Botulism: Symptoms and Treatment

Botulism: These symptoms indicate the food poisoning

Botulism is caused by bacteria. The first symptoms appear between 12 and 36 hours after ingestion of the poison.

• The bacterium Clostridium botulinum is responsible for botulism. However, it is not the germ itself that causes illness, but a metabolite of the bacterium, the highly toxic botulinum toxin. So botulism is not an infection, but a poisoning.
• These bacteria multiply in the absence of air and like to grow in protein-rich foods such as meat and sausages. Incidentally, this is also where the name of food poisoning comes from: the Latin word for “sausage” is “botulus”.
• Botulinum toxin is a very strong neurotoxin. By the way, you probably know it by another name from the beauty industry: Botox is nothing more than botulinum toxin.
• Botulinum toxin poisoning is manifested by fairly clear symptoms. In the beginning, nausea and vomiting occur, often accompanied by abdominal cramps and diarrhea. Diarrhea is later followed by stubborn constipation due to paralysis of the intestines.
• Since botulinum toxin is a neurotoxin that inhibits signal transmission between nerves and muscles, symptoms of paralysis gradually follow throughout the body.
• This paralysis typically begins in the muscles in the head and neck area and manifests itself in swallowing and speech disorders. The eyelids are also affected. Often the eyelids droop on one or both sides.
• After that, the paralysis spread to the entire body. Both arms and legs can be affected, but also the muscles of the respiratory tract.
• Double vision and dilated pupils are also characteristic of botulism, with the pupillary reflex being either weakened or absent. There is also a dry mouth.
• Incidentally, children under the age of one are not allowed to eat honey because it actually always contains the Clostridium botulinum bacterium. This can lead to what is known as infant botulism in young children.
• You can read more about whether honey is healthy in another article.

If botulism is suspected, it must be treated in an intensive care unit

Botulism is a life-threatening food poisoning. The shorter the time between ingestion of the poison and the appearance of the first symptoms, the higher the mortality rate. The mere suspicion of food poisoning, therefore, makes immediate treatment in the intensive care unit absolutely necessary.

• Treatment consists primarily of the administration of an antidote. This botulism antiserum can neutralize the toxin that is freely present in the blood. However, it does not work against the botulinum toxin that is already bound to nerve structures.
• Since most of the venom is bound within 24 hours, it is important to administer the antidote as early as possible. Since the antidote can also be dangerous and, in the worst case, trigger severe allergic reactions, it must first be tested for compatibility with a small dose into the skin.
• In addition, an attempt is made to remove any botulinum toxin that may still be present in the digestive tract from the body with the help of gastric lavage and enemas.
• If the respiratory muscles become paralyzed, the person concerned must be artificially ventilated. By the way, we also explain what an interdisciplinary intensive care unit is.