Botulinum toxoid

Passive immunity can be provided by equine botulinum antitoxin or by specific human hyperimmune globulin, while endogenous immunity can be induced by immunization with botulinum toxoid... 

However, severe constraints do exist on DoD use of IND drugs and vaccines for CBW defense in military combat. The issue of IND use arose in the Gulf War in the case of pyridostigmine bromide (PB), which was regarded as the most effective pretreatment against exposure to the nerve gas Soman, and pentavalent botulinum toxoid (BT)... 

Engstrom HA, Andersson PO, Ohlson S (2006) A label-free continuous total-intemal-reflection-fluorescence-based immunosensor. Anal Biochem 357 159-166 Sapsford KE, Rasooly A, Taitt CR et al (2004) Detection of Campylobacter and Shigella species in food samples using an array biosensor. Anal Chem 76 433 140 Sapsford KE, Taitt CR, Loo N et al (2005) Biosensor detection of botulinum toxoid A and staphylococcal enterotoxin B in food. Appl Environ Microbiol 71 5590-5592... 

A botulinum toxoid vaccine is made available as an investigational agent through CDC for lab workers who work regularly with botulinum toxin or C. botulinum. Postexposure prophylaxis is not recommended at this time for asymptomatic patients (Arnon et al., 2001). 

Pulmonary Dyspnea CNS Cranial nerve deficits are universal Descending symmetric paralysis Gastrointestinal Constipation (later in course) OTHER FORMS OF BOTULISM ISOLATION/DECON PRECAUTIONS Droplet precautions Extensive precautions for laboratory personnel VACCINE Botulinum toxoid vaccine available but restricted in use to military and laboratory personnel. POSTEXPOSURE PROPHYLAXIS None... 

Cardella, M., Jemski, J., Tonik, E., Fiock, M. (1963). Resistance of guinea pigs immunized with botulinum toxoids to aerogenic challenge with toxin. US Army Biological Laboratories Report Test No. 60-TE-1323. OTIC AD0404870. 

Jemski, J. (1961a). Aerosol challenge of guinea pigs, parenterally immunized with botulinum toxoid, with type D botulinum toxin disseminated by the Hartman fixture at 75°F and 50... 

A pentavalent botulinum toxoid (botulinum toxin in different antigenic types) has been used for more than 30 years in some countries to prevent the disease in laboratory workers and to protect troops against attack. Pre-exposure immunization for the general population is neither feasible nor desirable the vaccine is ineffective for postexposure prophylaxis. Treatment of botulism consists of passive immunization and supportive care. Most licensed antitoxins contain antibodies against the most common toxin types A, B, and E. About 9% of recipients of equine antitoxin developed urticaria, serum sickness, or other hypersensitivity reactions. In 2% of recipients anaphylaxis occurred within 10 minutes of antitoxin... 

Fiock, M.A., Cardella, M.A., and Gearinger, N.F. 1963. Studies on immunity to toxins of Clostridium botulinum. IX. Immunologic response of man to purified pentavalent ABCDE botulinum toxoid. J. Immunol. 90 697-702. 

F. Vaccination. Vaccination is the preferred method of biological defense. Fully licensed vaccines are currently available for anthrax, cholera, plague and smallpox. Vaccines for botulinum toxoid, Q fever, Rift Valley fever, tularemia, and VEE currently exist as IND products and would be available only under protocol with informed consent, therefore would not be readily available on the battlefield. No vaccine is currently available either FDA licensed or under IND status, for glanders, brucellosis, Staphylococcus enterotoxin B, ricin, or T-2 mycotoxins. 

The lower line (reference) is an average of three reference channels. Arrows indicate sample (100 ng mL botulinum toxoid A) and amplifier (anti-fcofu/mum antibodies) injection. 

Botulinum Toxoid, Types A B C D E, aluminum phosphate adsorbed. 

Vaccines. Anthrax and smallpox vaccines can be used before exposure and also for postexposuie prophylaxis. A pentavalent (ABODE) botulinum toxoid is currently used for laboratory workers at high risk of exposure. It is not effective for postexposure prophylaxis. Vaccines are not currently available for plague, tularemia, or viral hemorrhagic fevers. 

During the Gulf War, a moral dilemma faced US and Coalition military commanders With a limited supply of both botulinum toxoid and anthrax vaccines, who should receive them Some commanders clearly regretted that only partial vaccinations were performed, and would preferred to have the risk equally parceled out, rather than only treating an arbitrarily chosen group. It was finally decided that some was better than none, and those troops and personnel stationed in areas more likely to be under a BW threat were given priority for inoculation. 

A 1965 US Army consent form listed five botulinum toxoids for protection against A, B, C, D, and E type botulinum toxins. Frederick R. Sidell, Ernest T. Takafuji, and David R. Franz, eds.. Textbook of Military Medicine, Part I Warfare, Weaponry, and the Casualty Medical Aspects of Chemical and Biological Warfare (Washington, DC Borden Institute, Walter Reed Army Medical Center 1997) p. 61. 

Plague and the Vietnam War (1965-1975) Botulinum Toxoid and the Gulf War (1991) Vaccinating for Anthrax in the Twenty-First Century Historicai Development The Current Controversy... 

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