Clostridium botulinum and Botulism

1. Clostridium botulinumand Botulism A Caitlin, Farida, Nino, Natalie and Simon Presentation

2. OUTLINE • Introduction to C. Botulinum • Introduction to Botulism • Infant Botulism • Food-Borne Botulism • Wound Botulism • Bioterrorism

3. Gram positive rods Spore forming Anaerobic bacteria Produces toxin that causes botulism Seven neurotoxic subtypes, labeled A-G First recognized and isolated in 1896 by Van Ermengem Clostridium botulinum

4. Botulism • Botulism is a neuroparalytic disease • It is caused by the potent protein toxin released from C. botulinum • Once released into the bloodstream it irreversibly binds to the acetylcholine receptors in the neuromuscular junction • It alters the mechanism for acetylcholine release, making the neuron unresponsive to action potentials • Three major types: Infant, food-borne, and wound • Potential bio-weapon due to its potency

7. Infant Botulism • Most common form • 2 per 100,000 live births in US • Afflicts babies from 1 week – 1 year • Antigenic variations types A/B • Caused by: • Ingesting contaminated foodstuff • Lack of breast milk • Untreated natural honey and corn syrup • Household dust containing C. botulinum spores

8. Signs and Symptoms Poor feeding (weak sucking) Weak gag Weak cry Decreased movement Appearing lethargic Flat, blunted facial expression Trouble swallowing Excessive drooling Muscle weakness Breathing problems Ptosis (Drooping eyelids) Poor head control Decreased anal sphincter tone Decreased deep tendon reflexes Treatment and Recovery New drug: BabyBIG®, Botulism Immune Globulin Intravenous (Human) (BIG-IV) Drastically reduces lethargy, IV feeding and overall hospital stay With early detection, proper treatment, no long term effects observed Infant Botulism

9. Food-borne Botulism • Second most common form • Caused by eating food containing the toxin produced by C. botulinum • Antigenic variations types A/E • Non-commercially canned food is at a higher risk for being contaminated • Dangerous because most contaminated foods cannot be detected until too late

10. Signs and Symptoms 12 – 36 hrs after Muscle weakness, Diarrhea Blurred vision Vomiting Eventual Paralysis Treatment and Recovery Equine Botulinum Antitoxin Lingering symptoms are fatigue and respiratory difficulty With early detection, proper treatment, no long term effects observed Prevention Inspect canned food for Bulging Loose lids Mold Odor Proper home canning procedures: Hygiene Time schedule, Proper processing method Equipment Avoiding home canning or cheaply produced commercial food Food-borne Botulism

11. Wound Botulism • Least common, but on the rise • Occurs when spores inoculate a wound and anaerobic conditions allow germination and subsequent production of the toxin • Associated with IV drug use (rise in black tar heroine use), and medical equipment ex. catheters • Often misdiagnosed as other neurological syndromes

12. Bioterrorism • C. botulinum is one pathogenic microorganism that has been researched and developed into a biological weapon. • Many countries, and now terrorists, have developed and used botulinum toxin as a biological weapon. • From 1990 to 1995, aerosols were dispersed at multiple sites in downtown Tokyo and at US military installations in Japan on at least 3 occasions by Japanese terrorists. • In 1995, Iraq revealed that it had deployed more than 11,000 L of botulinum toxin into specially designed SCUD missiles.

13. Bioterrorism • Smallpox and anthrax may be getting the most attention, but bio-defense researchers have long been concerned about botulinum toxin, the deadliest of all potential toxic threats gram for gram. • A biological attack with the botulinum toxin would more likely be dispersed in an aerosolized form. • Currently, the US military possesses limited quantities of an investigational heptavalent antitoxin, which might be available in the event of a terrorist attack

14. QUESTIONS