This document discusses Clostridium botulinum and botulism. It covers the classification, morphology, toxins produced, epidemiology, pathogenesis, clinical signs, diagnosis and prevention of botulism in humans and animals. Botulism is caused by a potent toxin produced by C. botulinum which prevents the release of acetylcholine at neuromuscular junctions. There are three main forms - foodborne, infant, and wound botulism. The toxin is extremely lethal and botulinum toxin has been developed as a biological weapon due to its high toxicity.

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.  Introduction
 History
 Epidemiology
 Transmission
 Pathogenesis
 Disease in Humans
 Disease in Animals
 Treatment
 Diagnosis
 Prevention and Control

3.  Class : Clostridia
 Order : Clostridiale
 Family : Clostridiaceae
 Genus : Clostridium
 Species : C. botulinum

4. Clostridium botulinum -
Gram positive rods
Spore forming – Inactivated at higher temp
Anaerobic bacteria
Produces toxin that causes botulism
Toxin: Destroyed by boiling

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.  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. 1793, Justinius Kerner (Kerner’s disease.)
• “Wurstgift’’
“Botulus” = Latin for sausage
1895, Emile von Ermengem
• Isolated organism during Belgium outbreak

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. Ingestion
• Organism
• Spores
• Neurotoxin
Wound contamination
Inhalation

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. Can result from airway obstruction or
paralysis of respiratory muscles
Secondary complications related to
prolonged ventilatory support and intensive
care

12. Three forms
• Foodborne
• Wound
• Infant
All forms fatal and a medical emergency
Incubation period: 12-36 hours

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. 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. 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. Poor feeding (weak sucking)
Weak gag
Weak cry
Decreased movement
Appearing lethargic
Flat, blunted facial expression

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.  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. Intensive care immediately
• Ventilator for respiratory failure
Botulinum antitoxin
• Derived from equine source
• Used on a case-by-case basis
Botulism immune globulin

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.  Cattle and sheep
 Horses
 Birds and poultry
 Mink and ferrets
 Uncommon in dogs and pigs
• Fairly resistant
 No natural cases documented in cats

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.  Progressive ascending ataxia
 Recumbent
 Head turned into flanks
 Cranial nerve dysfunction
 Rumen stasis; bloat
 Atonic bladder - loss of urination

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.  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. Good husbandry practices
Rodent and vermin control
Prompt disposal of carcasses
Avoid spoiled feedstuff or poor quality
silage
Vaccination in endemic areas

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. Forage poisoning”
• Ingest preformed toxin
Clinical Signs
• Dyspnea
• Flaccid tail
• Muscle tremors
• Severe paresis to rapid recumbency
• Unable to retract tongue, drooling

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. Clinical signs
• Paresis
• Muscle tremors
• Dysphagia
constipation, urine retention
• Death due to respiratory paralysis
Mortality greater than 90%

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. “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. 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. 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. Progressive symmetric ascending
weakness
• Rear limbs to forelimbs
Cranial nerve deficits
Respiratory paralysis
Lose ability to urinate and defecate

36. • Bloodwork and CSF: Normal
• Electromyography (EMG)
• Toxin in serum, vomitus, feces, or suspect
food/carrion
• Mouse neutralization test preferred
Treatment
• Supportive
• Antitoxin

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.  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.  Center for Food Security and Public Health
• www.cfsph.iastate.edu
WHO
OIE
WIKIPEDIA