Botulinum toxins decontamination

Theoretically, decontamination of a site after an aerosolized or food-borne release of botulinum toxin might prevent additional exposures. Botulinum toxin is easily inactivated in the environment with bleach or heat. Unfortunately, recognition of a covert release would probably occur long after decontamination would be helpful. If epidemiologic investigation identified a possible food source, and if the food were still available in the distribution chain, public health authorities would remove the food from potential consumers and submit it for laboratory testing. 

Atmospheric conditions and particle size determine the persistence of aerosolized toxin in the environment. Temperature and humidity extremes facilitate toxin degradation, and smaller particles dissipate more quickly into the atmosphere. Studies estimate that aerosolized toxin would decay between less than 1 and 4% per minute. At a 1% decay rate, insubstantial amounts of toxin would remain after 2 days (36). Although botulinum toxin can penetrate mucosal surfaces, it cannot penetrate intact skin. If a release were recognized or announced, and authorities anticipated potential airborne exposure, people could protect themselves by covering their mouths and noses with clothing, such as underwear, shirts, scarfs, or handkerchiefs. In addition, after exposure, washing with soap and water would decontaminate clothing, and a 0.1% hypochlorite bleach solution would be effective on contaminated objects and surfaces (36). 

For the same reason that decontamination is only moderately important after individuals are exposed to a respirable toxin aerosol, medical personnel are probably at only limited risk from secondary aerosols. Because toxins are not volatile, casualties of a toxin attack can, for the most part, be handled safely and moved into closed spaces or buildings, unless they were very heavily exposed. Prudence dictates, however, that patients be handled as if they were chemical casualties or, at a minimum, that they be washed with soap and water. The risk to medical personnel is of greater concern with some agents. Secondary exposure might be a hazard with very potent bacterial protein toxins, such as botulinum toxin or the staphylococcal enterotoxins. (Note Decontamination and isolation of patients or remains could be much more important and difficult after an attack with a bacteria or virus that replicates within the body.)... 

Decontaminate your equipment in the usual manner. Botulinum toxins are not absorbed through the skin, and the patients do not transmit the disease. 

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