Botulism in Maryland

From 2015 to 2018 there were over ten cases of botulism identified in Maryland.  The vast majority of cases in Maryland occur among infants.

Botulism is a bacterial illness that causes paralysis beginning with the face and head nerves.  If untreated illness can progress to cause descending paralysis of respiratory muscles, arms and legs.

Signs and symptoms in an adult might include diplopia, blurred vision, ptosis, slurred speech, dysphagia, dry mouth and muscle weakness.  Patients with foodborne illness might also experience abdominal pain, nausea, vomiting and diarrhea.

Signs and symptoms in an infant can include poor feeding, diminished sucking and crying ability, neck and arms/legs weakness, constipation and respiratory distress with respiratory failure.

Transmission of Botulism

Botulism is caused by a toxin produced from clostridium botulinum which is a type of bacteria that produces spores and usually lives in the soil.  Transmission differs by type of botulism:

  • Foodborne botulism occurs when a person ingests botulinum toxin which leads to illness within a few hours to days. A frequent source is home canned foods prepared in an unsafe manner.
  • Infant botulism occurs when an infant ingests spores of C. botulinum which in turn grows in the infants intestinal tract and produces toxin that poisons the child.
  • Wound botulism occurs when wounds become infected with C. botulinum which then produces the toxin in the wounds from which the patient becomes poisoned.
  • Adult intestinal colonization is rare. Most patients have a history of gastrointestinal surgery or significant gastrointestinal illness.  Also, some adult patients have received medications that predispose them to the C. botulinum growing in the patients bowel.
  • Iatrogenic botulism occurs after an overdose of injected botulinum toxin for cosmetic or medical purposes.

Diagnosis of Botulism

The initial diagnosis of botulism is based upon clinical signs and symptoms.  If you experience any signs or symptoms which you believe can relate to botulism please report immediately to your primary care physician and/or emergency department.

Botulism testing is performed at the Maryland Department of Health Laboratories Administration and requires prior approval from the health department before your family physician can run the test.

Treatment of Botulism

If botulism is suspected contact your local health department or primary care physician or go to the emergency department immediately.  The Maryland Department of Health can be contacted at 410-767-6700 during business hours.  If you are unable to reach the Health Department and questions exist contact your primary care physician immediately or go to the closest emergency room immediately for examination.

For non infant cases botulism antitoxin must be administered as soon as possible.  The sooner the antitoxin is administered the more likely the patient will recover.

Prevention of Foodborne Botulism

Many cases of foodborne botulism are caused by improperly processed home-canned, preserved or fermented foods that were contaminated with the toxin.  Contamination can happen when food is handled improperly, when it is made, when it is stored or when it is used by consumers.

Guidelines for safe home canning and other tips to reduce the risk of foodborne botulism are available at https://www.cdc.gov/botulism/consumer.html

Call today for your consultation (410) 644-7655.

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