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Clostridium botulinum

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Clostridium botulinum

  1. 1. Sub. To - Sub. By - Dr. Rajani Joshi Bhagraj Godara Dr. Kanchan Jangir Roll No. 06 Dr. Krupa Soni B.V.Sc &A.H 3rd Year DEPARTMENT OF VET. PUBLIC HEALTH
  2. 2.  Introduction  History  Epidemiology  Transmission  Pathogenesis  Disease in Humans  Disease in Animals  Treatment  Diagnosis  Prevention and Control
  3. 3.  Class : Clostridia  Order : Clostridiale  Family : Clostridiaceae  Genus : Clostridium  Species : C. botulinum
  4. 4. Clostridium botulinum - Gram positive rods Spore forming – Inactivated at higher temp Anaerobic bacteria Produces toxin that causes botulism Toxin: Destroyed by boiling
  5. 5. Seven neurotoxic subtypes, labeled A-G - All cause flaccid paralysis Cooked Meat medieum Natrual Habitate – Endospore in soil and aquatic environment Horse blood – Narrow zone of hemolysis
  6. 6.  Botulism is a neuroparalytic disease  is caused by the potent protein toxin released from C. botulinum  it 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. 7. 1793, Justinius Kerner (Kerner’s disease.) • “Wurstgift’’ “Botulus” = Latin for sausage 1895, Emile von Ermengem • Isolated organism during Belgium outbreak
  8. 8.  In U.S., average 110 cases each year • Approximately 25% food-borne • Approximately 72% infant form • Remainder wound form  1977, Largest botulism outbreak Poorly preserved jalapeno peppers  Alaska • 27% of U.S. foodborne botulism cases • 1950-2000  226 cases from 114 outbreaks
  9. 9. Ingestion • Organism • Spores • Neurotoxin Wound contamination Inhalation
  10. 10.  Incubation period • ingestion: unknown • foodborne: 6 hours-8 days • wound: 4-14 days • inhalation: (estimated) 24-36 hours  Toxin enters bloodstream from mucosal surface or wound  Binds to peripheral cholinergic nerve endings  Inhibits release of acetylcholine, preventing muscles from contracting  Symmetrical, descending paralysis occurs beginning with cranial nerves and progressing downward
  11. 11. Can result from airway obstruction or paralysis of respiratory muscles Secondary complications related to prolonged ventilatory support and intensive care
  12. 12. Three forms • Foodborne • Wound • Infant All forms fatal and a medical emergency Incubation period: 12-36 hours
  13. 13.  Second most common form  Caused by - toxin ingested from contaminated food  Most common from home-canned foods Signs and Symptoms  12 – 36 hrs after  Muscle weakness,  Diarrhea  Blurred vision  Vomiting  Eventual Paralysis
  14. 14. Organism enters wound • Develops under anaerobic conditions • From ground-in dirt or gravel • It does not penetrate intact skin • Associated with addicts of black-tar heroin
  15. 15. Most common form Afflicts babies from 1 week – 1 year Caused by: • Ingesting contaminated foodstuff • Lack of breast milk • Household dust containing C. botulinum spores
  16. 16. Poor feeding (weak sucking) Weak gag Weak cry Decreased movement Appearing lethargic Flat, blunted facial expression
  17. 17.  Nausea, vomiting, diarrhea  Double vision  Difficulty speaking or swallowing  Descending weakness or paralysis • Shoulders to arms to thighs to calves  Symmetrical flaccid paralysis  Respiratory muscle paralysis
  18. 18.  Clinical signs  Toxin in serum, stool, gastric aspirate, suspected food  Culture of stool or gastric aspirate • Takes 5-7 days  Electromyography also diagnostic  Mouse neutralization test • Results in 48 hours
  19. 19. Intensive care immediately • Ventilator for respiratory failure Botulinum antitoxin • Derived from equine source • Used on a case-by-case basis Botulism immune globulin
  20. 20.  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
  21. 21.  Cattle and sheep  Horses  Birds and poultry  Mink and ferrets  Uncommon in dogs and pigs • Fairly resistant  No natural cases documented in cats
  22. 22. Ingestion of toxin Incubation • 24 hours to 7 days Sources • Spoiled stored silage or grain • Silage using poultry litter or products Phosphorus deficiency in cattle(pica)
  23. 23.  Progressive ascending ataxia  Recumbent  Head turned into flanks  Cranial nerve dysfunction  Rumen stasis; bloat  Atonic bladder - loss of urination
  24. 24.  History  Bloodwork and CSF tap: Normal  ELISA test available for type C & D  Definitive diagnosis • Demonstration of toxin in serum, gut contents or organs  Electromyography (EMG)
  25. 25.  Symptomatic and supportive  Nutritional  Ventilatory support, if needed  Metronidazole  Antitoxin, in early stages • Ineffective by the time clinical signs are present • Can block further uptake of toxin
  26. 26. Good husbandry practices Rodent and vermin control Prompt disposal of carcasses Avoid spoiled feedstuff or poor quality silage Vaccination in endemic areas
  27. 27.  Horses, especially foals, are highly sensitive to botulism toxin  Type B & C toxins  Incubation period • 24 hours to 7 days  Sources • Contaminated feed • Wound infections
  28. 28. Forage poisoning” • Ingest preformed toxin Clinical Signs • Dyspnea • Flaccid tail • Muscle tremors • Severe paresis to rapid recumbency • Unable to retract tongue, drooling
  29. 29. “Shaker Foal” syndrome • Most 2 weeks to 8 months old • On a high nutrition plane Spores in contaminated feed Usually type B • Most common in KY and eastern seaboard
  30. 30. Clinical signs • Paresis • Muscle tremors • Dysphagia constipation, urine retention • Death due to respiratory paralysis Mortality greater than 90%
  31. 31. Good husbandry Rodent and vermin control Avoid spoiled feed Prophylactic vaccine for pregnant mares • Currently only type B botulinum toxoid available for horses
  32. 32. “Limber neck” Types C and E Good sentinel species Sources: • Decomposed vegetation or invertebrates • Ingest toxin or invertebrates with toxin • Contaminated feed or water of chickens
  33. 33. Occurs 12-48 hours after ingestion Droopy head Drowsy Wing and leg paralysis • Unable to hold their head up • Unable to use their wings or legs Eyelid paralysis
  34. 34. Rare Type C; few cases type D Source • Ingestion of carrion • Wetland areas with avian botulism epizootics Incubation period • Few hours to 6 days
  35. 35. Progressive symmetric ascending weakness • Rear limbs to forelimbs Cranial nerve deficits Respiratory paralysis Lose ability to urinate and defecate
  36. 36. • Bloodwork and CSF: Normal • Electromyography (EMG) • Toxin in serum, vomitus, feces, or suspect food/carrion • Mouse neutralization test preferred Treatment • Supportive • Antitoxin
  37. 37.  C. Many countries, and now terrorists, have developed and used botulinum toxin as a biological weapon.  Potential Bioterrorism Threat  Extremely potent and lethal  Easily produced and transported Signs of deliberate aerosol or foodborne release of toxin
  38. 38.  Botulism toxin is the most poisonous substance known  High lethality: 1 aerosolized gram could potentially kill 1 million people  Isolated fairly easily from soil  Could be released as an aerosol or as a contaminant in the food supply  Expensive, long-term care needed for recovery
  39. 39.  Center for Food Security and Public Health • www.cfsph.iastate.edu WHO OIE WIKIPEDIA

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