Botulism: Treatment, Cost and Side Effects

Also known as botulism poisoning, it is a rare and serious illness caused by a bacterial (Clostridium botulinum) infection either through food or through wounds. Botulism can be of three different forms: foodborne botulism, wound botulism and infant botulism. The disease is quite symptomatic and causes difficulty in swallowing and speaking, trouble breathing, drooping eyelids, blurred and double vision, dry mouth, weakness in the facial muscles, nausea and vomiting, abdominal cramps and paralysis.

These are all results of foodborne botulism. Wound borne botulism causes the same symptoms. Infant botulism shows symptoms in the baby’s body once the toxin stays in the body over 18 hours. The baby suffers from constipation, irritability, drooling and drooping eyelids, fatigue, difficulty in sucking and feeding, weak cry and floppy movements and paralysis due to weak muscles. Botulism can result in death if left untreated. Patients affected with botulism will be required to be hospitalised.

Infants are treated with Botulism immune Globulin Intravenous-Human, called as BabyBig or BigV. If respiratory problems occur, patients will need to be put on ventilator for various weeks and months along with intensive care and nursing. Patients are given antitoxins injections and sometimes with antibiotics too to prevent secondary infection. Surgery may also be required in order to remove the infection from wounds.

Botulism must be treated as soon as possible after the diagnosis is made. If it is a case of foodborne botulism, it is treated by clearing the digestive system with the help of a medication called enema. Enema aids in inducing bowel movements and vomiting so that the intestines get cleared off the toxin as soon as possible.

If the infection is in the wound, it is removed surgically. An early diagnosis of botulism helps in getting the toxin cleared soon with the help of an antitoxin. The antitoxin reacts with the toxin in the blood stream and stops it from affecting the nerves. Due to the regenerating properties of nerves, the antitoxin treatment is considered helpful because the nerves that have already been damaged by the toxin get regenerated. This antitoxin is mainly derived from horse and is known as equine immunoglobulin.

This has been found unsafe for treating botulism in infants, so, infants are treated with another antitoxin derived from humans. Antibiotics like penicillin C and metronidazole are used for treating only wound botulism. Breathing aids are used if the lung muscles are affected. Patients are put on mechanical ventilation for as long as conditions do not improve. Therapy may be required for improvement of speech, help in swallowing and help other parts of the body to function appropriately.

Any person with the symptoms of getting weak muscles, drooping eyelids, impaired speech and paralysis must get checked by the doctor. On diagnosing the presence of the toxin in the body, the person becomes eligible for botulism treatment.

If on diagnosis no botulinum toxin is found in the body, the person will not eligible for treatment for botulism.

There is usually no side effect for the treatment for botulism. The antitoxin treatments are considered quite safe and effective as well. Only the antibiotic treatment must be given with care only to patient with wound borne botulism patients because in other types it can enhance the release of the toxins in the body.

After the treatment procedures are done, during the recovery phase patients are subjected to rehabilitation wherein they are helped to improve their swallowing, speech and other functions of the muscles and nerves.

It takes several months to recover completely from botulism after receiving the treatments.

The treatment for botulism in India has not reached a very advanced stage and the antitoxins are not yet available in the country. Although, doctors do provide treatment for botulism and the consultation fees can range from Rs. 500 to Rs. 1,000. The surgery and antitoxin treatment may cost more. But actual prices for the treatment are not available in India yet.

Yes, the results of the treatment are permanent unless the patient get affected by the bacteria again in life.

There is no alternative treatment for botulism. But botulism can be prevented. The toxins are reported to be destroyed when subjected to high temperatures. So, it is recommended to boil home canned foods before consuming it. Foods with foul smell, those with expired dates and foods stored at incorrect temperatures must be avoided. Babies less than 12 months should not be fed with honey as honey is reported to contain the spores of C. botulinum and get infected by the toxin.