Botulism drugs

Drugs There is an antitoxin stored at the CDC. To arrange to use this antitoxin, call your state health department (or CDC at 404-639-2206 or 404-639-3753 workdays, or call weekends or evenings at 404-639-2888). This chemotherapy (antitoxin) available from CDC is a licensed trivalent equine antitoxin for serotypes A, B, and E. There is no reversal of botulism disease with this drug, but the antitoxin does usually prevent further nerve damage. The U.S. Department of Defense (DOD) has a heptavalent equine despeciated antitoxin for serotypes A - G (IND). DOD also has pentavalent toxoid (vaccine) for serotypes A - E (IND). The currently recommended schedule is for use at zero, two, and twelve weeks with a one year booster. This vaccine is supposed to induce solidly protective antitoxin levels in greater that 90 percent of those vaccinated after one year. Contact USAMRIID, (U.S. Army Medical Research Institute of Infectious Diseases), Fort Detrick, Maryland. Tel. 301-619-2833. 

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). 

Food and Drugs Administration (FDA). (2006). FDA warns consumers not to drink bolthouse farms carrot juice due to botulism concerns, http //www.cfsan.fda.gov/ lrd/fpcarro2. htmlAccessed Dec. 08. 

Reliable antidotes for botulism are not available. In some cases, anticholinesterase drugs may improve muscle strength, albeit temporarily. Guanidine and 4-aminopyri-dine also have limited usefulness. Management depends primarily on supportive measures, such as administering antitoxin and maintaining respiration. 

Foodborne botulism accounts for approximately 1,000 cases per year worldwide, of which approximately 30 occur in the United States. Home processed foods account for 94% of U.S. cases. Infantile botulism, a form of the disease in which C. botulinum spores are ingested by infants due to food contamination, occurs in approximately 60 children per year in the United States, more than half of which are in California. Wound botulism, typically involving intravenous drug users who either inject drugs intravenously or in the subcutaneous tissue (a practice known as skin-popping ), is reported one to three times per year in the United States. It can also occur in other types of contaminated wounds such as a severe crush injury or other areas of contaminated avascular tissue. Botulism due to intestinal colonization by C. botulinum is extremely rare only seven cases have been reported in the literature (CDC, 1998). 

The authors suggested that suxamethonium should be avoided in patients with suspected botulism and in patients with muscle weakness of unknown origin. Wound botulism had been observed before in drug users... 

Passaro DJ, Werner SB, McGee J, Mac Kenzie WR, Vugia DJ. Wound botulism associated with black tar heroin among injecting drug users JAMA 1998 279(ll) 859-63. 

Garlic is most commonly consumed as a food, rather than as a supplement. According to the Food and Drug Administration (FDA), chopped garlic and oil mixes left at room temperature have the ability to result in fatal botulism food poisoning (84). Such products need to be kept refrigerated,... 

With the exception of smallpox, next-generation candidates to replace the two current vaccines (smallpox and anthrax), and vaccines for botulism, tularemia, and Venezuelan equine encephalomyelitis will not be approved and available until the end of the decade at the earliest, hampered in part by the normal process for new drug approval and by the risk-averse nature of lead agencies within the Department of Defense. 

Wound botulism, a relatively rare form of the disease, results from the production of toxin by organisms that multiply in a contaminated wound. Wounds associated with botulism may not appear obviously infected (38). Before 1980, wound botulism was most likely associated with complicated wounds, such as extensive crush injuries, compound fractures and other wounds associated with avascular areas. Since 1980, most cases have occurred in illicit drug users, including intravenous drug users with contaminated needle puncture sites or drug users with nasal and sinus wounds secondary to chronic cocaine sniffing (38). In 2001, there were 23 reported cases of wound botulism in the United States, with one death (39). 

From 1980 to the present time, wound botulism has been observed predominantly in illicit drug users following repeated subcutaneous administration of black tar heroin, or in individuals with nasal or sinus lesions from chronic cocaine abuse (Anderson et al., 1997). During the last decade alone, wound botulism from black tar heroin has exceeded the total reported wound botulism cases during the preceding 40 years by a factor of almost three (Sandrock and Murin, 2001). 

Doctors in Oakland, California, have reported a number of cases of "wound" botulism occurring in drug addicts. This is due to... 

An Efficient Drug Delivery Vehicle for Botulism Countermeasure 275... 

To demonstrate the feasibility of delivering a therapeutic compound via the DDV, we examined the separation of the prototype drug carrier dextran from DDV. The results indicated that the drug carrier components were satisfactorily separated from DDV and diffused into cytosol. As described in the results section, the targeting component of the DDV, i.e., rHC was nontoxic. Therefore, the DDV approach presented here may be a physiologically compatible and a feasible targeted drug delivery method to counteract botulism. 

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