- Botulism neurotoxins (A-F) could be transmitted through aerosol or contaminated food and water supplies.
- Botulism is not transmitted from person-to-person.
- Incubation period is 12-36 hours (up to several days).
- Early symptoms include blurred vision, diplopia, and dry mouth.
- Later symptoms include dysarthria, dysphagia, dysphonia, ptosis and the development of a symmetrical, descending progressive paralysis, and respiratory failure.
- Patients are usually alert and afebrile.
- Diagnosis primarily through compatible clinical presentation.
- Spinal protein is normal and characteristic findings are seen on EMG (facilitation of the compound muscle action potential on repetitive nerve stimulation).
- Toxin can be detected in serum (collect 30 cc in red top) and stool (foodborne botulism) by mouse neutralization bioassay performed at California Microbial Diseases Laboratory.
- Standard precautions. Patients do not require isolation rooms.
- Supportive care is the mainstay of therapy. Prolonged ventilatory support is often required in severe cases.
- Botulism anti-toxin (for A, B and E toxins) is in limited supply and is available only from the Division of Communicable Disease Control, California Dept. of Health Services.
- Currently, there is no available post-exposure prophylaxis.
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