Botulism Immune Globulin

Eitzen, 2003). Botulism Immune Globulin Intravenous (human), a pentavalent investigational vaccine, is available through the California Department of Health Services for administration in infantile botulism. 

Botulism is an immune globulin. Botulism immune globulin contains IgG antibodies representative of the immunized donors who contribute to the plasma pool of the derived product. It is indicated in the treatment of patients younger than 1 year of age with infant botulism caused by type A or B. 

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. 

Botulism immune globulin harvested from human donors experimentally exposed to toxoid ... 

Frankovich TL, Amon SS. 1991. Clinical trial of botulism immune globulin for infant botulism. Western Journal of Medicine 154 103. 

Amon, S. S. (1993) Clinical trial of human botulism immune globulin. In Botulinum and Tetanus Neurotoxins Neurotransmission and Biomedical Aspects (B. R. DasGupta, ed.), Plenum Press, New York. pp. 477-482. 

Botulism (adjunctive therapy to antitoxin), gas gangrene and tetanus (adjunctive therapy to human tetanus immune globulin)... 

Although infant botulism was not recognized until a large outbreak occurred in Califomia in 1976 (Pickett et ah, 1976), it is currently the most prevalent form of botulism in the United States, accounting for approximately 70% of all cases (Shapiro et al., 1998). Because infant botulism results from a continual production of BoNT, it appears to be more effectively treated by antitoxin than is foodborne botulism. In a recently concluded 5 year randomized clinical trial carried out with a human botulinum immune globulin (BIG-IV), it was found that administration of BIG-IV within 3 days of hospitalization resulted in a 3 week reduction in the mean hospital stay, as well as substantial reductions in the time needed for intensive care and mechanical ventilation (Amon et al., 2006). In a nationwide open label study, BlG-lV was found to be effective even when administered 4—7 days after hospital admission, although to a somewhat lesser extent than when infusion was initiated at 3 days (Arnon et al., 2006). 

Injected forms of antibodies which have been generated in another body or animal can be isolated, purified, and administered as standard human immune serum globulin (ISG), and ISG plus preparation, or as an animal antiserum or antitoxin. Some serums which are available are those for rabies, snake and insect bites, botulism, and tetanus. Temporary immunity of up to six months to hepatitis can be imparted by one "gamma globulin" shot. More permanent active immunity is available to health care workers. 

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