Wound botulism is caused by toxin produced within a wound infected with Clostridium botulinum bacteria. For example, if soil containing botulism spores fell into an open wound, the spores could turn back into bacteria and produce toxins.
Infant botulism is caused by consuming the spores of botulism bacteria, which then grow in the intestines and release toxin. The reason you shouldn’t feed honey to an infant is because of the risk the honey might contain botulism spores.
All three forms of botulism can be life-threatening and should be treated as medical emergencies. Foodborne botulism is especially dangerous, because many people can be poisoned by eating from the same contaminated food source.
Botulism can be prevented. Food-borne botulism often occurs from home-canned foods with low acid content, such as asparagus, green beans, beets and corn. However, outbreaks of botulism from more unusual sources such as chopped garlic in oil, chili peppers, tomatoes, improperly handled baked potatoes wrapped in aluminum foil, and home-canned or fermented fish.
People who do home canning should follow strict hygienic procedures to reduce contamination of foods. Oils infused with garlic or herbs should be refrigerated. Potatoes that have been baked while wrapped in aluminum foil should be kept hot until served or refrigerated. Because the botulism toxin is destroyed by high temperatures, people who eat home-canned food should consider boiling the food for 10 minutes before eating it to ensure safety. Instructions on safe home canning can be obtained from county extension services or from the US Department of Agriculture.
Because honey can contain spores of Clostridium botulinum (a source of infection in infants), children less than 12 months old should not be fed honey. Honey is safe for people 1 year of age and older.
Wound botulism can be prevented by promptly seeking medical care for infected wounds, cleaning wounds with soap and water, and not using injectable street drugs.
If diagnosed early, botulism can be treated with an antitoxin that blocks the actions of the toxin circulating in the blood. This can prevent patients from worsening, but recovery still takes many weeks. Physicians may try to remove contaminated food remaining in the gut by inducing vomiting or by using enemas. Wounds should be treated, usually surgically, to remove the source of the toxin-producing bacteria. Good supportive care in a hospital is the core therapy for all forms of botulism.
The bacterium Clostridium botulinum is the same bacterium that is used to produce Botox or Myobloc, pharmaceuticals for clinical and cosmetic use. However, what is used in Botox treatments is the purified and diluted neurotoxin A. Treatment is administered according to the needs and tolerance of the patient.
Botulism can result in death due to respiratory failure. However, in the past 50 years, the proportion of patients with botulism who die has fallen from about 50% to 8%. Patients who survive an episode of botulism poisoning may have fatigue and shortness of breath for years and long-term therapy may be needed to aid recovery.
CDC Disease Information: Botulism
Developed in cooperation with the Immunization Action Coalition and the Centers for Disease & Control and Prevention (CDC).