Botulism

Please click the frequently asked questions below for further information and IPC precautions required:

• What is Botulism?

  Botulism is a serious bacterial illness that leads to paralysis, and is caused by a toxin that affects the body’s nerves. Botulism toxins are one of the most lethal known substances and are included among potential bioterrorism threats. The bacterial spores exist widely in the environment and can grow and produce toxins in anaerobic conditions.

  Botulism occurs naturally in three forms:

  1. Food-borne botulism – an intoxication caused by eating food that containing botulism toxins;
  2. Intestinal botulism (Including Infant botulism) – caused by the consumption of botulism spores, which then germinate into bacteria and release toxins within the intestines of adults (adult intestinal toxaemia) or babies under one year of age (infant botulism)
  3. Wound botulism – caused by spores infecting a wound, germinating into bacteria, then releasing toxins.

  

• How does it spread?

  Food-borne botulism

  As a result of high standards of food hygiene in the UK, the chances of getting food-borne botulism from food bought in this country are low.

  There’s a slightly higher risk if you produce your own food, particularly if this involves canning.

  But following food hygiene procedures and canning recommendations will reduce any risk.

  Do not eat food from bulging or damaged cans, and avoid eating foul-smelling preserved foods, foods stored at the incorrect temperature and out-of-date foods.

   

  Infant botulism

  In many cases of infant botulism, the specific cause is not identified so it may not always be possible to prevent it.

  But you should avoid giving honey to babies under the age of 1 as it’s been known to contain Clostridium botulinum spores.

   

  Wound botulism

  People who inject heroin can get botulism. This is often through injecting heroin, contaminated with the bacteria, into the skin or muscles.

• What are the symptoms?

  The time it takes to develop symptoms can vary from a few hours to several days after exposure to the Clostridium botulinum bacteria or their toxins.

  Depending on the exact type of botulism, some people initially have symptoms such as feeling sick, being sick (vomiting), stomach cramps, diarrhoea or constipation.

  Without treatment, botulism eventually causes paralysis that spreads down the body from the head to the legs.

  Symptoms can include:

  • drooping eyelids
  • blurred or double vision
  • facial muscle weakness
  • difficulty swallowing (dysphagia)
  • slurred speech
  • breathing difficulties

  Affected babies may also have a weak cry, find it difficult to feed, and have a floppy head, neck and limbs.

• Why is this important?

  If NIAS staff are aware that the patient has a suspected or confirmed case this should be communicated to the Control Room (Emergency or Non-emergency as appropriate) and the staff in the receiving unit when transferring the patient to ensure effective patient care and management.

• IPC Precautions
  • Standard Precautions should be used.
  • Hand Hygiene should be completed as per the 5 moments in line with usual practice.
  • Eye protection should be risk assessed for any concern regarding a splash risk.
  • Gloves and Aprons should be risk assessed and worn if contact with the patient’s blood or bodily fluids.
  • Laundry should be treated as per usual local policy.
• What cleaning is required?

  All equipment and the ambulance should have an in-between patient clean, paying particular attention to touch points.

• Do staff need prophylaxis or follow up?

  No staff follow up required.