Botulism is a rare but potentially life-threatening illness that paralyzes the body. It is the result of exposure to a toxin produced by the Clostridium botulinum bacteria. This toxin is among the most poisonous substances known to humans.

There are three major types of botulism:

• Infant botulism. Occurs in a small number of infants who get C. botulinum in their intestinal tract from breathing in spores (microscopic, dormant “eggs”) of C. botulinum or eating foods that have come into contact with the spores of C. botulinum. This type of botulism makes up about 72 percent of all botulism cases every year.
  
  
• Foodborne botulism. Typically occurs from eating contaminated home-canned foods, but also can occur from eating other types of contaminated foods. This type of botulism makes up about 25 percent of all botulism cases every year.
  
  
• Wound botulism. Occurs when wounds become infected with C. botulinum. This type of botulism makes up about 3 percent of all botulism cases every year.

Symptoms of foodborne botulism typically appear within 12 to 36 hours of exposure to C. botulinum. However, symptoms can begin as early as six hours or as late as two weeks after exposure. Infant botulism tends to occur within 18 to 36 hours of exposure. Wound botulism usually causes symptoms about one week after a person is exposed to the C. botulinum bacteria.

Symptoms of botulism may include facial weakness, slurred speech and the inability to urinate. Patients may experience muscle weakness that begins in the shoulders, and then moves down the body, causing paralysis. This paralysis can restrict breathing and result in death unless the patient is put on a breathing machine (ventilator). Symptoms of botulism in infants may include constipation, lethargy and poor feeding.

Blood tests and stool tests are the most direct methods of diagnosing botulism. These tests involve taking samples of a patient’s blood or stool for laboratory analysis.  

Treatments for botulism may vary, depending on the type of botulism infection. Patients with foodborne or wound botulism may be treated with certain antitoxins (antibodies that can neutralize toxins). This may reduce the severity of a patient’s symptoms when administered during an early stage of the illness. Patients with severe botulism may require hospitalization and breathing assistance. Infant botulism may be treated with botulism immune globulin (BIG), human-derived antibodies that are safer for children than the equine-derived antibodies used to treat adults with botulism. BIG may reduce the duration and severity of infant botulism.

Most patients with botulism recover, but it can take weeks to months before they feel better. Paralysis and other symptoms slowly resolve as new nerve endings grow to allow muscle movement. Patients may experience shortness of breath or fatigue for years after a botulism infection has been successfully treated. Patients may also have continued difficulty speaking or swallowing. Only about 8 percent of botulism cases end in death, according to the U.S. Centers for Disease Control and Prevention (CDC).

The risk of botulism can be reduced by taking certain preventive steps. Foodborne botulism is often the result of improper methods of canning foods at home. Therefore, people who engage in home canning are urged to follow strict hygienic guidelines. Honey and corn syrup containing C. botulinum spores are a common cause of infant botulism. As a result, children younger than 1 year of age should not be given these foods. Wounds should be immediately and properly cleaned and cared for to avoid infection by C. botulinum.