Botulism history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.

History and Symptoms

Food-borne and Wound Botulism

• Classic symptoms of food-borne botulism usually occur between 12–36 hours after consuming the botulinum toxin. However, they can occur as early as 6 hours or as late as 10 days after.
• Wound botulism has a longer incubation period, usually between 4–14 days.
• Common symptoms of either form usually include:
  • Dry mouth
  • Difficulty swallowing
  • Slurred speech
  • Drooping eyelids
  • Muscle weakness
  • Double and/or blurred vision
  • Vomiting
  • Blatter
  • Sometimes diarrhea
  • These symptoms may progress to cause paralytic ileus with severe constipation, and eventually body paralysis. The respiratory muscles are affected as well, which may cause death due to respiratory failure. These are all symptoms of the muscle paralysis caused by the bacterial toxin.

In all cases illness is caused by the toxin made by C. botulinum, not by the bacterium itself. The pattern of damage occurs because the toxin affects nerves that are firing more often.

Infant Botulism

Infants less than 12 months of age are susceptible, with 95% of cases occurring between the ages of 3 weeks and 6 months of age at presentation. The mode of action of this form is through colonization by germinating spores in the gut of an infant. Symptoms includes

• Constipation
• Generalized weakness
• Loss of head control and difficulty feeding.
• Like the other forms of botulism, the symptoms are caused by the absorption of botulinum toxin, and typically progress to a symmetric descending flaccid paralysis. Death is the eventual outcome unless the infant receives artificial ventilation.