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Disease Name: Botulism


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Please review the Idaho Reportable Disease Rules (IDAPA 16.02.10) for the most up-to-date information.

Treatment and other information


Overview / Case Definition

Botulism occurs after absorption of botulinum toxin (caused by the bacterium Clostridium botulinum) into the circulation from a mucosal or wound surface. There are three major subtypes of botulism and they consist of foodborne, infant, and wound.

Botulism, Foodborne

Ingestion of botulinum toxin results in an illness of variable severity. Common symptoms are diplopia, blurred vision, and bulbar weakness. Symmetric paralysis may progress rapidly.

Botulism, Infant

An illness of infants, characterized by constipation, poor feeding, and "failure to thrive" that may be followed by progressive weakness, impaired respiration, and death.

Botulism, Wound

An illness resulting from toxin produced by Clostridium botulinum that has infected a wound. Common symptoms are diplopia, blurred vision, and bulbar weakness. Symmetric paralysis may progress rapidly.


Restrictions

None


Reporting

Immediately, at time of identification.

Reportable by Healthcare and Labs:

Reportable by Food Service Facility:

Suspect Reportable:

Reporting Timeframe: Immediately, at time of identification.



Diagnosis / Testing

The State Epidemiologist must be notified prior to submission of samples for Clostridium botulinum

During regular business hours, call 208-334-5939.  After hours, call Idaho State Communications at 800-632-8000 and ask that the state epidemiologist be paged. 

Specific labeling and shipping requirements must be followed:  http://healthandwelfare.idaho.gov/Health/Labs/SentinelLabs/tabid/2153/Default.aspx

A toxin neutralization bioassay is used to detect toxin in serum, stool, enema fluid, gastric aspirate, or suspect foods.

Foodborne

Detection of botulinum toxin in serum, stool, or patient's food, or isolation of Clostridium botulinum from stool

Infant

Detection of botulinum toxin in stool or serum, OR isolation of Clostridium botulinum from stool

Wound

Detection of botulinum toxin in serum, OR isolation of Clostridium botulinum from wound


Treatment

Antitoxin for Infant Botulism

A supply of Baby BIG® is solely maintained by the California Department of Public Health’s Infant Botulism Treatment and Prevention Program http://www.infantbotulism.org/. The California program can be contacted 24/7 at (510) 231-7600.

Antitoxin for Non-infant Forms of Botulism

Antitoxin is available through CDC.  The healthcare provider must discuss the situation with the Idaho State epidemiologist prior to release of the antitoxin. 

Call (208) 334-5939 during normal business hours or (800) 632-8000 to have the epidemiologist paged after business hours.  The epidemiologist will determine whether to refer the provider to CDC. 

If antitoxin is deemed necessary, a discussion between the provider and CDC will be arranged.  CDC will make all arrangements for delivery directly with the provider.


Additional Information

Treatment and other information


Click to Call South Central Public Health District

Click to Call the Idaho State Epidemiologist

Click to Call Idaho State Communications