Talk:Botulism

Removed this paragraph:

One common symptom is a certain rigidity to the arms - botulism patients have often been compared to dinosaurs such as the mighty T-rex for their distinctive arm position. The T-Rex arm positioning has also been compared that of malformed babies born with stumpy. all about noodles

Table

Botulism 1

1) Year, 1st recognized & isolated?	1) 1896 (Van Ermengem)
2) Microbe involved?	2) Clostridium botulinum
3) Properties....	3) spore-forming, anaerobic bacillus
4) Subtypes produce...	4) 7 toxins (1/sub-sp) A-G types ¹
5) U.S. outbrakes are due to types...	5) A, B (soil) or E (fish) ²
6) Symptoms develope...	6) between 12-36 hours
7) Symptoms are...	7) dry mouth, difficulty swallowing, double vision, vomiting, diarrhea
8) Which is of most concern?	8) respiratory failure
¹ Types C & D are not human pathogens. A "mouse protection" test determines the type of C. botulinum present (antibodies used).
² A & B found in soil. Type E is found in fish. Optimum temp for A & B is 35-40° C. Minimum pH is 4.6. 25 min @ 100°C to kill. Optimum temp for E is 18-25. Minimum pH is 5.0. <0.1 min @ 100°C to kill.

---

Botulism 2

1) Mode of action of toxin.	1) blocks the release of acetylcholine from nerve endings ¹
2) Infant botulism: characteristics...	2) most common type in US, germinating spores in gut, results in; constipation, weakness, loss of head control & difficulty feeding
3) One possible cause...	3) under pastuerized honey
4) Why does infection occur?	4) lack of competitive inhibition from adult microflora
¹ Infection does not occur in healthy adults & children more than 1 year old. Rather, the toxin made by C. botulinum causes illness.

Most potent toxin on earth?

It is true that Botulism toxin us normally referred to as "the most potent toxin on earth." I am unsure of the accuracy of that statement. I just finished editing the article, with special attention to infant botulism, as I am a California pediatrician with some experience in that disease.

I thought about adding information regarding the theoretical use of botulinum toxin as a tool of bioterrorism, but decided against it. I don't want to give the loonies any ideas.

I hope my edits don't arouse any controversy. I changed the term "infection" to the more technically correct "colonization," and de-emphasized the link to honey, as it is not a major player. I also edited some aspects of infant physiology (e.g. acidity of the stomach) and bacteriology (spores vs. bacteria, etc.). Finally, updated the "treatment" section to reflect current recommendations of treatment for infants with BabyBIG. If I have time, I will come back and reference some of those edits. I also have some cool pictures, but believe they are likely copyright protected. Pkoetters 00:33, 12 August 2006 (UTC)

Honey

I removed the following untrue statement from the article:

Many cases are caused by the under-pasteurization of honey and other foods (under-pasteurization occurs often in honey bob and other foods labelled as "organic" or "natural").

It is not true for the following reasons: 1. Clostridium botulinum spores are everywhere, not just in honey. The best place to find them is in your vacuum cleaner bag, which indicates the wideness of their presence. They are very hard to kill, which is why they can survive in honey, which kills most pathogens. 2. Pasteurization of honey would not kill Clostridium botulinum spores. If enough heat were applied to kill the spores, honey would be utterly ruined. This would be true for many other foods as well. Canned goods that are low acid (such as green beans) must be processed at very high heat to be safe. 3. Even if all spores were killed, simply exposing the honey for a few moments to the air (with dust) would reintroduce the spores. This is true of any other food as well.

I also would ask for documentation (primary sources only) that honey is proven to be the cause of infant botulism. Honey may be a suspect but has not been shown to actually be the source. This would be hard to prove, anyway, and probably moot, since the spores are literally everywhere. Wikipedia should not propagate myths. I will correct the statement about honey and botulism. Pollinator 04:21, 24 Feb 2004 (UTC)

That doesn't seem right, because I was under the impression that Clostridium botulinum was an obligate anearobe, which would mean that exposing a food to air would not introduce spores.

You're correct that C. botulinum is an obligate anaerobe, but Pollinator is talking about the spores. The spores really are everywhere and that's how Clostridium rods protect themselves - by making hardy spores so they don't die. C. tetani does the same thing, when it enters a deep wound and its spores germinate and cause tetanus. It's when the _spores_ come into an anaerobic environment that they "hatch," so to speak, and then the bacterium comes out and the cascade begins. This way the bacteria gets the best of both worlds; since it's a spore-former, it can survive - not thrive, survive - in our environment and then germinate when the environment changes to anaerobic. I hope that helps. - ddlamb 08:24, 18 January 2006 (UTC)

The FDA link given at the bottom of the article places the honey issue in perspective: "Of the various potential environmental sources such as soil, cistern water, dust and foods, honey is the one dietary reservoir of C. botulinum spores thus far definitively linked to infant botulism by both laboratory and epidemiologic studies." This clearly does not say that other causes are any less important, simply that they have not been identified. (update: 1 case of infant formula was reported in 2005) --Seejyb 21:05, 23 August 2006 (UTC)

Uses

How about something on Botox? At least a link to the article Botox PrometheusX303 15:09, 21 December 2005 (UTC)

Botox is botulin toxin JFW | T@lk 15:46, 21 December 2005 (UTC)

Ok I think I understand. Both articles branch from Clostridium botulinum, botulism being an illness caused by the toxin, Botox being the toxin in commercial form. —The preceding unsigned comment was added by PrometheusX303 (talk • contribs) .

Indeed. JFW | T@lk 23:32, 22 December 2005 (UTC)

Bananas

Where did the last sentence of Treatment (the banana bit) come from? The placement of the citation would lead one to believe that it is supported by the FDA article, which is most definitely is NOT. Further, the purported calmative affect of bananas is a complete non sequitur, since calming the stomach would have no impact on the illness (or a very negative impact, if the supposition is true that lack of stomach acidity encourages C. Botulinum’s colonisation). I am moving the citation back one sentence to the part the FDA article actually supports, but leaving the banana bit with a citation needed tag. If the editor who introduced that titbit could cite it, that would be appreciated. {Kevin/Lastin posting sans cookies} 12.96.58.22 15:34, 28 December 2006 (UTC)

I'm going to call WP:BOLLOCKS on this one and just cut the line out all together. If anybody can support it, they can put it back. – ClockworkSoul 22:17, 28 December 2006 (UTC)

Mortality Rate

Between 1910 and 1919, the death rate from botulism was 70 percent in the United States ... Up to 60% of botulism cases can be fatal if left untreated.

This implies that between 1910 and 1919 treatment actually killed more people than the disease would have if the people were left untreated. Otherwise it should say that up to 70% of cases could be fatal if untreated, given mortality rate in the 1910's. No references were cited for these statistics, which makes it a little more tricky to work out what's going on.

203.206.161.248 01:38, 2 March 2007 (UTC)

I inserted a template about inconsistency. It also says that the death rate dropped to 2% in the 1990's, but that the WHO reports it being between 5 and 10%, while other sources reporting it to be about 7.5%. Why this difference, from 2 to 7.5%? 170.140.93.108 (talk) 01:39, 20 March 2008 (UTC)

While poorly formatted, most of the data isn't inconsistent. The first set of data (70%..9%..2%) is referring to US death rates. The 60% statement does not specify a region (World, US, etc.) but is referring to a current day case that is left untreated. Due to the lack of a region on the second percentage, the 60% doesn't directly contradict the 70% value. The next sentence states the WHO (international) levels for mortality. The line after this is the only one which may be inconsistent as it goes back to somewhat contradict the other US values (or at least the decreasing trend of those values), specifying a recent 7.5% death rate (in opposition to the previously stated 2%, (though this may be due to an increase in cases, particularly in 2007, as the 2% refers to only the early 90's). That being said, the data is, overall, of relatively poor quality and the section should probably be rewritten. 67.186.192.117 (talk) 11:15, 24 March 2008 (UTC)

Aerobic v. Anaerobic environment

It's been wrong for a while, I won't fix it, but someone should do some research. I am pretty sure it works an Aerobic and not Anaerobic, just saying.—Preceding unsigned comment added by 66.75.46.48 (talk)

Nope, anaerobic is correct:

"In general, germination of botulinum spores is favored in food kept at warm temperatures under anaerobic conditions for a long period of time." (Source: Botulism and Clostridium Botulinum)

-- MarcoTolo 21:38, 16 July 2007 (UTC)

"Common symptoms of either form usually include dry mouth, difficulty swallowing, slurred speech, drooping eyelids, muscle weakness, double and/or blurred vision, vomiting, blatter and sometimes diarrhea." What is blatter? Is it supposed to be bladder, and if so, what is the effect on the bladder? —Preceding unsigned comment added by 155.109.5.21 (talk) 19:17, 5 October 2007 (UTC)

Microbiota

Microbioa link leads to the wrong page. The disambiguation page would be better, but there is no entry for microbiota in the sense indicated in the text - just pages for microflora and microfauna. —Preceding unsigned comment added by 195.153.160.240 (talk) 13:22, 8 February 2008 (UTC)

Prevention

Under the prevention section it says "Because the botulism toxin is destroyed by high temperatures, home-canned foods are best boiled for 10 minutes before eating." Botulism toxins are only destroyed if heated to 240-250 degrees Fahrenheit for at least twenty minutes, preferably more. Can someone please change this, or look into it a bit more. (Source: [1] --Papershirt (talk) 02:07, 7 April 2008 (UTC)

• You are correct, I find that 10 minutes is listed for some foods but 20 minutes for others. To keep it simple I will change the article to read 20 minutes. Gandydancer (talk) 12:34, 22 August 2008 (UTC)

The WHO disagrees with the requirement for 20 minutes, and says "The toxin is destroyed by normal cooking processes (heating at >85C for five minutes or boiling for a few minutes). " [2]. The source listed by the previous commenter says that it should be boiled at 240f (115c) for 20 minutes. This is only to kill the spores, and may be needed when originally doing the canning (depending on the ph). It also requires a pressure-cooker. KennyMacD (talk) 18:26, 13 December 2010 (UTC)

I've changed this today back to 10 minutes for post canned foods as this is the time specifically listed by the US CDC for cooking foods that have been canned.--M R G WIKI999 (talk) 12:58, 30 August 2011 (UTC)

CDC

Some sections seem to be from the CDC web site http://www.cdc.gov/nczved/dfbmd/disease_listing/botulism_gi.html 72.87.188.74 (talk) 03:11, 29 July 2008 (UTC)

Just noticed the same thing. I doubt the CDC cares, but it would be best to add proper cites anyway. Also, the stats are out of date. --71.225.253.124 (talk) 23:06, 27 August 2008 (UTC)

Review

Clin Infect Dis PMID 16163636 JFW | T@lk 22:09, 31 December 2008 (UTC)

Botulant

What is the adjectival form of botulism? 75.118.170.35 (talk) 00:59, 17 January 2009 (UTC)

Botulistic. I think - there are no Google hits for 'Botulant', and lots for 'Botulistic'. Baffle gab1978 (talk) 20:50, 15 February 2009 (UTC)

US centric

This article is wa-a-a-a-a-ay too US-centric. Most of the data cited is from the CDC and really not relevant to the rest of the world! --Gak (talk) 07:50, 7 March 2009 (UTC)

Actually it is relevent for most of the world, at least the western world. French, German, Polish & Spanish wikipedia's use data from their countries and most sections are exacly the same. Further on I checked with an official health site in my country (Poland) and also statistics are very similiar with about 30 cases yearly (which is exacly the same percentage considering population of both countries). —Preceding unsigned comment added by 87.205.81.141 (talk) 22:22, 12 April 2009 (UTC)

Even so, so much of data indicates is for the USA and the wording on the few that might be global seem unlikely they would be, I do not believe any of these are bad data to have but really their should be at least some attempt to give some impression of the global rate or clerify the sources might be or might not be referring to global numbers. If the numbers are similar to developed nations are they the same in developing nations or is their any abnormalities in various regions? —Preceding unsigned comment added by 98.162.247.51 (talk) 11:41, 28 February 2010 (UTC)

Most common cause of botulism

"Wound botulism, the least common of the three in developing countries; but is by far the most common cause of botulism in developed countries.[1][2"

This looks wrong. Maybe the developing/ developed is backwards. Franklinjefferson (talk) 02:10, 9 March 2009 (UTC)

Sweeteners (honey, aspartame) and risk to infants

The article refers to honey and aspartame (in the same sentence) as potentially harmful to infants. I wonder if this may be misleading, as the mechanism in each case is quite different. Also, the claim about aspartame is neither elaborated nor referenced here.

My understanding is that sugar in honey inhibits the growth of bacteria such as C. botulinum; the danger of infant botulism from honey has more to do with (a) contamination in the hive, e.g. due to bacterial growth in the bodies of dead bees and soil-derived spores in beeswax, and (b) the fact that honey cannot be adequately heat-treated to kill the bacteria without ruining it.

In the case of aspartame, the bacteriostatic effect normally observed with high sugar/low moisture content is absent. That is, it is the absence of sugar rather than the presence of aspartame that would be the risk factor, with regard to botulism.

Some potentially relevant references:

Nakano et al., "Multiplication of Clostridium botulinum in dead honey-bees and bee pupae, a likely source of heavy contamination of honey", Int J Food Microbiol, 1994 Feb;21(3):247-52

Nevas et al., "Contamination routes of Clostridium botulinum in the honey production environment", Environmental Microbiology, Volume 8 Issue 6, Pages 1085 - 1094

Labbé and García, Guide to foodborne pathogens, 3rd ed. (2001), Chapter 6

Yiu H. Hui, Handbook of food science, technology, and engineering, Vol. 2, Chapter 75

Screwtop (talk) 12:54, 25 April 2009 (UTC)

An authorititative review (Sobel) says that honey can be implicated in 20% of cases of infant botulism. The mechanism is the subject of debate, but clearly contamination is a concern. I don't think we should be citing primary research studies to further your point. Sobel doesn't mention aspartame, which sounds like a load of baloney. JFW | T@lk 23:39, 10 May 2009 (UTC)

Death rate

"Between 1910 and 1919 the death rate from botulism was 70% in the United States, dropping to 9% in the 1980s and 2% in the early 1990s, mainly because of the development of artificial respirators. Up to 60% of botulism cases are fatal if left untreated."

Okay, so treated and untreated folks taken together in the US in the 1910s died 70% of the time, but untreated cases in general cause mortality less than or equal to 60% of the time? What were the doctors in the 10s doing, exactly? That needs some straightening up. Rufwork (talk) 19:57, 4 April 2012 (UTC)