What Is Botulism?
Key takeaways:
Botulism is a rare but life-threatening illness that causes your muscles to become paralyzed. It’s also highly preventable.
Botulism is caused by different things like eating foods that are not properly preserved or feeding honey to infants.
The treatment for botulism usually involves managing the symptoms caused by muscle paralysis.
You’ve probably heard that it’s dangerous to feed honey to babies. Or, you may have been told at some point not to eat food from a can that has a dent or crack in it. That’s because doing these things can cause a disease called botulism. Although it’s a rare disease (110 cases of botulism are reported to happen in the U.S. each year), it can cause serious symptoms and even lead to death.
The good news is that botulism is highly preventable, and there are many steps you can take to avoid getting sick with this serious condition.
How do you know you have botulism?
Botulism can cause rapid onset of serious and scary symptoms.
Botulism causes weakness and paralysis
The main symptom is muscle paralysis (not being able to move your muscles). This usually starts from the head or neck and moves down the body. Both sides of the body are usually equally affected. Since many functions in your body are powered by muscles, muscle weakness and paralysis can lead to:
Difficulty swallowing and speaking
Difficulty moving your arms or legs
Blurry vision or seeing double
Difficulty breathing
Death
Botulism can also cause nausea, vomiting, and diarrhea.
Usually, people with botulism have no fever. And, despite the muscle weakness and paralysis, their ability to feel things is not affected.
Why can't you feed honey to infants
Now for the reason you don’t give honey to babies. Spores from Clostridium botulinum can exist in honey, and most adults are able to inactivate them in their gut. However, babies younger than 12 months of age who eat honey are at risk for bacterial toxins getting released into their gut and causing botulism. Babies don't have a mature enough immune response to fight the bacterial spores like adults do.
Some signs to look for in babies who may have botulism include:
Limpness in arms and legs (floppy baby)
Poor appetite
Constant crying and can’t be comforted
Constipation
Low energy
Lagging of the eyelids
Difficulty breathing
If you notice signs of botulism in your infant or child, take them directly to the emergency department or call 911 for help.
What causes botulism?
So, how can you go from eating something to developing severe muscle paralysis? Here’s how it happens:
1) You come in contact with a specific type of bacteria called Clostridium botulinum.
2) This bacteria makes a protective coating called a spore.
3) Sometimes, the spore releases a lethal substance known as a toxin.
4) In the case of Clostridium botulinum, the toxin is a neurotoxin, which means that it attacks the nervous system. It does this by blocking nerve cells in the body from communicating properly with one another. This is what causes muscles to stop working.
What can you get botulism from?
It turns out that the spores that cause botulism are very hardy. Because the spores can exist just about anywhere, you can actually eat or breathe in the spores without knowing it and may never become sick. But if you come in contact with enough of them in certain situations where the toxins get released, you can get sick with botulism. Here are some of those situations:
Improper food handling/home food canning: Foods can get contaminated with bacterial spores when they are not cooked at the right temperature or not preserved properly, like when canning foods at home.
Inhalation of toxins: In this form of bioterrorism, botulinum spores can be used as a biological weapon where many spores are released and breathed in.
Wound infections: You can also get botulism through an infection of a wound. This usually happens with wounds that occur with drug use.
Cosmetic injections: You may have heard of Botox, one of many anti-wrinkle medications that contain small doses of botulinum toxin. It’s very rare to get botulism if these injections are done properly. But it has been reported in people who had too much injected in a short period of time or injections performed by unqualified people.
Sometimes the cause isn’t known, and people get botulism without having an infected wound or eating contaminated food.
Treatment for botulism
Since botulism is life-threatening, it requires hospitalization with close monitoring. There are different ways to treat botulism depending on how unwell a person is and what their symptoms are. Generally, people with botulism are cared for in an intensive care unit. Treatments for botulism typically include:
Breathing machine: If you’re having trouble breathing, you may need help from a special machine.
Wound infection treatment: If you have an infected wound, you will need antibiotics to stop the spread of the infection. You may also need surgery to remove infected tissue in order to help the wound heal better.
Antitoxin medication: If the infection is caught early enough, you may be given a medication called botulism antitoxin that can slow down the progression of the disease.
How to prevent exposure to botulism
Because botulism can be life-threatening, knowing how to avoid exposure to bacterial spores is the best way to prevent yourself from getting it.
Properly handling foods when canning or preserving at home is key. You can boil the home-canned foods for 10 minutes to inactivate the toxin. However, the spores may still exist in the canned food.
To further decrease your risk for getting botulism, you can also do the following:
Avoid eating expired canned or other preserved foods.
Look out for signs that canned foods may be contaminated with bacterial spores. This includes leaking and bulging of cans or jars, visible cracks in the food containers, and foam in the food. Also, if the canned food smells bad or if it appears moldy, then throw it out.
Have cosmetic botulinum toxin injections done by a qualified health professional and only have the recommended amount injected.
If you are injecting drugs, there is help to stop. You can call the Substance Abuse and Mental Health Services Administration for more information at 1-800-662-HELP (4357). If you notice any redness, driage, swelling, or pain coming from injection sites, see a healthcare provider right away.
The bottom line
Botulism is rare but life-threatening. Getting supportive treatments early on during the illness is key to recovering. The best thing you can do to prevent botulism is avoid exposure to the spores that cause it in the first place. To prevent infant botulism, do not feed honey to infants younger than 12 months old.
Why trust our experts?
References
Bai L., et al. (2018). Clinical analysis of 86 botulism cases caused by cosmetic injection of botulinum toxin (BoNT). Medicine (Baltimore).
Centers for Disease Control and Prevention. (2006). Botulism: Epidemiological overview for clinicians.
Centers for Disease Control and Prevention. (2018). Injection drug use and wound botulism.
Jeffery, I. A., et al. (2021). Botulism. StatPearls.
Johns Hopkins Center for Health Security. (2014). Botulinum toxin (botulism).
National Organization for Rare Disorders. (n.d.). Botulism.
Solomon, H. M., et al. (2001). Clostridium botulinum. U.S. Food and Drug Administration Bacteriological Analytical Manual (BAM).
Substance Abuse and Mental Health Services Administration. (2022). SAMHSA’s national helpline.
World Health Organization. (2018). Botulism.
