Disclaimer. I am not a licensed health practitioner. This is just
another post on knowledge and understanding
you might wish to acquire in advance of a disaster in case no higher
care is available. As long as our society is functioning, you should
leave anything more substantial than applying a Band-Aid to the
professionals. No medication, including those available over the
counter, should be taken without consulting a physician.
Information shared here is for educational and entertainment purposes
only. It is not medical advice nor a substitute for licensed medical
care.
So what do you need to know? What symptoms does botulism cause?
Abdominal cramps? Fever? Vomiting? You don't know? Read on!
Botulism stands alone in the field of pathogens linked to food
poisoning. There is no diarrhea or abdominal cramps. No fever.
Vomiting and nausea
may occur with two less common forms of the
disease, and only after the onset of other symptoms. There's really
nothing in the symptoms for most people to associate with food. And it
is the most deadly form of food poisoning. You don't want to be dealing
with it without a functioning hospital.
Armageddon Medicine was the only off-grid medicine book to
address this topic at all. Most of the information in this post comes
from the Centers for Disease Control.
There are three types of botulism:
- Wound botulism accounts for about 29% of all botulism cases.
It is contracted primarily by drug abusers injecting heroin. The
injection site itself does not often look infected. As it is a disease
that affects people who aren't likely to survive long in a collapsed
society due to their addiction, it won't be discussed any further.
- Infant botulism comprises the majority of botulism cases in
the United States. As all parents are warned, honey is never to be
given to an infant under twelve months of age. Honey has been shown to
contain the Clostridium botulinum spores that cause botulism.
The spores reproduce in the infant's intestines and release the toxin
that causes botulism. However, honey is implicated in only about 20% of cases in infants. Many of the remaining 80% of
cases are believed to originate from dust in the soil and air. It's
been observed that many infants with botulism live near construction
sites.
- Food-borne botulism arises from eating contaminated foods.
All forms of botulism have the same symptoms. As mentioned above, there
are no gastrointestinal complaints. The toxin that causes botulism
affects the central nervous system. The incubation period ranges from 6
hours to 10 days, with 18-36 hours being average. In infants, the
first sign of botulism is constipation, followed by lethargy, weakness,
difficulty feeding, and an altered cry, progressing to paralysis, where
the baby becomes very floppy. (Botulism was first described as "floppy
baby syndrome.") With intensive hospital care, the survival rate is
almost 100%.
In older individuals, weakness and paralysis start from the top of the
head and work their way down. Signs and symptoms start with the droopy
eyelids, blurred or double vision, difficulty chewing and swallowing,
and a dry mouth. Facial paralysis sets in, followed by postural
hypotension (inability to stand without the risk of passing out). This
near-paralysis descends down the spinal column affecting the neck,
followed by the shoulders, upper arms, and forearms, and fingers. It
progresses to the chest muscles, and then it hits the thighs, lower
legs, and feet. Respiratory paralysis may set in anywhere along the way
and the patient will need mechanical support to survive. Recovery may
take months. Only a few cranial nerves may be affected, or it may be
the whole body. Progression may take hours or days and appears to be
dose-dependent. Paralysis occurs due to the toxin binding to the nerve
endings. It is irreversible, but the nerve endings do eventually
regenerate. The paralysis eventually resolves but outpatient therapy
may be required for months.
Interestingly, the sensory system is completely intact and patients are
entirely cognizant. Assuming they are still able to breathe (via
intubation), they can respond to questions, even if only by moving
fingers or toes. That is, of course, assuming the paralysis has not
extended that far. Death in botulism patients is due to pharyngeal
muscle paralysis and insufficient respiratory intake due to paralysis of
the diaphragm and other muscles used in respiration.
The symptoms of botulism are very similar to those for myasthenia
gravis. Myasthenia gravis is most common in women under forty and men
over sixty. It may appear in infants whose mothers have the condition.
Myasthenia gravis is uncommon in children. Botulism also looks similar
to
Guillain-Barre. Both myasthenia gravis and Guillain-Barre are
autoimmune diseases with rapid onset as well. However, neither occurs
in an outbreak. If there are two or more cases, the diagnosis is
botulism.
Most of the twenty to thirty cases of food-borne botulism that occur in
the United States each year arise from home-canned foods, especially
vegetables and fish. Some occur due to a relatively unknown
source--baked potatoes wrapped in foil. Statistics from the CDC for
1950-1996 showed that 65% of botulism cases came from home-canned foods,
while 7% were from commercially canned products. The remaining were
undetermined. Of the foods that were implicated, 40% were vegetables,
13% fish, 7% marine mammals, 2% fruits and pork, 1% each of condiments,
dairy, beef, and poultry; 4% other, and 30% unknown. While "unknown"
seems high, keep in mind that botulism can take several days to
manifest. By that time, the food to blame is already long gone to the
dump. While there can be "outbreaks" of botulism because two or more
people ate the same food, botulism is not transmitted from person to
person contact.
We've reviewed the symptoms and the sources, and undoubtedly, because
Clostridium botulinum
is the culprit implicated here, some are wondering why antibiotics
aren't being used. And the reason is, antibiotics, also known as
antibacterials, are effective only against
bacteria. Botulism is
an illness that arises because the botulinin toxin produced by the
bacteria have attached to the nerve endings. The bacteria simply made
the toxin. Botulism antitoxin is only available from the CDC.
So let's now take a look at exactly how botulism happens. The
Clostridium botulinum
bacteria are found everywhere in the soil at low levels. But they
don't reproduce really well there. They just kind of chill or hang out,
not really doing much with their lives. Maybe a few grow near some
beans or carrots or beets and hang onto those veggies when they're
harvested and taken inside. The veggies get washed and still a few
bacteria might hang on and get eaten. They do nothing. No one gets
sick. Their little bacterial lives have been a waste.
The beans are slated for canning. They get washed pretty well. No one can
see
any dirt. They get carefully processed according to directions. The
temperature reaches 250 degrees Fahrenheit and stays there for at least 3 minutes. The
Clostridium botulinum bacteria are killed
off. Their lives were also wasted. The heat under the canner is turned
off, and life in that house proceeds as usual.
Next up for the canner are the beets. But something goes wrong. Nobody
really remembers what. Maybe the gauge on the canner isn't working or
the gasket is cracked. For some reason, temperature and pressure aren't
reached. Or maybe Grandma forgets when the gauge started rocking and
thinks it's been 90 minutes when it has only been 30 or 60 and the requisite temperature to kill the bacteria isn't reached. Maybe
society's been a wreck for a while and people are getting more desperate
to preserve food. Mom decides to make jam from some berries that are
just a bit too gone and should really be given to the chickens or thrown
away. Whatever the cause, the proper temperature isn't reached. Those
Clostridium botulinum bacteria have been awakened. They are
really excited. Really super happy. And they indulge in wild, non-stop
orgies and reproduce faster than mice and rabbits ever dreamed. But,
you know, they're subtle about it. They don't want anyone to know, so
they don't change the color of the food, and they don't make a stink.
Because if they do, then people won't get sick. They multiply for weeks
or months or longer. And still, no one can tell.
Properly home-canned and commercially canned foods are safe to eat
straight from the can. Improperly canned stuff may kill you. However,
it's hard to tell if food containing botulism was improperly canned. It doesn't smell or
have an off appearance. And you can't taste a difference, either. To
be safe (and this comes from the CDC), all home-canned low-acid foods
should be boiled for 10 minutes plus an additional minute for every
1,000 feet above sea level to deactivate the toxin.
In the US today, life is still pretty normal. Anyone suspected of
botulism poisoning is given antitoxin and may do some time with a
ventilator. Weeks or months wouldn't be unusual. Post-collapse, there
will not be any antitoxin. Ventilation will have to be done
round-the-clock with a bag-valve mask. Most families won't be able to
do it.
There are very limited accounts of using activated charcoal, even
several hours after the suspect food was ingested. The studies suggest
that for whatever reason, the botulinum toxin remains in the stomach for
a while, where the activated charcoal can bind to it. As the
progression and outcome of the disease appears to be dose-dependent, a
case of botulism is not always fatal. Getting the patient to swallow
copious amounts of activated charcoal before those muscles become
affected may be critical to a positive outcome.
Links to related posts:
Activated Charcoal
Food Poisoning Overview
For further reading:
Armageddon Medicine, pp 340-342, 483
https://www.cdc.gov/botulism/pdf/bot-manual.pdf (free download manual)
https://www.sciencedirect.com/science/article/abs/pii/S0196064495702148 mice treated with AC more likely to survive
https://academic.oup.com/cid/article/41/8/1167/379325
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4774742/ cows
http://www.veterinaryworld.org/Vol.8/November-2015/6.pdf cows
https://calpoison.org/news/botulism (use of activated charcoal)
https://www.msdmanuals.com/home/infections/bacterial-infections-anaerobic-bacteria/botulism (use of activated charcoal)
https://www.who.int/csr/delibepidemics/clostridiumbotulism.pdf
https://www.ncbi.nlm.nih.gov/pubmed/9652437
https://www.fda.gov/food/consumers/what-you-need-know-about-foodborne-illnesses
https://www.fsis.usda.gov/wps/wcm/connect/a70a5447-9490-4855-af0d-e617ea6b5e46/Clostridium_botulinum.pdf?MOD=AJPERES
26 february 2020
