When botulism is a notifiable, life-threatening poisoning, which is caused by a potent neurotoxin. Botulism is also known colloquially as meat poisoning or sausage poisoning.

What is botulism?

According to percomputer, botulism is the technical term for poisoning caused by the metabolic product of the bacterium Clostridium (Cl.) Botulinum.

This is the strengthened nerve poison known to us. The disease is caused by germs that were found in spoiled sausage products when they were first described. The Latin name botulus for sausage can be traced back to this.

In Germany, only a few cases of botulism in humans are known each year. Consumers can largely prevent illness by handling food correctly.

Botulism occurs very rarely in Germany. Around 20 cases are reported to the Robert Koch Institute each year. However, since a disease often leads to death, botulism is a serious disease that requires immediate treatment by a doctor.

Even the suspicion of botulism must be reported. Botulism is not contagious. Botulism is not only found in humans. The disease also repeatedly breaks out among our pets and farm animals, especially ruminants.

Causes

If certain circumstances come together, the botulism bacterium can produce toxins in the absence of oxygen, which damage the nerves and result in the actual poisoning.

Today, different ways are known in which the pathogens for botulism can get into the human body. In Germany, the cause lies mostly in the consumption of food contaminated with toxins, especially meat. Canned food can also be affected. The problem is that contaminated foods do not differ from harmless foods in terms of smell or appearance and a possible health risk cannot be foreseen by laypeople.

The botulism poison can also get into the bloodstream and later to the nerves through open wounds. In very rare cases, newborn babies have colonization of the intestines with Cl. Botulinum is conceivable. This is because the bacterium can only germinate in the intestine and form toxins there in the first few months. This form of botulism is unlikely in children who have reached the age of one and in adults.

Recently, we have also been discussing a connection between high-performance agriculture and the development of botulism. However, there are no official results or recommendations on this yet.

Symptoms, ailments & signs

With food botulism, the first symptoms appear approximately 2 to 48 hours after the body absorbs the bacterial toxin. The poison severely interferes with the transmission of signals between nerves and muscles. This in turn paralyzes the affected muscles.

In most patients, the muscles of the eye are affected first, which is noticeable as blurred vision, sensitivity to light or the perception of double images. In addition, the eyelids become heavy and can hardly be kept open. Botulism is associated with typical symptoms.

These primarily include nausea, vomiting, and diarrhea. In addition, the bacterial toxins also damage the nerve cells, which results in symptoms of paralysis all over the body. The palate, lips and larynx are particularly affected. As a result, the patient suffers from difficulty swallowing. This in turn increases the risk that the sick person will choke.

Another common sign of botulism is the cessation of saliva production, causing dry mouth. If the poisoning continues, the internal organs also suffer. After three to eight days, there is even a threat of life-threatening respiratory paralysis. Without proper treatment, this can be fatal. Although the symptoms of botulism are extremely serious, it does not affect the patient’s consciousness.

Diagnosis & course

In the case of botulism, the doctor usually makes the diagnosis on the basis of the typical symptoms. He asks the patient what foods he recently consumed. A blood sample is then taken and examined for botulinum toxin in the blood serum.

If necessary, a further stool sample is taken. In most cases, the result of the diagnosis is then already established. Occasionally, a differential diagnosis for other gastrointestinal diseases must also be made to rule them out.

First of all, the nerve toxin reaches the place where it unfolds its harmful effects – the nerve cell – via the bloodstream. Here the poison blocks the signal transmission from the central nervous system.

Within a few hours, those affected complain of nausea, diarrhea, constipation, difficulty swallowing and dry mouth. The muscles become paralyzed. The muscles go limp. Ultimately, this can also affect the respiratory muscles, which are vital for us.

Complications

Various complications can arise with botulism. First of all, botulism makes it difficult to speak and swallow, which can lead to inflammation in the throat. In extreme cases, the symptoms develop into pneumonia, which in connection with the underlying disease can be fatal. Often the result of meat poisoning is respiratory paralysis, which, if left untreated, leads to death.

In severe cases, botulism can lead to cardiac arrest. Food poisoning often affects those affected long after they have recovered. Physical exhaustion often remains and the symptoms of paralysis can develop into permanent paralysis. Breathing problems often occur after respiratory paralysis, which can lead to headaches, difficulty concentrating and panic attacks.

Less often, respiratory paralysis can lead to a lack of oxygen and its consequences. Because of its far-reaching complications, botulism should be treated as quickly as possible. If the food poisoning is treated and cured early, usually no long-term damage remains. If left untreated, the disease is fatal in 25 to 70 percent of cases. A medical clarification of the complications is therefore recommended in any case

When should you go to the doctor?

A doctor should be consulted immediately if botulism is suspected. If the poisoning is treated adequately in a timely manner, long-term damage is extremely rare. The matter is completely different if the poisoning is not treated professionally. Then not only threaten serious complications and long-term damage, but there is also a significant risk of dying from poisoning.

In Germany, botulism is mainly caused by the consumption of contaminated meat and sausage products, including canned food. For the consumer, the spoiled food cannot always be recognized by a change in appearance or smell. As soon as botulism symptoms occur after consuming meat or sausage products, a doctor must therefore be consulted immediately, even if the food consumed appeared completely normal.

Typical signs of meat poisoning are nausea, vomiting and diarrhea, especially in connection with muscle paralysis, speech disorders and difficulty swallowing. As soon as patients experience these symptoms, a doctor should be consulted immediately. In severe cases, botulism can lead to acute respiratory paralysis and cardiac arrest. If the symptoms are pronounced, no time should be wasted and the emergency doctor should be called immediately.

Treatment & Therapy

Those affected should be treated immediately by a doctor. Usually, however, botulism is only recognized late by the doctor, as it initially concludes that there are more harmless gastrointestinal diseases. Especially if it is the only one or the first of several people who have consumed the affected food. The attending physician can administer an antidote and detect the pathogen using blood or stool samples.

If botulism is detected in a timely manner, there is a good chance that sufferers can be completely cured. Sometimes the neurotoxin can stay in the body for several months, so that the treatment takes a longer time.

Those affected are cared for in the intensive care unit in the hospital, at least for the first few days. Gastric lavage is supposed to remove food residues from the body, while medication alleviates the symptoms and an antidote is supposed to deactivate the neurotoxin.

Outlook & forecast

The prognosis for botulism depends to a large extent on how severe the poisoning is, how quickly it is recognized and whether the patient immediately receives intensive medical treatment. For small children, in the case of infant botulism, as well as for older people or people with health problems in any case, a prognosis must also be more pessimistic than for healthy patients.

If left untreated, the death rate from botulism is 70 percent and more because the botulinum toxin causes paralysis that can affect the heart or respiratory muscles. In these cases, cardiac arrest or respiratory paralysis occurs. In survivors, paralysis of the cranial nerves and an insufficient supply of oxygen to the brain can in some cases lead to permanent damage.

If a botulism disease is detected in good time and treated with intensive care medicine, the prognosis is much more positive. The mortality rate is significantly reduced to less than ten percent. However, patients have to prepare for lengthy rehabilitation. The symptoms of paralysis caused by the botulinum toxin regress only very slowly, over the course of several months. However, permanent damage beyond this is rare. As a rule, patients can lead a normal life after overcoming botulism.

Prevention

Botulism can be effectively prevented. To do this, you should pay attention to certain things in connection with food. So it is advisable not to consume foods from bloated doses. In addition, care should be taken to strictly adhere to the cold chain for heat-sensitive foods and to follow the storage recommendations printed on the packaging.

Honey does not belong on the pacifier of babies. If food is preserved in your own kitchen, as is the case, for example, when canning vegetables, sterilization is recommended. This means briefly heating the food to 100 degrees Celsius. If this is not possible, double heating can kill botulism spores and prevent them from multiplying further.

Aftercare

In milder cases, no follow-up care is necessary. The patient can go on living without symptoms and is released from medical care. However, this does not mean that immunity against botulism has arisen. Poisoning with the bacterial toxins is possible again. Those affected have no choice but to take suitable preventive measures.

In the Western European world, this includes avoiding food from damaged canned goods and glasses. If meat is cured and fish is pickled, it is essential to adhere to current hygiene standards. Strong heating of the food has been shown to kill the pathogens. Preventing the disease from recurring requires a high level of personal responsibility in everyday life.

Botulism is not always gentle. Symptoms such as weak breathing and paralysis can sometimes still be felt after months or years. The patient then has to present himself regularly to his treating doctor. This will order a blood and stool sample to determine the state of recovery. Paralysis can usually be relieved with drug treatment.

It is advisable not to exercise physical strain during follow-up care. Botulism usually does not lead to permanent damage, which is why a suitable therapy provides complete freedom from symptoms. Healing often takes an unusually long time, especially in older people.

You can do that yourself

Botulism is a life-threatening disease. We strongly advise against self-treatment. Those affected must seek medical treatment immediately. If the general condition improves, however, measures can be taken to support the body in the healing process.

Since the gastrointestinal tract was also paralyzed due to the poisoning and artificial nutrition was often necessary, it is important to build up the diet slowly. Flatulent and strongly irritating foods are to be avoided. A sufficient fluid intake – ideally mineral rich still water – to look for. Once digestion gets going again, the menu should contain plenty of fresh vegetables and whole grain products.

During the illness, the body uses up its reserves of fat and minerals, which need to be replenished. It is also possible to take nutritional supplements that offer micronutrients in concentrated form. Light walks in the fresh air stimulate digestion and the immune system.

The body can also be supported homeopathically in the healing process. In the acute phase of the disease, Arsenicum album is the first choice for food poisoning. Then the Schüssler salts number 3 (Ferrum phosphoricum), 6 (Calium sulfuriucim) and 7 (Magnesium phosphoricum) can be taken as an immune treatment in tablet form. To compensate for the side effects of antibiotic treatment, it is advisable to take probiotics at the same time. These enable the intestine to be repopulated with healthy intestinal bacteria.

Botulism

Botulism Guide