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How Do You Get Botulinum Toxins? 5 Types of Botulism

Botulinum toxins are typically ingested through food, although they can enter the body in other ways as well. Learn about 5 different types of botulism

Botulism is a condition caused by botulinum toxin produced by the bacteria Clostridium botulinum. Botulinum toxins can lead to flaccid paralysis of muscles.

Botulinum toxins are typically ingested through food, although they can enter the body in other ways as well.

  • Processed food: Improperly canned or processed foods with low acid or low oxygen can promote the growth of preformed botulinum toxins.
  • Wounds: Botulinum spores can get into an open wound and produce toxins. Wound botulism is common in people who inject black tar heroin.
  • Honey: Spore-contaminated honey can cause severe infection in infants, leading to infant botulism.
  • Inhalation: Bioterrorism or accidental inhalation of toxins can cause symptoms of foodborne botulism, although this is very rare.
  • Water: Drinking water that is not boiled or disinfected can cause botulism.
  • Surgery or antibiotic therapy: Some surgical procedures or antibiotic therapy can alter gut flora and cause the growth of Clostridium botulinum. 
  • Botox injections: Medical or cosmetic use of Botox can result in adverse side effects.

Botulism does not spread from person to person. Botulism develops if a person ingests the toxin or the Clostridium botulinum species grows in the intestine.

Clostridium botulinum produces botulinum toxins in the presence of:

  • Low oxygen or no oxygen environment (anaerobic)
  • Low acid
  • Low sugar
  • Low salt
  • Certain temperature ranges
  • Certain amounts of water

What are different types of botulinum toxins?

Table: Types of botulinum toxins and effect on humans or other mammals

Types of botulinum toxins
Cause human botulism
Cause botulism in mammals, birds, and fish

A
Yes
No

B
Yes
No

C
No
Yes

D
No
Yes

E
Yes
Yes

F
Yes (rarely)
No

G
No
No

5 types of botulism

1. Foodborne botulism

Some processed foods contain botulinum toxins due to improper processing such as low oxygen levels or improper storage temperature.

Foods where botulinum toxins are commonly found include:

  • Low acid preserved vegetables:
    • Green beans
    • Spinach
    • Mushrooms
    • Beets
  • Fish:
    • Canned tuna
    • Fermented, salted, and smoked fish
  • Meat products:
    • Ham
    • Sausage

Symptoms of foodborne botulism include:

  • Vomiting
  • Nausea
  • Stomach pain
  • Diarrhea
  • Marked fatigue
  • Weakness
  • Vertigo
  • Facial weakness
  • Trouble breathing
  • Drooping eyelids
  • Nausea and vomiting
  • Paralysis

2. Wound botulism

Wound botulism occurs through an open sore, when a botulinum spore enters through the sore and produces toxins. Symptoms typically occur 2 weeks after toxin release and are similar to foodborne botulism. Wound botulism is common in people who abuse substances such as black tar heroin. Symptoms of wound botulism include:

  • Facial weakness
  • Drooping eyelids
  • Paralysis
  • Trouble breathing
  • Drooping eyelids
  • Blurred or double vision
  • Difficulty swallowing or speaking

Treatment of foodborne and wound botulism can be treated with an antitoxin if diagnosed early. These antitoxins block the action of neurotoxins circulating in the blood. Other treatment approaches include:

  • Enema administration and inducing vomiting
  • Surgical removal of toxin-producing bacteria and treating the wound
  • Antibiotic therapy

3. Infant botulism

Infant botulism occurs when infants under 6 months of age ingest spores of Clostridium botulinum. These spores colonize the intestine and release botulinum toxins. Unlike foodborne botulism, infant botulism occurs due to a less developed immune system in the intestine. Symptoms of infant botulism include:

  • Constipation
  • Weight loss
  • Weakness
  • Loss of head control
  • Altered cry
  • Poor feeding
  • Fewer facial expressions
  • Uncontrolled drooling

4. Inhalation botulism

Inhalation botulism is caused by accidental inhalation of toxins in aerosols. Symptoms are visible within 1-3 days and are similar to foodborne botulism. However, they culminate into muscle paralysis and respiratory failure.

If you suspect exposure to toxins via aerosols, you should prevent additional exposure to the toxins. Your clothes would be removed and stored in a plastic bag to be washed later with soap and water. You should take a bath immediately and decontaminate yourself.

5. Waterborne botulism

Although rare, preformed toxins can be found in water that is not boiled or disinfected. Boiling and disinfecting water can destroy the toxin, thereby reducing the risk of infection.

SLIDESHOW

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Medically Reviewed on 12/9/2021

References

Image Source: iStock Images

Centers for Disease Control and Prevention. Botulism. https://www.cdc.gov/botulism/testing-treatment.html

World Health Organization. Botulism. https://www.who.int/news-room/fact-sheets/detail/botulism

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