Botulism
Download
1 / 48

Botulism - PowerPoint PPT Presentation


  • 446 Views
  • Updated On :

Botulism. Overview. Organism History Epidemiology Transmission Disease in Humans Disease in Animals Prevention and Control . Organism. Clostridium botulinum Gram positive Obligate anaerobic bacillus Spores Ubiquitous Resistant to heat, light, drying and radiation

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Botulism' - RexAlvis


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Overview l.jpg
Overview

  • Organism

  • History

  • Epidemiology

  • Transmission

  • Disease in Humans

  • Disease in Animals

  • Prevention and Control

Center for Food Security and Public Health Iowa State University 2004


Organism l.jpg
Organism

  • Clostridium botulinum

    • Gram positive

    • Obligate anaerobic bacillus

    • Spores

      • Ubiquitous

      • Resistant to heat, light, drying and radiation

      • Specific conditions for germination

        • Anaerobic conditions

        • Warmth (10-50oC)

        • Mild alkalinity

Center for Food Security and Public Health Iowa State University 2004


Neurotoxins l.jpg
Neurotoxins

  • Seven different types: A through G

    • Different types affect different species

    • All cause flaccid paralysis

    • Only a few nanograms can cause illness

    • Binds neuromuscular junctions

  • Toxin: Destroyed by boiling

  • Spores: Higher temperatures to be inactivated

Center for Food Security and Public Health Iowa State University 2004


Neurotoxins5 l.jpg
Neurotoxins

Center for Food Security and Public Health Iowa State University 2004



History7 l.jpg
History

  • 1793, Justinius Kerner

    • “Wurstgift”

  • “Botulus” = Latin for sausage

  • 1895, Emile von Ermengem

    • Isolated organism during Belgium outbreak

  • U.S. outbreaks led to improved industry processing

Center for Food Security and Public Health Iowa State University 2004



Transmission9 l.jpg
Transmission

  • Ingestion

    • Organism

    • Spores

    • Neurotoxin

  • Wound contamination

  • Inhalation

  • Person-to-person not documented

Center for Food Security and Public Health Iowa State University 2004



Epidemiology11 l.jpg
Epidemiology

  • In U.S., average 110 cases each year

    • Approximately 25% food-borne

    • Approximately 72% infant form

    • Remainder wound form

  • Case-fatality rate

    • 5-10%

  • Infective dose- few nanograms

Center for Food Security and Public Health Iowa State University 2004


Epidemiology12 l.jpg
Epidemiology

  • 1977, Largest botulism outbreak

    • Michigan - 59 people

    • Poorly preserved jalapeno peppers

  • Alaska

    • 27% of U.S. foodborne botulism cases

    • 1950-2000

      • 226 cases from 114 outbreaks

Center for Food Security and Public Health Iowa State University 2004



Human disease l.jpg
Human Disease

  • Three forms

    • Foodborne

    • Wound

    • Infant

  • All forms fatal and a medical emergency

  • Incubation period: 12-36 hours

Center for Food Security and Public Health Iowa State University 2004


Foodborne botulism l.jpg
Foodborne Botulism

  • Preformed toxin ingested from contaminated food

  • Most common from home-canned foods

    • Asparagus, green beans, beets, corn, baked potatoes, garlic, chile peppers, tomatoes; type A

    • Improperly fermented fish (Alaska); type E

Center for Food Security and Public Health Iowa State University 2004


Slide16 l.jpg

110

100

90

80

70

60

50

40

30

20

10

0

Reported Cases

1982 1987 1992 1997 2002

Year

MMWR

Center for Food Security and Public Health Iowa State University 2004


Infant botulism l.jpg
Infant Botulism

  • Most common form in U.S.

  • Spore ingestion

    • Germinate then toxin released and colonize large intestine

  • Infants < 1 year old

    • 94% < 6 months old

  • Spores from varied sources

    • Honey, food, dust, corn syrup

Center for Food Security and Public Health Iowa State University 2004


Slide18 l.jpg

110

100

90

80

70

60

50

40

30

20

10

0

Reported Cases

1982 1987 1992 1997 2002

Year

MMWR

Center for Food Security and Public Health Iowa State University 2004


Wound botulism l.jpg
Wound Botulism

  • 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

Center for Food Security and Public Health Iowa State University 2004


Adult clinical signs l.jpg
Adult Clinical Signs

  • 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

Center for Food Security and Public Health Iowa State University 2004


Infant clinical signs l.jpg
Infant Clinical Signs

  • Constipation

  • Lethargy

  • Poor feeding

  • Weak cry

  • Bulbar palsies

  • Failure to thrive

Center for Food Security and Public Health Iowa State University 2004


Diagnosis l.jpg
Diagnosis

  • 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

Center for Food Security and Public Health Iowa State University 2004


Treatment l.jpg
Treatment

  • Intensive care immediately

    • Ventilator for respiratory failure

  • Botulinum antitoxin

    • Derived from equine source

    • CDC distributes

    • Used on a case-by-case basis

  • Botulism immune globulin

    • Infant cases of types A and G

Center for Food Security and Public Health Iowa State University 2004


Animals and botulism l.jpg

Animals andBotulism


Animals l.jpg
Animals

  • Cattle and sheep

  • Horses

  • Birds and poultry

  • Mink and ferrets

  • Uncommon in dogs and pigs

    • Fairly resistant

  • No natural cases documented in cats

Center for Food Security and Public Health Iowa State University 2004


Cattle and sheep l.jpg
Cattle and Sheep

  • 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

    • Carcasses: Baled or chopped into hay

Center for Food Security and Public Health Iowa State University 2004


Ruminants clinical signs l.jpg
Ruminants: Clinical Signs

  • Progressive ascending ataxia

  • Recumbent

  • Head turned into flanks

  • Cranial nerve dysfunction

  • Rumen stasis; bloat

  • Atonic bladder - loss of urination

Center for Food Security and Public Health Iowa State University 2004


Cattle and sheep diagnosis l.jpg
Cattle and Sheep: Diagnosis

  • 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)

Center for Food Security and Public Health Iowa State University 2004


Cattle and sheep treatment l.jpg
Cattle and Sheep: Treatment

  • 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

Center for Food Security and Public Health Iowa State University 2004


Horses l.jpg
Horses

  • 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

Center for Food Security and Public Health Iowa State University 2004


Adult horses l.jpg
Adult Horses

  • “Forage poisoning”

    • Ingest preformed toxin

  • Clinical Signs

    • Dyspnea

    • Flaccid tail

    • Muscle tremors

    • Severe paresis to rapid recumbency

    • Unable to retract tongue, drooling

Center for Food Security and Public Health Iowa State University 2004


Foals l.jpg
Foals

  • “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

Center for Food Security and Public Health Iowa State University 2004


Foals clinical signs l.jpg
Foals: Clinical Signs

  • Clinical signs

    • Paresis, recumbent

    • Muscle tremors

    • Dysphagia

    • Ptosis, mydriasis, decreased PLR

    • Ileus, constipation, urine retention

    • Death due to respiratory paralysis

  • Mortality greater than 90%

Center for Food Security and Public Health Iowa State University 2004


Birds and poultry l.jpg
Birds and Poultry

  • “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

Center for Food Security and Public Health Iowa State University 2004


Birds and poultry clinical signs l.jpg
Birds and Poultry:Clinical Signs

  • 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

Center for Food Security and Public Health Iowa State University 2004


Mink and ferrets l.jpg
Mink and Ferrets

  • Type C

    • Occasionally A and E

  • Sources

    • Chopped raw meat or fish

    • Improper storage of meat by-products

  • Vaccine available for type C

Center for Food Security and Public Health Iowa State University 2004


Slide37 l.jpg
Dogs

  • Rare

  • Type C; few cases type D

  • Source

    • Ingestion of carrion

    • Wetland areas with avian botulism epizootics

  • Incubation period

    • Few hours to 6 days

Center for Food Security and Public Health Iowa State University 2004


Slide38 l.jpg
Dogs

  • Progressive symmetric ascending weakness

    • Rear limbs to forelimbs

  • Cranial nerve deficits

  • Respiratory paralysis

  • Lose ability to urinate and defecate

Center for Food Security and Public Health Iowa State University 2004


Slide39 l.jpg
Dogs

  • Diagnosis

    • Bloodwork and CSF: Normal

    • Electromyography (EMG)

    • Toxin in serum, vomitus, feces, or suspect food/carrion

    • Mouse neutralization test preferred

  • Treatment

    • Supportive

    • Antitoxin

Center for Food Security and Public Health Iowa State University 2004



Human prevention l.jpg
Human: Prevention

  • Do not feed honey to children <1 yr of age

  • Proper food preservation methods

    • Proper time, temperature and pressure

      • 80oC for 30 min or 100oC for 10 min

  • Prompt refrigeration of foods

  • Boil foods for > 10 minutes

  • Decontamination

    • Boil suspected food before discarding

    • Boil or chlorine disinfect utensils used

  • Center for Food Security and Public Health Iowa State University 2004


    Ruminants prevention l.jpg
    Ruminants: Prevention

    • Good husbandry practices

    • Rodent and vermin control

    • Prompt disposal of carcasses

    • Avoid spoiled feedstuff or poor quality silage

    • Vaccination in endemic areas

    Center for Food Security and Public Health Iowa State University 2004


    Equine prevention l.jpg
    Equine: Prevention

    • Good husbandry

    • Rodent and vermin control

    • Avoid spoiled feed

    • Prophylactic vaccine for pregnant mares

      • Currently only type B botulinum toxoid available for horses

    Center for Food Security and Public Health Iowa State University 2004


    Potential bioterrorism threat l.jpg
    Potential Bioterrorism Threat

    • Aum Shinriky cult

    • Extremely potent and lethal

    • Easily produced and transported

    • Signs of deliberate aerosol or foodborne release of toxin

      • No common source

      • Large number of acute cases clustered

      • Uncommon toxin type (C, D, F, G)

    Center for Food Security and Public Health Iowa State University 2004


    Potential bioterrorism threat45 l.jpg
    Potential Bioterrorism Threat

    • Point source aerosol release

      • Incapacitate or kill 10% of persons within 0.5 km downwind

    • CDC surveillance system

      • Prompt detection of botulism related events

    Center for Food Security and Public Health Iowa State University 2004


    Additional resources l.jpg
    Additional Resources

    • CDC – Division of Bacterial and Mycotic Diseases

      • http://www.cdc.gov/ncidod/dbmd/ diseaseinfo/botulism_g.htm

    • Center for Civilian Biodefense Strategies

      • http://www.hopkins-biodefense.org/pages/agents/ agentbotox.html

    Center for Food Security and Public Health Iowa State University 2004


    Acknowledgments l.jpg
    Acknowledgments

    Development of this presentation was funded by a grant from the Centers for Disease Control and Prevention to the Center for Food Security and Public Health at Iowa State University.

    Center for Food Security and Public Health Iowa State University 2004


    Acknowledgments48 l.jpg
    Acknowledgments

    Author:

    Co-author:

    Reviewers:

    Glenda Dvorak, DVM, MS, MPH

    Radford Davis, DVM, MPH

    Danelle Bickett-Weddle, DVM, MPH

    Jean Gladon, BS

    Center for Food Security and Public Health Iowa State University 2004