Botulism Flashcards
- Know the following characteristics about each bacterial disease studied for this unit:
a. Genus and species name (English equivalent if given)
b. Gram reaction
c. Cell shape
d. Disease name
e. Virulence factors
f. Transmission
g. Clinical symptoms of disease
h. Vaccine available
i. Treatment
a. Genus and species name (English equivalent if given): Clostridium botulinum
b. Gram reaction: G +
c. Cell shape: Bacillus
d. Disease name: Botulism
e. Virulence factors:
Very powerful exotoxin
Neurotoxin
neuro: nervous system
toxin: poison
Colorless, tasteless, odorless
Blocks nerve stimulus of muscles: causes flaccid paralysis do to destruction of motor neuron endings
f. Transmission:
Food-borne botulism: Consume food contaminated by toxin
Wound botulism: growth of bacteria in necrotic tissue leads to production of exotoxin
Infant/Intestinal botulism: seen in infants under age 1
g. Clinical symptoms of disease:
h. Vaccine available: Yes BUT……..Only for military or high risk lab personnel/ None for public
Very painful to receive
Several months to build protective immunity
Not effective against all forms of botulinum toxin
i. Treatment: Antibiotics of no value against toxin
Cipro: kills bacteria
Antitoxin: Passive immunity (antiserum) neutralizes exotoxin
Adults: Equine Heptavalent (against 7 strains)
Infants: Human antiserum called BIG
stop spread of paralysis
doesn’t reverse paralysis
Ventilator: supportive therapy
Several months to recover
Food botulism: indue vomiting or use enemas to remove any food not absorbed
Wound botulism: may require surgery to clean out wound
Botulism - Genus and species name
Clostridium botulinum
Botulism - Gram reaction of bacteria
G+
Botulism - Cell shape
Bacillus
Botulism - Spore location
terminal
Botulism - Oxygen requirement
anaerobic bacteria
What is the disease name for Clostridium botulinum?
Botulism
What are the Virulence factors for Botulism?
Very powerful exotoxin
Neurotoxin
neuro: nervous system
toxin: poison
Colorless, tasteless, odorless
Blocks nerve stimulus of muscles: causes flaccid paralysis do to destruction of motor neuron endingsTransmission of Botulism. How does it happen?
Food-borne botulism: Consume food contaminated by toxin
Wound botulism: growth of bacteria in necrotic tissue leads to production of exotoxin
Infant/Intestinal botulism: seen in infants under age 1
What are the Clinical symptoms of botulism.
What are the clinical symptoms for all 3 forms?
Early: (Gastrointestinal symptoms typically do not occur in wound botulism cases)
abdominal pain
nausea
vomiting
diarrhea
constipation
1 – 2 days later
Muscle paralysis
starts in head, face, neck
blurred vision, slurred speech, droopy eyelids
spreads to arms, legs
paralyzes respiratory system
Respiratory Failure
Most common cause of death
Recovery usually includes need for ventilation
Full recovery may take few weeks to 1 year (new nerve endings must regrow)
Fatality rate: 2 – 3 % with supportWhat is the virulence factor?
Exotoxin – Strongest Known Toxin
Neurotoxin
Why is the virulence factor categorized as a neurotoxin?
neuro: nervous system
toxin: poison
What are some characteristics about the virulence factor?
Colorless, tasteless, odorless
Blocks nerve stimulus of muscles: causes flaccid paralysis do to destruction of motor neuron endings
What stage of the bacteria life cycle produces the virulence factor?
Produced under anaerobic conditions
Can the bacteria produce the exotoxin in the aerobic human body?
Normally: Spores cannot germinate in human body and cells cannot grow
What type of muscle paralysis results from the virulence factor? How would paralysis of a stroke victim differ from paralysis in a botulism patient?
Flaccid Paralysis
Limbs lose their tone; become flabby
Similar to stroke victim
Exotoxin enter synaptic knob (end of nerve) and inhibit release of acetylcholine
Acetylcholine needed to stimulate muscle contraction
Can the virulence factor cross the brain barrier?
1
What is acetylcholine and how does the virulence factor affect the release of acetylcholine from motor neurons?
Acetylcholine is a neurotransmitter, the virulence factor affects it by inhibiting the release of acetycholine. By not having in acetycholine being released there is nothing stimulating muscle contraction, therefore you have flaccid paralysis.
What nerves in the human body are typically affected first by the botulism toxin?
starting at head, then limbs, then trunk
Approximately how many people could be killed by 1 gram of this toxin?
1 gm could kill more than 1 million people
Can the botulism toxin be destroyed using heat? If so, at what temperature and for how long?
Yes
Cooking above 1850F (890C) for 5 - 10 minutes destroys exotoxin
Mode of transmission for Food Botulism
Eating preformed botulism toxin
Mode of transmission for Wound Botulism
C. botulinum bacteria/spores get into a deep, necrotic wound; produce toxin that gets absorbed into body
Mode of transmission for Infant Botulism
Infant ingests C. botulinum bacteria/spores; bacteria survives in anaerobic nitch in gut and produces toxin in baby’s intestinal tract which is then absorbed into body
Which form is most common in the United States?
Infant Botulism
Represents 72% of botulism cases in the USA (75 – 100 cases)
Which form is least reported in the US?
Wound Botulism
Represents 3% of cases in USA (2009: 23 cases)
What form would most likely be used in bioterrorism?
Food-borne
Which form is contracted by consuming preformed toxin?
Food borne botulism
Which form typically does not have gastrointestinal symptoms?
Gastrointestinal symptoms typically do not occur in wound botulism cases
Is any form contagious?
No
What is the most common cause of death for all human forms?
Respiratory Failure
How easy would it be for a bioterrorist to get botulism for dispersal?
High
Environmental organism
Found through out the world
Most researched/developed BW on Earth
Is there a human vaccine for botulism? If so, what is the component?
Only for military or high risk lab personnel/ None for public
Very painful to receive
Several months to build protective immunity
Not effective against all forms of botulinum toxin
Vaccine
4 shot series
TOXOID
inactivate toxin with formalin
What antibiotic can kill the bacteria that causes botulism?
Cipro: kills bacteria
Are antibiotics affective against botox?
Antibiotics of no value against toxin
Why does treatment require antitoxins?
Antitoxin: Passive immunity (antiserum) neutralizes exotoxin
Adults: Equine Heptavalent (against 7 strains)
Infants: Human antiserum called BIG
Are antitoxins the same as antiserum?
Yes
What type of immunity is being applied when administering antitoxins?
Passive immunity
What is the antitoxin for Adults?
Adults: Equine Heptavalent (against 7 strains)
What is the antitoxin for Infants?
Infants: Human antiserum called BIG
Does the antitoxin reverse paralysis? Why or why not?**
doesn’t reverse paralysis
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Why is a ventilator typically needed in treating a patient suffering from botulism poisoning?
Ventilator: supportive therapy
What are some medical uses of botox?
Treatment of:
Migraine Head-ache
Cerebral Palsy
Back Pain
Parkinson’s disease
Reduce excessive sweating
Cosmetic reduction of wrinkles in the skinWhat is the therapeutic botox?
Therapeutic Botox: 0.005% of the estimated human fatal dose
Is there immunity after recovery from natural infection of botulism?
Immunity does not develop
Small quantity of Botulinum toxin needed to kill, exposure does not induce Ab response after exposure
Amount of toxin necessary to induce immunity is toxic
