III.

Symptoms and Treatment

Symptoms of botulinum poisoning can appear after only a few hours but may occur over a week after exposure. From 18 to 36 hours is typical. The neurotoxin blocks nerve signals to muscles, causing paralysis. The brain functions normally but muscles in the body become flaccid or limp. Symptoms start with the face and eyes, and may include blurred vision, slurred speech, or difficulty swallowing. Muscle weakness progresses downward through the body. When the paralysis reaches the chest and diaphragm, breathing stops and the victim dies from lack of oxygen.

An antitoxin can block the effects of the toxin if given in time. The available antitoxins come from the blood serum of horses given small doses of botulinum. The horses’ immune systems produce special molecules against the toxin. Some people have serious reactions to horse serum products, however. An experimental antitoxin derived from humans is available for infants with botulism. Work on a reliable vaccine against botulism continues, but a vaccine would need to work against the multiple strains of the illness. A vaccine designed to work against five strains is available to high-risk laboratory personnel and the military, but is still in the investigational stage.

Victims may need to be put on respirators to assist breathing for six to eight weeks, and possibly up to several months. Wound botulism is also treated with penicillin.