Botulism neurotoxins (A-F) could be transmitted by aerosol or contamination of food and water supplies.
Botulism is not transmitted from person to person.
- Incubation period is 12-36 hours (can be 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 is primarily based on a 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.