Gram-positive, anaerobic, spore-forming, rod shaped, that produces a neurotoxin.

Incubation Period

12 - 36 hours after consumption or as early as 6 hours or as late as 10 days.

Symptoms

Vomiting, diarrhea, blurred vision, double vision, drooping eyelids (ptosis), slurred speech (dysphonia), difficulty swallowing (dysphagia), dry mouth, and muscle weakness. Infants with botulism appear lethargic, feed poorly, are constipated, and have a weak cry and poor muscle tone.

Illness Duration

Varies, can be days to months.

Complications

If untreated, symptoms may progress to paralysis of arms, legs, torso and respiratory muscles. Respiratory failure and death can occur.

Infective dose

As few as 10 - 100 bacterial spores can cause infection.

Treatments

Supportive care is given. Botulinum anti-toxin is helpful if given early. Infant botulism can be treated with a human derived anti-toxin available from the California Department of Health. If a patient enters respiratory failure and paralysis, a ventilator may be needed. Removal of food from a patients gastro-intestinal system may be needed through induced vomiting or enemas.

Testing

Stool, serum and suspected food products can all be tested for the botulinum toxin.

Communicability

Person to person transmission does not occur.

Nationally Notifiable

Monitored very closely; the 24-hour number for state health departments to call is (770) 488-7100.

Clostridium perfringens

Gram-positive, anaerobic, spore forming, rod shaped bacteria that produces toxins, two of which are active in the human intestinal tract.

Incubation Period

Usually 8 - 24 hours.

Symptoms

Watery diarrhea and abdominal cramps. Nausea is not common; vomiting and fever are rare.

Illness Duration

Generally lasts 24 - 48 hours. In immune compromised persons, may last 1-2 weeks.

Complications

Complications and/or death very rarely occur. Clostridial gas gangrene can cause fatal complications. A rare illness is also caused by Type C strains, known as enteritis necroticans or pig-bel disease and is often fatal.

Infective dose

It is thought that large numbers of organisms are needed to make people sick. Greater than 100,000 per gram.

Treatments

Supportive care, antibiotics are not indicated.

Testing

Stool culture.

Communicability

During acute infection within 4 weeks after illness; asymptomatic persons may rarely transmit for months or longer.

Nationally Notifiable

Laboratories and physicians should notify the health department so any possible outbreak cause may be found.