Botulism clinical manifestations

The data about fields of application of Silics in clinics for treatment for infectious diseases are presented in Table 4. From Table 4 it is evident that the field of application of Silics is rather large and covers both intestinal infections and toxicoses which victimize infants, as well as viral hepatitis, and botulism. It is appropriate to mention here that inclusion of Silics into the complex treatment of patients suffering from salmonellosis, dysentery, and intestinal toxicoses accelerates normalization of clinic manifestations of these diseases by a factor of two and more. In the case of botulism the normalization of symptoms characteristic of lesions of the nervous system is shortened by almost 4 days. If intestinal infections are not severe, Silics can be recommended as a single therapeutic agent. In the case of a considerable diarrheal syndrome it is more expedient to use it together with rehydration substances. Inclusion of Silics into a complex of therapeutic agents for patients suffering from viral hepatitis substantially accelerates recovery rates of patients, so that their normal level of bilirubin and activity of alanine aminotranspherase are recovered within shorter periods of time. 

Other clinical forms of the disease share many of these signs and symptoms. The presentation and dma-tion of the disease are coupled to the relative persistence of the toxin in blocking the release of ACh at peripheral nerve synapses. Although untreated botulism is potentially deadly, the availability of antisemm has dramatically reduced the mortality rates for the common clinical manifestations of the disease. Severe cases of foodbome botulism may still require ventilatory support for over a month, and neurological symptoms can sometimes persist for more than a year (Mackle et al., 2001). 

II. Indications. Botulinum antitoxin is used to treat clinical botulism (see page 136) to prevent progression of neurologic manifestations. It is generally not recommended for treatment of infant botulism however, open-label clinical trials have been under way in California with human-derived botulism immune globulin (BIG) and have been extended nationwide. For information, call the California Department of Health Services at (510) 231-7600. 

Foodbome botulism is treated with a licensed trivalent equine antitoxin (serotypes A, B, and E) that is available only from the CDC. There is no other approved therapy for airborne botulism, although animal studies show that botulinum antitoxin can be very effective if given before the manifestation of clinical signs of disease. Mechanical ventilation is invariably necessary due to paralysis of respiratory muscles, if antitoxin is not given before the onset of clinical signs (Shapiro et al., 1997). 

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