Around ten cases of food botulism are suspected in Bordeaux. One person died. Symptoms can progress very quickly. You have to go to the emergency room.
Botulism is a paralyzing disease linked to a toxin produced by Clostridium botulinum bacteria. Foodborne botulism is caused by the ingestion of contaminated food. Because of infant botulism, which affects children under 12 months, the consumption of honey is not recommended for infants. THE preserves “homemade”, if they are not prepared following a strict hygiene protocol can cause botulism. What is botulism? What are the symptoms botulism? How to heal him ?
Definition: what is botulism?
Botulism is a paralyzing disease due to a toxin (botulinum toxin) produced by a bacteria (Clostridium botulinum). “It is the toxin that makes you sick, not the bacteria itself.” underlines Christelle Mazuet, head of the National Reference Center for Anaerobic Bacteria and Botulism at the Pasteur Institute. This toxin is extremely powerful and targets nerve endings. This disease affects both humans and animals, particularly birds and cattle. . We distinguish :
► Food botulism is the most common type of botulism in France. It is caused by ingesting food contaminated with botulinum toxin.
►Infant botulism : less common. It occurs in children under one year old when they ingest the bacteria which then implants in the digestive tract and produces its toxin. “This is a colonization of the digestive tract” explains Christelle Mazuet. It is because of the risk of botulism that honey is not recommended before the age of 12 months in children.
► wound botulism which develops during a deep wound or fracture: the bacteria then enters the wound to produce the toxin and contaminate the person
► iatrogenic botulism caused by misuse or accidents in the injection of treatments based on botulinum toxin used in particular in aesthetic medicine. However, there has never been a confirmed case in France.
Symptoms: vision problems, dry mouth, paralysis
“Botulism is a descending flaccid paralysis” explains Christelle Mazuet.
- It starts with vision problems (the person sees double, has drooping eyelids).
- Then, come speech and swallowing problems and poor salivation.
- Then, depending on the quantity and type of toxin ingestedparalysis may extend to the respiratory muscles and upper and lower limbs.
The person may also present digestive symptoms (nausea, vomiting, diarrhea, etc.). Thus, the most serious forms can lead to quadriplegia and respiratory insufficiency or even incapacity. Without medical care, the prognosis is therefore lethal.
What are the treatments for botulism?
“The treatment is essentially symptomatic” explains Christelle Mazuet. “intensive respiratory care with assisted ventilation will be put in place in the most serious cases to allow people to breathe“. There is a serum that neutralizes botulinum toxins but it is only effective if injected within 24 hours of the onset of symptoms. The vast majority of patients treated quickly recover without after-effects, but the duration of treatment and convalescence can sometimes last several months. Antibiotics have no action on botulinum toxin, and are therefore not prescribed.
What are the causes of botulism?
Food botulism is caught byingestion of contaminated products by botulinum toxin. It is most often linked, in France, to the consumption of foods in family or artisanal preserves, more rarely industrially manufactured. These include preserved low-acid plants (green beans, olives, asparagus). All “homemade” charcuterie products (ham, raw ham) are also at risk. There are more rare cases of contamination with seafood products such as artisanal smoked/salted-dried fish.
Honey and botulism
It is because of the risk of botulism that honey is not recommended before the age of 12 months in children. It should never be added to infant food, nor used on finger or pacifier to calm an agitated infant suffering from colic. As recalled byHandles, spores of the Clostridium botulinum bacteria can be contained in honey, which remains the only identified source of dietary exposure to this bacteria, according to the current state of knowledge. L’child under one year old is particularly susceptible to this infection because its immune system is not quite ready to defend itself against microbes. After a year, the child’s defenses are more effective and allow him to eliminate the spores on his own.
Who are the people at risk of botulism?
“There is no person at risk” underlines Christelle Mazuet. Indeed, everyone is likely to consume contaminated products. On the other hand, the sensitive populations (children and the elderly) are likely to develop severe forms of the disease and will naturally have more difficulty recovering.
Symptoms can progress very quickly and it is best to go to the emergency room : “In severe forms, patients may be in intensive care within a few hours of the first symptoms appearing..” underlines Christelle Mazuet. Examinations are generally carried out by neurologists in order to rule out other neurological conditions (stroke, autoimmune neuropathy, etc.). We practice a certain number of samples and analysis as well as electromyograms. A blood sample as well as a stool collection will be sent to the National Reference Center for Anaerobic Bacteria and Botulism at the Pasteur Institute in order to confirm the diagnosis.
Botulism prevention is based on basic food hygiene rules:
- wash food very carefully before canning them – “it only takes a few grams of soil to cause botulism” underlines Christelle Mazuet.
- respect the cold chain and expiration dates
- keep the refrigerator at a temperature between 3 and 5°C
- There is a botulinum vaccine, however, it is reserved for exposed people, and can cause significant side effects. It is not used in France.
Thanks to Dr Christelle Mazuet, head of the National Reference Center for Anaerobic Bacteria and Botulism at the Institut Pasteur.