Botulism is a rare but serious illness that causes descending paralysis. Children under the age of 12 months are most at risk of infection. Botulism can occur following the ingestion of contaminated food, soil or dust. Care should be taken when canning fruit, vegetables and meat at home.
For further information please see the fact sheet or contact your local public health unit on 1300 066 055.
See reference: Sobel J. Botulism. Clin Infect Dis. (2005) 41(8):1167-1173. doi: 10.1086/444507 .
Confirmation of botulism requires:
Laboratory testing for Clostridium botulinum toxin is available at ICPMR-Pathology West (Discuss with the Clinical Microbiologist on call, (02) 9845-6255).
Botulinum immunoglobulin (BabyBIG®) derived from human donors for the treatment of infant botulism (< 1 year of age) is available from the California Department of Public Health.
Equine-derived heptavalent antitoxin (BAT®) for older children and adults is available through NSW Health from the national stockpile.
These two botulinum antitoxin products (described below) can be considered for the treatment of suspected or confirmed botulism in addition to supportive treatment. In infant botulism (or other forms of intestinal botulism), antibiotics are not used to treat the infection because of the risk that lysis of intraluminal Clostridium botulinum may increase the amount of toxin available for absorption.
If botulinum antitoxin is to be used it should be administered as soon as possible. Antitoxin does not reverse paralysis but arrests its progression. Skin testing for sensitivity to antitoxin should be performed before administration.
The preferred product for the treatment of infant botulism is BabyBIG®. Consider BAT® for infants requiring treatment if BabyBIG® is unavailable or its delivery is likely to be significantly delayed.
Treating clinicians need to consider the following points: