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American Family Physician May 2003Recent events have demonstrated that bioterrorists have the ability to disseminate biologic agents in the United States and cause widespread social panic. Family... (Review)
Review
Recent events have demonstrated that bioterrorists have the ability to disseminate biologic agents in the United States and cause widespread social panic. Family physicians would play a key role in the initial recognition of a potential bioterrorism attack. Familiarity with the infectious agents of highest priority can expedite diagnosis and initial management, and lead to a successful public health response to such an attack. High-priority infectious agents include anthrax, smallpox, plague, tularemia, botulism, and viral hemorrhagic fever. Anthrax and smallpox must be distinguished from such common infections as influenza and varicella. Anthrax treatment is stratified into postexposure prophylaxis and treatment of confirmed cutaneous, intestinal, or inhalation anthrax. Disease prevention by vaccination and isolation of affected persons is key in preventing widespread smallpox infection. Many resources are available to physicians when a bioterrorism attack is suspected, including local public health agencies and the Centers for Disease Control and Prevention.
Topics: Anthrax; Bacterial Infections; Bioterrorism; Botulism; Hemorrhagic Fevers, Viral; Humans; Plague; Smallpox; Tularemia; Vaccines; Virus Diseases
PubMed: 12751654
DOI: No ID Found -
Anales de Pediatria (Barcelona, Spain :... May 2008We report a case of botulism in a 40 day old infant. The patient presented a descending flaccid paralysis requiring mechanical ventilation for 12 days. She is the first...
We report a case of botulism in a 40 day old infant. The patient presented a descending flaccid paralysis requiring mechanical ventilation for 12 days. She is the first European patient treated with Human Botulism Immune Globulin. A few weeks later a second case of infant botulism was detected in our geographical region in Southern Spain. We emphasise the importance of an early diagnosis and treatment with Human Botulism Immune Globulin to decrease morbidity.
Topics: Botulinum Toxins; Botulinum Toxins, Type A; Botulism; Diagnosis, Differential; Female; Humans; Infant; Neuromuscular Agents; Paraplegia
PubMed: 18447997
DOI: 10.1157/13120050 -
Annals of Medicine 2023Botulism is a rare disease, and infant botulism (IB) even rarer, especially when steering the condition to honey consumption. IB is considered a life-threatening disease...
BACKGROUND
Botulism is a rare disease, and infant botulism (IB) even rarer, especially when steering the condition to honey consumption. IB is considered a life-threatening disease as it leads to severe neurological symptoms. Exploring the knowledge, attitude, and practice (KAP) among mothers on the relationship between honey and IB will help public health professionals implement appropriate maternal health education materials targeting infant health and increase the awareness of the paediatric primary care providers, physicians, and nurse practitioners about the risk of IB among their patients.
OBJECTIVES
To determine the knowledge of mothers from Hail city in Saudi Arabia (SA) regarding IB and assess their attitude and practice towards feeding honey to their infants before 12 months of age.
METHODS
Using a comparative cross-sectional study, in February 2022, we broadcasted an online questionnaire through social networking and evaluated the KAP of 385 mothers.
RESULTS
Less than half (48%) of the mothers have heard about IB, 40% of them knew the relation between honey ingestion and IB and only 6.5% acknowledged that they knew the causative agent for IB. The prevalence of feeding honey to infants before 12 months was 52%. Mothers from Hail city were less likely to provide honey to their infants ( = 0.002).
CONCLUSION
The study revealed that mothers from Hail city have relatively low knowledge of IB and that they hold favourable perceptions of using honey as a food supplement and feeding honey to their infants before 12 months. Considering the high prevalence of honey feeding with the known low incidence of IB in SA, Medical professionals should consider IB in their differential diagnosis particularly in the presence of neurological symptoms.
Topics: Female; Humans; Infant; Child; Botulism; Saudi Arabia; Honey; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice
PubMed: 37943711
DOI: 10.1080/07853890.2023.2279746 -
Euro Surveillance : Bulletin Europeen... Jun 2023
Topics: Humans; Botulism; Disease Outbreaks; Iatrogenic Disease; Clostridium botulinum
PubMed: 37289430
DOI: 10.2807/1560-7917.ES.2023.28.23.2300280 -
Clinical Pharmacology and Therapeutics Jul 2022Botulism antitoxin heptavalent (A, B, C, D, E, F, and G - Equine; BAT) product is a sterile solution of F(ab') and F(ab') -related antibody fragments prepared from...
Botulism antitoxin heptavalent (A, B, C, D, E, F, and G - Equine; BAT) product is a sterile solution of F(ab') and F(ab') -related antibody fragments prepared from plasma obtained from horses that have been immunized with a specific serotype of botulinum toxoid and toxin. BAT product is indicated for the treatment of symptomatic botulism following documented or suspected exposure to botulinum neurotoxin serotypes A to G in adults and pediatric patients. Pharmacokinetic and exposure-response models were used to explore the relationship between BAT product exposure and the probability of survival, and the occurrence of relevant moderate clinical signs observed during the preclinical development of BAT product to justify the clinical dose. The predicted probability of survival in humans for all serotypes of botulinum neurotoxin was more than 95.9% following intravenous administration of one vial of BAT product. Furthermore, this BAT product dose is expected to result in significant protection against clinical signs in human adults for all botulinum neurotoxin serotypes. Our exposure response model indicates that we have sufficient antitoxin levels to give full protection at various theoretical exposure levels and, based on neutralization capacity/potency of one dose of BAT product, it is expected to exceed the amount of circulating botulinum neurotoxin.
Topics: Animals; Botulinum Antitoxin; Botulinum Toxins; Botulism; Horses; Humans
PubMed: 35467014
DOI: 10.1002/cpt.2620 -
Ugeskrift For Laeger Feb 2022The review summarises the current knowledge of the treatment of iatrogenic botulinum toxin overdose. The symptoms may be diffuse, and suspicion should be raised based on... (Review)
Review
The review summarises the current knowledge of the treatment of iatrogenic botulinum toxin overdose. The symptoms may be diffuse, and suspicion should be raised based on time of symptom appearance relative to the time of exposure. Iatrogenic botulism may appear if the maximum recommended total dose of botulinum toxin has been exceeded and if the drug is spread locally from the site of injection or is redistributed to the systemic circulation. The adverse drug reactions frequency is possibly underreported. Fast initiation of the available antidote may be needed. The guideline provided on treatment of iatrogenic botulism is developed from non-iatrogenic botulism.
Topics: Botulinum Toxins, Type A; Botulism; Humans; Iatrogenic Disease
PubMed: 35179113
DOI: No ID Found -
Archives of Pathology & Laboratory... Jun 2004This review article is designed to thoroughly familiarize all health care professionals with the history, classification, epidemiology, clinical characteristics,... (Review)
Review
OBJECTIVE
This review article is designed to thoroughly familiarize all health care professionals with the history, classification, epidemiology, clinical characteristics, differential diagnosis, diagnostic evaluation (including laboratory-based testing), treatment, and prognosis of botulism. It is especially targeted toward clinical laboratorians and includes a detailed enumeration of the important clinical laboratory contributions to the diagnosis, treatment, and monitoring of patients with botulism. Finally, the bioterrorism potential for botulism is discussed, with an emphasis on the clinical laboratory ramifications of this possibility.
DATA SOURCES
Included medical periodicals and textbooks accessioned from computerized and manual medical literature searches. More than 1000 medical works published from the 1800s through 2003 were retrieved and reviewed in this process.
DATA SYNTHESIS
Pertinent data are presented in textual and tabular formats, the latter including 6 tables presenting detailed information regarding the clinical parameters, differential diagnosis, diagnostic studies, laboratory testing, and therapeutic approaches to botulism.
CONCLUSIONS
Because botulism is such a rare disease, a keen awareness of its manifestations and prompt diagnosis are absolutely crucial for its successful treatment. The bioterrorism potential of botulism adds further urgency to the need for all health care professionals to be familiar with this disease, its proper evaluation, and timely treatment; the need for such urgency clearly includes the clinical laboratory.
Topics: Biological Warfare; Botulinum Toxins; Botulism; Clinical Laboratory Techniques; Clostridium botulinum; Humans; Prognosis; Safety
PubMed: 15163234
DOI: 10.5858/2004-128-653-CBATCL -
Przeglad Epidemiologiczny 2018The main aim of the study is to assess the epidemiological situation of foodborne botulism in Poland in 2016 compared to previous years.
OBJECTIVES
The main aim of the study is to assess the epidemiological situation of foodborne botulism in Poland in 2016 compared to previous years.
MATERIALS AND METHODS
In this assessment we reviewed national surveillance data on foodborne botulism cases published in the annual bulletin “Infectious diseases and poisonings in Poland in 2016” and in previous publications, as well as unpublished data retrieved from botulism case reports for 2016 sent from Sanitary-Epidemiological Stations to the Department of Epidemiology NIPH-NIH.
RESULTS
In 2016, a total of 26 foodborne botulism cases (including 18 laboratory confirmed) were reported and the annual incidence rate (0.07 per 100,000 population) was slightly lower than both the previous year and the median incidence from 2010-2014. The highest incidence in the country was noted in Lubelskie (0.33), Warmińsko-mazurskie (0.28) and Zachodniopomorskie provinces (0.23). The incidence in rural areas (0.10 per 100,000 population) was twice as high as in urban areas (0.05); incidence among men was 8 times as high as among women; the highest incidence (0.36) was observed in men in the age group of 50-59 years. Most cases were associated with consumption of homemade canned fish or pork products and mixed or unknown types of canned meats. All patients were hospitalized. Three deaths related to the disease were reported.
CONCLUSIONS
In 2016, the epidemiological situation of foodborne botulism in Poland has not changed significantly. This study suggests the need for training of health care professionals to improve diagnosis of botulism as well as continuous health education with respect to how to safely preserve, store and consume food at home.
Topics: Adolescent; Adult; Age Distribution; Botulism; Child; Child, Preschool; Female; Humans; Incidence; Infant; Infant, Newborn; Male; Middle Aged; Poland; Registries; Rural Population; Sex Distribution; Urban Population; Young Adult
PubMed: 30111083
DOI: No ID Found -
MBio Jun 2022In early life, the immature human gut microbiota is prone to colonization by pathogens that are usually outcompeted by mature microbiota in the adult gut. Colonization...
In early life, the immature human gut microbiota is prone to colonization by pathogens that are usually outcompeted by mature microbiota in the adult gut. Colonization and neurotoxin production by a vegetative Clostridium botulinum culture in the gut of an infant can lead to flaccid paralysis, resulting in a clinical outcome known as infant botulism, a potentially life-threatening condition. Beside host factors, little is known of the ecology, colonization, and adaptation of C. botulinum to the gut environment. In our previous report, an infant with intestinal botulism was shown to be colonized by neurotoxigenic C. botulinum culture for 7 months. In an effort to gain ecological and evolutionary insights into this unusually long gut colonization by C. botulinum, we analyzed and compared the genomes of C. botulinum isolates recovered from the infant feces during the course of intoxication and isolates from the infant household dust. A number of observed mutations and genomic alterations pinpointed at phenotypic traits that may have promoted colonization and adaptation to the gut environment and to the host. These traits include motility, quorum-sensing, sporulation, and carbohydrate metabolism. We provide novel perspectives and suggest a tentative model of the pathogenesis of C. botulinum in infant botulism. While the clinical aspects of infant botulism and the mode of action of BoNT have been thoroughly investigated, little is known on the pathogenesis and adaptive mechanisms of C. botulinum in the gut. Here, we provide for the first time a comprehensive view on the genomic dynamics and plasticity of C. botulinum over time in a case of infant botulism. The genomic and phenotypic analysis of C. botulinum isolates collected during the disease course offers an unprecedented view of C. botulinum ecology, evolution, and pathogenesis and may be instrumental in developing novel strategies for prevention and treatment of toxicoinfectious botulism.
Topics: Botulism; Clostridium botulinum; Feces; Gastrointestinal Microbiome; Genomics; Humans; Infant
PubMed: 35499308
DOI: 10.1128/mbio.02384-21 -
Human Vaccines & Immunotherapeutics Nov 2022Botulinum neurotoxins (BoNTs) are the most toxic known proteins. Naturally occurring botulism in humans is caused by botulinum serotypes A, B, E, and F. Vaccination is...
Botulinum neurotoxins (BoNTs) are the most toxic known proteins. Naturally occurring botulism in humans is caused by botulinum serotypes A, B, E, and F. Vaccination is an effective strategy to prevent botulism. In this study, a tetravalent botulinum vaccine (TBV) that can prevent serotypes A, B, E, and F was developed using the C-terminal receptor-binding domain of BoNT (Hc) as an antigen. To develop a suitable vaccine formulation, binding experiments of antigens and aluminum adjuvant in different buffers, and experiments of TBV at different antigen concentrations, were conducted. Our results showed that the optimal vaccine formulation buffer was a pH 6.0 phosphate buffer, and the suitable antigen concentration was 40 or 80 µg/ml of each antigen. A pilot-scale TBV was then prepared and evaluated for immunogenicity and stability. The results showed that TBV could elicit strong protective efficacy against each BoNT in mice, and remain effective after two years of storage at 4ºC, indicating that the preparation was stable and highly effective. Adsorption experiments also showed that the antigens could be well adsorbed by the aluminum adjuvant after 2 years of storage. Our results provide valuable experimental data supporting the development of a tetravalent botulinum vaccine, which is a promising candidate for the prevention of botulinum serotypes A, B, E, and F.
Topics: Aluminum; Animals; Botulinum Toxins; Botulinum Toxins, Type A; Botulism; Clostridium botulinum; Mice; Vaccines, Combined
PubMed: 35435814
DOI: 10.1080/21645515.2022.2048621