Botulism is a rare and severe illness. Sometimes, it can be fatal if left untreated or inappropriately treated. In this article, we discuss the antitoxin therapy to treat patients with foodborne botulism.
Although the studies and data on botulism are sparse, somethings are clear. Timely administration of antitoxin can reduce mortality however, in spite of appropriate treatment with antitoxin, some patients can suffer from respiratory failure1.
Food botulism is a life-threatening disease. It is caused by the ingestion of food, which contains preformed botulinum neurotoxins. If a type of food is consumed widely and is contaminated, it can cause many illnesses. It is the most powerful natural poisonous substance known to humankind. There are seven kinds of botulism toxin serotypes were identified between the periods of 1919 to 1970. They were named by the alphabets between A-G. Most of the cases of human botulism are caused by the botulinum neurotoxin serotypes of A, B, and E and the other serotypes have pathogenic potential. Antitoxin treatment for botulism is the approved therapy administered to patients after the onset of symptoms2. It is considered a public health emergency and should be reported to public health authorities immediately whenever a case of food botulism is identified.
Foodborne botulism is caused due to the intake of toxin (poisonous substance within a living substance), which is produced by Clostridium botulinum. This bacterium grows best in the food at room temperatures (70° – 110°F). Foodborne botulism is food poisoning. It is a rare illness but can be a life-threatening bacterial illness. It may cause paralysis if food is undigested. This medical condition is extremely rare but it is so hazardous that every case is considered as a public health emergency. It is found that infant botulism is the most common form of botulism in the United States3.
Foodborne botulism emerges after eating the food that contains the bacterium toxin, which is produced by Clostridium botulism. Any type of awful smell or taste is not given by this toxin to the food. The main cause of this medical condition can be because of improper processed home-canned foods or meats which are preserved at home. This illness is non-communicable hence it can’t be spread from one person to another. Usually, this illness is transmitted via contaminated canned foods which may not be properly cooked or reheated after preserving it. Good hospital care is required if a person is suffering from foodborne botulism. Antitoxin is the solution in most cases for the treatment of foodborne botulism. Unattended botulism may result in the death of a person.
Antitoxin Therapy to Treat Patients with Foodborne Botulism
An antitoxin is an antibody that can fight against specific toxins. Antitoxins are produced by certain plants, animals, and bacteria in response to toxin exposure. Antitoxins also kill bacteria and other microorganisms. They are injected into organisms including humans to treat infectious diseases. It is necessary to understand the antitoxin therapy to treat patients with foodborne patients.
It is good to give antitoxins immediately to patients after being diagnosed with foodborne botulism. Providing antitoxin at the initial stage is better and also effective in reducing the number of mortality rates. Antitoxin therapy is used to treat patients with foodborne botulism successfully.
The first of its kind botulinum antitoxin was developed by the US Army Medical Research Institute of Infectious Diseases in the year 1970s4. Foodborne botulism is treated with the help of serotype AB and E. Botulism antitoxins contain antibodies or antibody antigen-binding fragments, which block the neurotoxin produced by the bacterial species Clostridium botulinum Guanethidine and 4-aminopyridine antitoxins are used for the treatment of botulinum paralysis but these are not very effective. The use of local antibodies like penicillin G and metronidazole may help to eradicate Clostridium botulinum wound botulism. Botulism antitoxins can neutralize circulating botulism toxin in the body of an individual, preventing toxin binding to the neuromuscular junction, but cannot reverse the paralysis. The only drug available in the market to treat botulism is an equine antitoxin.
Many discussions have taken place to understand the determinants to improve the safety characteristics of botulinum. Many species can be changed from a horse to any other animals like sheep or goat so that lower immunogenicity of antiserum is received. It is extremely important to choose the correct immunogen to improve the power of the product. Two ways to improve the safety and potency of the product are fractionation of the antitoxin and affinity purification.
While we discuss the efficacy of antitoxin therapy in treating foodborne botulism, it is also important to know the safety in using them. The dosing level of the current botulinum antitoxin is unnecessarily high compared to the amount of toxin involved in the intoxication. If there is proper optimization of the dosage of the antitoxin then the safety of the product can be improved. Antitoxin does not provide any clear benefits. Despite using antitoxin therapy for the treatment of foodborne botulism patients some patients suffer from respiratory failure. Major adverse effects are an infusion reaction, type 1 hypersensitivity and serum sickness syndrome. The most serious effect of the antitoxin is anaphylaxis. Hence, antitoxin therapy to treat patients with foodborne botulism must be properly evaluated.
Ways to Prevent Foodborne Botulism
Considering the risks and issues regarding the usage of antitoxin therapy to treat patients with foodborne botulism, preventing botulism is more important. A person should properly process and prepare the canned and preserved foods to avoid foodborne botulism. It should be noted that home-canned products should be heated to 241°F with the help of a pressure cooker so that all the spores of Clostridium botulism are killed.
- United States Department of Agriculture (USDA) also provides some guidelines to the public for home canning.
- Home-canned food should at least be boiled for 10 minutes before eating as it will destroy the botulism toxin.
- Reheated foods should be heated at 165°F. Frozen foods, if defrosted in the refrigerator itself may prove good as compared to that at room temperature.
- It is better to avoid containers that are bulged. They should not be opened. Commercial cans that have a bulge in them should be returned to the vendor.
- Even foods that emit an awful odor should not be eaten or even tasted.
- One should avoid storing garlic/oil at room temperature.
- It is also advised that baked potatoes should not be stored at room temperature.
Often the question is asked whether one can get botulism due to refrigerated food. It is better to refrigerate all the leftovers and cooked food within 2 hours of cooking (should be 1 hour if the temperature is above 90°F). The most common cause of foodborne botulism is improper home-canned food, especially those foods which are low in acid like vegetables and meats. World Health Organization coordinates with various national and local authorities to contain the outbreak at their source.
Hence, to conclude the topic we come to know that foodborne botulism arises due to the consumption of the contamination of canned and processed foods. It is a rare medical condition with a lack of proper solutions. If diagnosed at an earlier phase the patient can be saved but to recover fully it can at least take a year. Foodborne botulism is fatal. Antitoxin therapy is used to treat patients with foodborne botulism. Though antitoxin can cure the illness it has some adverse effects. To get better product research should be done and dose level should be decreased as currently, the dose level is more than the toxic present in the body.
- Foodborne Botulism or Botulism Food Poisoning: Causes, Symptoms, Treatment, Prevention, Complications