage instructions and by discarding rusty, swollen or otherwise damaged cans.

31. Botulism In The United States: A..., Annals 1 Aug 98 botulism in the United States A Clinical andEpidemiologic Review. REVIEW.botulism in the United States A Clinical and Epidemiologic Review. http://www.acponline.org/journals/annals/01aug98/botulism.htm

Annals of Internal Medicine Current Issue Past Issues Library for Internists Subscriptions ... Email this page Annals of Internal Medicine REVIEW Botulism in the United States: A Clinical and Epidemiologic Review Annals of Internal Medicine , 1 August 1998. 129:221-228. Botulism is caused by a neurotoxin produced from the anaerobic, spore-forming bacterium Clostridium botulinum. Botulism in humans is usually caused by toxin types A, B, and E. Since 1973, a median of 24 cases of foodborne botulism, 3 cases of wound botulism, and 71 cases of infant botulism have been reported annually to the Centers for Disease Control and Prevention (CDC). New vehicles for transmission have emerged in recent decades, and wound botulism associated with black tar heroin has increased dramatically since 1994. Recently, the potential terrorist use of botulinum toxin has become an important concern. Ann Intern Med. Annals of Internal Medicine From the Centers for Disease Control and Prevention, Atlanta, Georgia. For current author addresses, see end of text Botulism is a neuroparalytic illness caused by a neurotoxin produced from the anaerobic, spore-forming bacterium

32. Botulism only). botulism (foodborne botulism and infant botulism). Direct specificquestions to your medical provider.). What is botulism? botulism http://www.state.sd.us/doh/Pubs/botulism.htm

South Dakota Department of Health - Office of Disease Prevention - 605-773-3737 in South Dakota only) BOTULISM (food-borne botulism and infant botulism) (This material is provided for informational purposes only and is not a substitute for medical care. Direct specific questions to your medical provider.) What is botulism? Botulism is a rare but serious food poisoning caused by a toxin produced by the bacteria, Clostridium botulinum. What causes botulism? Food-borne botulism is caused by eating a food containing the toxin. It often involves improperly processed home-canned foods. Botulism in infants under one year of age has been associated with eating of contaminated honey. How is botulism spread? Person to person spread does not occur. A person must eat contaminated food that has not been properly cooked or reheated after the toxin has been produced by the bacteria. With infant botulism, an infant must eat bacterial spores, which then produce the toxin in his/her gastrointestinal tract. What are the symptoms of botulism?

33. What Is Botulism What is botulism? (10/22/2001). Not indicated. botulism is a rare neuromusculardisease caused by a toxin produced by the bacterium, Clostridium botulinum. http://www.state.sd.us/doh/Bioterrorism/botulism.htm

What is Botulism? Quick reference - Infective dose Incubation period Duration of illness Symptoms Mortality 0.0001 ug/kg (type A toxin) 12-36 hours for food-borne 24-36 hours up to several days for inhalation Death in 24-72 hours; lasts months if not lethal Blurred or double vision; general weakness, poor reflexes, dizziness, dry mouth, slurred speech, difficulty swallowing, loss of muscle control, and paralysis For intentional toxin release, high, without respiratory support Transmission Isolation precautions for hospitalized Persistence of organism Patient decontamination Not transmitted from person to person Standard Food/water ~weeks Not indicated Botulism is a rare neuromuscular disease caused by a toxin produced by the bacterium, Clostridium botulinum . Since 1990 there have been 3 cases of botulism confirmed in South Dakota. How do you get botulism? It is not spread from person to person. You may contract botulism by eating contaminated food that has not been properly cooked or reheated after the toxin has been produced by the bacteria. Botulism may also be contracted by breathing in the aerosolized toxin. Wounds can also become infected by exposure to C. botulinum

34. NY-PA-OH Sea Grant: Botulism In Lakes Erie, Ontario 2002. NY/PA/OH Sea Grant botulism in Lakes Erie, Ontario. The shore? Thesebirds were killed by the bacterial disease botulism. According http://www.seagrant.sunysb.edu/botulism/default.htm

New York Sea Grant: Home Page Pennsylvania Sea Grant Home Page ... Home Page Site Created and Maintained by: Paul C. Focazio NYSG Assistant Communicator Last Updated: Tuesday, November 19, 2002 NY/PA/OH Sea Grant: Botulism in Lakes Erie, Ontario The situation For bird watchers, the chance to see a common loon is exciting. In the Fall 2000, though, their excitement turned to disappointment as they found many of these beautiful birds washed up along the New York shore of Lake Erie. And loons weren’t the only dead birds found in the Lakes. Hundreds of mergansers, grebes, mallard ducks, ring-billed and herring gulls, and other dead waterfowl littered the shoreline. What was the cause of death for these birds and fish that were beginning to wash up on Lake Erie's shore in late 2000? And, as Sea Grant announced in July 2002, on Lake Ontario's shore? These birds were killed by the bacterial disease botulism. According to the New York State Department of Environmental Conservation, the agency in charge of collecting, counting and conducting pathology on the birds, more than 5,000 birds were impacted by the outbreak in 2000 alone.

35. NY-PA-OH Sea Grant: Botulism In Lakes Erie, Ontario - About Botulism NY/PA/OH Sea Grant botulism in Lakes Erie, Ontario. What is botulism? Birdsand fish that have died from botulism decay and become hosts for maggots. http://www.seagrant.sunysb.edu/botulism/aboutbotulism.htm

New York Sea Grant: Home Page Pennsylvania Sea Grant Home Page ... Home Page NY/PA/OH Sea Grant: Botulism in Lakes Erie, Ontario What is Botulism? Botulism, a disease caused by Clostridium botulinum , has been recognized as a major cause of mortality in migratory birds since the 1900s. Although type C botulism has caused the die-off of thousands of waterfowl (especially ducks) across the western United States, type E botulism has been mainly restricted to fish-eating birds in the Great Lakes. Other outbreaks of type E have sporadically occurred in Alaska, Florida and California, and periodic outbreaks have occurred in Lake Michigan and Lake Huron over a 20-year period beginning in 1964. During 1999 and 2000, a large die-off of waterfowl occurred in Lake Erie and type E botulism was isolated in these outbreaks. In 2001, a large die-off of benthic fishes like sheepshead occurred along the shores, followed in the fall by another die-off of fish-eating birds.

36. Avian Botulism Avian botulism. What Is Avian botulism? Avian botulism, or Western duck sickness,is one of the three most important disease problems of wild migratory birds. http://www.nwhc.usgs.gov/facts/avian.html

Avian Botulism What Is Avian Botulism? How Serious Is It? Where Does It Occur? What Species Are Affected? ... Dedication Selecting any thumbnail image will display a full-sized version of the graphic. What Is Avian Botulism? Avian botulism, or Western duck sickness, is one of the three most important disease problems of wild migratory birds. Each year, many birds are paralyzed or die after exposure to a toxin produced by the botulinum bacterium. Two of the seven toxin types that have been identified commonly cause mortality in wild birds; one of these, type C, is most often associated with dieoffs of ducks, while type E primarily affects gulls and loons. How Serious Is It? Losses vary from year to year and from species to species. A few hundred birds may die one year at a specific location, with tens of thousands dying the following year at the same site. More than a million deaths from avian botulism have been reported in localized outbreaks in a single year. Outbreaks causing losses of 50,000 or more birds are fairly common. Initial Outbreaks of Type C Botulism in Wild Waterfowl Americas United States Europe-Africa Denmark Canada Great Britain Uruguay Netherlands Mexico Germany Australia-Asia Australia Italy New Zealand Spain Japan South Africa A Montana marsh experiences an outbreak of type C avian botulism.

37. NWHC: Avian Botulism Fact Sheet Avian botulism is a paralytic disease caused by ingestion of a toxin producedby the bacteria, Clostridium botulinum. Fact Sheet Avian botulism. http://www.nwhc.usgs.gov/whats_new/fact_sheet/fact_avian_botulism.html

Fact Sheet: Avian Botulism Cause Bacteria Clostridium botulinum , Types C and E toxins Host Type C toxin: waterfowl, shorebirds, colonial waterbirds, and others Type E toxin: gulls, loons, and others Transmission Avian botulism is a paralytic disease caused by ingestion of a toxin produced by the bacteria, Clostridium botulinum . This bacteria is widespread in soil and requires warm temperatures, a protein source and an anaerobic (no oxygen) environment in order to become active and produce toxin. Decomposing vegetation and invertebrates combined with warm temperatures can provide ideal conditions for the botulism bacteria to activate and produce toxin. There are several types of toxin produced by strains of this bacteria with birds being most commonly affected by type C and to a lesser extent type E. Birds either ingest the toxin directly or may eat invertebrates (e.g. chironomids, fly larvae) containing the toxin. Invertebrates are not affected by the toxin and store it in their body. A cycle develops in a botulism outbreak when fly larvae (maggots), feed on animal carcasses and ingest toxin. Ducks that consume toxin-laden maggots can develop botulism after eating as few as 3 or 4 maggots. Clinical Signs/Field Signs Healthy birds, affected birds, and dead birds in various stages of decay are commonly found in the same area. The toxin affects the nervous system by preventing impulse transmission to muscles which results in flaccid paralysis. Consequently, birds are unable to use their wings and legs normally or control the third eyelid, neck muscles, and other muscles. Birds with paralyzed neck muscles cannot hold their heads up and often drown. Death can also result from water deprivation, electrolyte imbalance, respiratory failure, or predation.

38. Infant Botulism - DrGreene.com - Caring For The Next Generation Honey and Infant botulism. My daughter is now 7 months old. I It maysave her life. The concern is with infant botulism. Botulinum http://www.drgreene.com/21_825.html

QUICK SEARCH A - Z Guide Allergies Allergy Care Guide Asthma Care Guide Bedwetting Breastfeeding Childhood Obesity Diabetes Care Guide Ear Infections Genetics Immunizations Infectious Diseases Parenting Potty Training Rashes Safety Sleep DrGreene.com Topic Centers Mission Reviews Awards Readers Comments Press Room Partners and Supporters Contact Us Pediatric Information A-Z Guide Allergy Care Guide Asthma Care Guide Diabetes Care Guide DrGreene´s Chats FAQ Fast Facts Feature Articles Guidelines Pediatric Updates Special Feature Top Tips Community Activty Guide Advanced Search Community Central Chat Chat Schedule Cute Faces Family Friendly Recipes Parent-to-Parent Resources The DrGreene Team Newsletter Prenatal Newborn Infants Toddlers Pre-Schoolers School Age Teens / Adolescents Multimedia Library Children's Health Fertility Honey and Infant Botulism My daughter is now 7 months old . I have been adding locally produced honey to my daughter's food to help with her allergies . In my opinion, this has decreased her allergy like symptoms. My wife and I have had great success decreasing our allergies with this practice. I was told that honey can hurt an infant. Is this true? Mark Torrans Pineville, Louisiana

39. Infant Botulism - DrGreene.com AZ Guide Infant botulism. Also known as botulism Infant botulism is spreadby these spores, not by preformed botulinum toxin (BoTox). http://www.drgreene.com/21_1037.html

QUICK SEARCH A - Z Guide Allergies Allergy Care Guide Asthma Care Guide Bedwetting Breastfeeding Childhood Obesity Diabetes Care Guide Ear Infections Genetics Immunizations Infectious Diseases Parenting Potty Training Rashes Safety Sleep DrGreene.com Topic Centers Mission Reviews Awards Readers Comments Press Room Partners and Supporters Contact Us Pediatric Information A-Z Guide Allergy Care Guide Asthma Care Guide Diabetes Care Guide DrGreene´s Chats FAQ Fast Facts Feature Articles Guidelines Pediatric Updates Special Feature Top Tips Community Activty Guide Advanced Search Community Central Chat Chat Schedule Cute Faces Family Friendly Recipes Parent-to-Parent Resources The DrGreene Team Newsletter Prenatal Newborn Infants Toddlers Pre-Schoolers School Age Teens / Adolescents Multimedia Library Children's Health Fertility Infant Botulism Also known as: Botulism Introduction: Sometimes constipation and slow feeding are the only symptoms of infant botulism, a disease that is sometimes caused by honey. What is it? The honey story is fascinating. The safety concern about honey arose because honey often contains spores that, under the right circumstances, can cause a disease discovered in 1976, called infant botulism. Infant botulism is spread by these spores, not by pre-formed botulinum toxin (BoTox). Botulism spores are found throughout nature – in soil, in dust, and on the unwashed surfaces of unpeeled fruits and vegetables. The spores are present in about 10 percent of the samples of honey tested. These spores are tough to kill. They are quite heat-resistant; some can survive boiling for several hours.

40. Botulism botulism. Symptoms of botulism. Infant botulism. Infant botulism. Clostridiumbotulinum can also cause sickness in very young children. http://www.foodbiotech.org/pathogens/botulism.htm

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