Botulism control

Sofos, J.N., Busta, F.F. and Allan, C.E. (1979) Botulism control by nitrate and sorbate in cured meats a review. J. Food Protect. 42, 739-770. 

Sodium nitrite is used to fix the colors in preserved fish and meats. It is also important (along with sodium chloride) in controlling the bacterium Clostridium botulinumy which causes botulism. Lunch meats, hams, sausages, hot dogs, and bacon are usually preserved this way. 

Botulism is usually not transmissable from one person to another. A supply of antitoxin against botulism is maintained by the Center for Disease Control and Prevention located in Atlanta, Georgia. Such antitoxin is effective against the severity of symptoms if administered early in the course of disease, and most patients eventually recover after weeks to months of supportive care. 

There is a balance to be drawn between risks. Looking at nitrite again, this ion has been used since the Middle Ages to preserve meat. It is the preservative in saltpetre which helps preserve cured meats and stop those who eat them getting botulism. There has been much research to find an alternative to nitrite as it can react with some amines to form carcinogenic nitrosamines. Risk analysis, reviewed in Chapter 4, is an important tool in controlling the use of additives. 

Wound botulism occurs where C. botulinum spores germinate in wound infections and develop into vegetative cells. In such cases, neurotoxin is produced which leads to the onset of neurological symptoms. According to the Centers for Disease Control and Prevention, 23 cases of wound botulism (13.6% of all botulism cases) were reported in 2001 in the U.S. Wound botulism has also been diagnosed after intravenous drug injection (Rundervoort et al., 2003). 

Botulism also affects animals, where intoxication is caused by C. botulinum types C and D. A bovine disease visceral botulism was reported in Germany (Bohnel et al., 2001). It was caused by a long-lasting exposure to low quantities of botulin toxin that interfered with the neurological control of intestinal physiology. Visceral botulism in cows may pose a health risk for milk consumers, although to date there are no precise data on how serious the problem is (Cobb et al., 2002). 

Spores may be transferred from soil and plants to the sea via rainwater, causing the prevalence in coastal waters of the same C. botulinum types as on the land. Such a correlation was observed in Great Britain, where the type B predominates both in soil and in bottom sediments. Similarly, 71% of fish and bottom-sediment samples collected in southern France were contaminated with type B, while C. botulinum type E was found only in 9.6% of samples (Each et al., 2002). However, it is commonly believed that non-proteolytic type E is characteristic for the marine environment. A distinguishing feature of type E strains is the ability to grow in low temperatures (about 3°C), which are typical for bottom layers of seas and oceans. Moreover, the bottom sediments provide anaerobic conditions for the outgrowth of Clostridium. Therefore, the marine environment promotes C. botulinum type E distribution. This has been further supported by the rate of fish and seafood contamination fish and seafood isolated in many countries are most frequently contaminated with C. botulinum type E (Dodds, 1993 a,b). Furthermore, epidemiological studies have shown that the majority of botulism cases linked to fish and seafood consumption reported between 1950 and 1996 in the U.S. were caused by C. botulinum type E (Centers for Disease Control and Prevention 1998). C. botulinum type F,... 

Fish and seafood are generally responsible for infections caused by C. botulinum type E (Centers for Disease Control and Prevention, 1998). Many verified cases of botulism type E have been reported in Japan (166 cases and 58 deaths between 1951 and 1960). In 2003, C. botulinum type E was involved in the outbreak in western Alaska linked to consumption of a beached whale (Anonymous, 2003). Many outbreaks were also associated with a Japanese izuschi dish containing fermented raw fish, vegetables, and cooked and malted rice (okji). In Canada, Alaska, or Scandinavia, botulism is caused by consumption of fish and fermented meat dishes, very often prepared as traditional native dishes (Kotev et ah, 1987 Knubley et ah, 1995). 

Commercial products usually do not pose health threats to their consumers. However, botulism cases acquired after consumption of commercially prepared canned foods have been reported. In the U.S., 62 outbreaks occurred in the years 1899 to 1973 (Lynt et al., 1975). Only 7% of outbreaks reported between 1950 and 1996 were linked to commercially processed foods (Centers for Disease Control and Prevention, 1998). The implicated foodstuffs included chopped garlic in soy oil stored in glass bottles at room temperature (Louis et al., 1988), sliced roasted eggplant in oil, yogurt with hazelnuts, stuffed lotus rhizome, bottled caviar, and canned peanuts (Chou et al., 1988 D Argenio et al., 1995). 

Dodds, K.L., Restaurant-associated botulism outbreaks in North America, Food Control, 1, 139-141, 1990. 

Injection of botulinum toxin is a rather innovative way to control localized muscle hyperexcitability. Botulinum toxin is a purified version of the toxin that causes botulism. Systemic doses of this toxin can be extremely dangerous or fatal because botulinum toxin inhibits the release of acetylcholine from presynaptic terminals at the skeletal neuromuscular junction. Loss of presynaptic acetylcholine release results in paralysis of the muscle fiber supplied by that terminal. Systemic dissemination of botulinum toxin can therefore cause widespread paralysis, including loss of respiratory muscle function. Injection into specific muscles, however, can sequester the toxin within these muscles, thus producing localized effects that are beneficial in certain forms of muscle hyperexcitability. 

Harris JB, Grubb BD, Maltin CA, Dixon R (2000) The neurotoxicity of the venom phospholipases A(2), notexin and taipoxin. Exp Neurol 161 517-26 Haug G, Wilde C, Leemhuis J, Meyer DK, Aktories K et al. (2003) Cellular uptake of Clostridium botulinum C2 toxin membrane translocation of a fusion toxin requires unfolding of its dihydrofolate reductase domain. Biochemistry 42 15284-91 Hauschild A (1993) Epidemiology of human foodborne botulism. In Hauschild A, Dodds KL (eds) Clostridium botulinum ecology and control in foods. Marcel Dekker, Inc. New York, pp 69-104... 

In foodborne botulism, complaints of nausea, vomiting, and diarrhea may accompany the initial neurologic symptoms. In later stages of the disease, constipation becomes more prominent. In infantile botulism, constipation is often the main symptom, along with characteristic flaccidity (the floppy baby ), poor suck reflex, poor feeding, and poor head control. 

Centers for Disease Control and Prevention. (1998). Botulism in the United States, 1899-1996 Handbook for epidemiologists, clinicians, and laboratory workers. Atlanta, GA Centers for Disease Control and Prevention. 

CDC (Centers for Disease Control and Prevention) (1995). Foodbome botulism - Oklahoma, 1994. Morb. Mortl. Wkly Rep. 44 200-2. 

Tetanus toxin poisoning produces tetanus, i.e. muscle contractions resulting in spastic paralysis. In contrast, Botulinum neurotoxins cause botulism, which is characterized by flaccid paralysis. This difference reflects differences in the anatomical level of action of these toxins. TeTx acts primarily on the CNS where it blocks exocytosis from inhibitory glycinergic synapses in the spinal cord. Loss of inhibitory control results in motoneuron firing. BoNTs act primarily in the periphery where they inhibit acetylcholine release at the neuromuscular junctions. 

Monitoring for impending respiratory failure should include continued assessment of the adequacy of gag and cough reflexes, oxygen saturation, vital capacity and inspiratory force. Control of oropharyngeal secretions is essential. Patients at risk for hypoventilation usually develop airway obstruction or aspiration. In patients with botulism, deterioration of respiratory function is an indication for controlled, anticipatory ventilation. The proportion of patients requiring mechanical ventilation has varied from 20% in a food-borne outbreak to 60% in infant botulism. 

Centers for Disease Control and Prevention, National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases. Surveillance for Botulism. Summary of 2001 Data, http // www.cdc.gOv/ncidod/dbmd/diseaseinfo/files/BotCSTE2001.pdf. Last accessed 4/15/06... 

Centers for Disease Control and Prevention (CDC). (2006), Botulism Treatment Overview for Clinicians. Atlanta, GA, Centers for Disease Control and Prevention, June 14. Last viewed October 10, 2006, http / www.bt.cdc.gov/agent/Botulism/clinicians/treatment.asp... 

It is is the third most toxic substance known after plutonium and botulism it is a protein toxin that is extracted from the castor bean (Ricinus communis). The USA Centers for Disease Control (CDC) considers 500 pg to be the lethal dose of ricin in humans if exposure is from injection or inhalation. Ricin is poisonous if inhaled, injected, or ingested, acting by the inhibition of protein synthesis. While there is no known antidote, the US military has developed a vaccine. 

The digestive system of children under one year old has not formed enough to protect itself from botulism organisms sometimes found in raw, uncooked honey. The Centers for Disease Control recommends that raw honey not be given to children under one year old as it can cause a sometimes fatal diarrhea. 

What are public health agencies doing to prevent or control botulism ... 

Public education about botulism prevention is an ongoing activity. Information about safe canning is widely available for consumers. State health departments and CDC have persons knowledgeable about botulism available to consult with physicians 24 hours a day. If antitoxin is needed to treat a patient, it can be quickly delivered to a physician anywhere in the country. Suspected outbreaks of botulism are quickly investigated, and if they Involve a commercial product, the appropriate control measui es are coordinated among public health and regulatory agencies. Physicians should report suspected cases of botulism co a state health department. 

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