Published Date: 2008-01-01 21:00:13
Subject: PRO> Botulism, canned food: aerosol risk
Archive Number: 20080101.0008

BOTULISM, CANNED FOOD: AEROSOL RISK
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Date: Mon 31 Dec 2007
From: Richard Gould <rgould@avdha.nshealth.ca>

Could you comment in the digest on how great is the risk from
exposure to botulinum toxin via the skin, mucous membranes, or
inhalation in a situation with contaminated food? It strikes me that
all or just about all cases of intoxication occur following ingestion.
--
J. Richard Gould MD MHSc FRCPC
Medical Officer of Health
Annapolis Valley, SouthWest, SouthShore
Wolfville, Nova Scotia
Canada
<rgould@avdha.nshealth.ca>
[Indeed, as Dr Gould states, just about all cases of botulism occur
following ingestion but aerosolization of toxin can occur if a can,
in which _Clostridium botulinum_ is replicating, explodes from
internal pressure related to gas formation. The risk of acquisition
of clinical botulism after an aerosol exposure is not entirely clear
but...
As an example of what might occur, in the early 1960s (1,2), as part
of the German biowarfare program, the laboratory workers exposed
rabbits and guinea pigs to aerosolized botulinum toxin type A. The
animals were enclosed in hermetically sealed containers during the
exposures and the workers wore "completely protective clothing."
Following the exposures, the animals were transferred to other
enclosures and later examinations were made by the workers with only
protective gloves.
By the 3rd day after the exposures, the workers developed pooling of
secretions in the mouth, an influenza-like feeling, and some
dysphagia to solids. The next day, increased weakness, difficulties
with gait and speech, and oculomotor pareses were noted. All 3 were
treated with botulinum antitoxin. Subsequently, they had slow
recoveries and their serum was shown to contain type A toxin in a
mouse assay.
Aerosolization botulism has also been studied in primates (3).
Overall, however, it was estimated that a point-source aerosol
release of botulinum toxin could incapacitate or kill 10 percent of
persons within 0.5 km (0.3 mi) downwind (4).
References
----------
1. Holzer VE: Botulismus durch inhalation. Med Klin 1962; 41: 1735-8.
2. Middlebrook, JL, Franz DR: Botulinum Toxins, in Medical Aspects of
Chemical and Biological Warfare, 1997, Borden Institute, Walter Reed
Army Medical Center: Washington, DC. p. 643-54.
3. Franz DR, Pitt LM, Clayton MA, et al: Efficacy of prophylactic and
therapeutic administration of antitoxin for inhalation botulism, in
Botulinum and Tetanus Neurotoxins: Neurotransmission and Biomedicine
Aspects, Das Gupta, BR (ed), 1993, Plenum Text: New York, pp 473-6.
4. Arnon SS, Schechter R, Inglesby TV, et al: Botulinum Toxin as a
Biological Weapon. JAMA 2001; 285: 1059-70. - Mod.LL]

See Also

2007
----
Botulism, canned green beans - USA (02): recall, positive culture 20071228.4164
Botulism, canned green beans - USA: recall 20071222.4111
Botulism, canned food, human, pet - USA: alert, recall 20070723.2366
Botulism, chili sauce - USA: alert, recall (02) 20070720.2331
Botulism, chili sauce - USA: alert, recall 20070719.2316
Botulism, olives - USA ex Italy: recall 20070329.1085
Botulism, olives - USA: recall 20070311.0861
Botulism, olives - USA (FL, GA, NY): recall 20070310.0847
Botulism, baby food - North America: alert, recall (02) 20070220.0636
Botulism, baby food - North America: alert, recall 20070218.0618
2006
----
Botulism, carrot juice - North America (USA, Canada) (03) 20061021.3026
Botulism, carrot juice - North America (USA, Canada) 20061012.2925
Botulism, carrot juice - Canada (ON) ex USA 20061009.2899
Botulism, carrot juice - USA (multistate) (02) 20061007.2880
Botulism, carrot juice - USA (multistate): FL 20060930.2808
Botulism, carrot juice - USA (GA): alert 20060916.2638
Botulism, gravy, chili sauce - Canada (02): background 20060927.2760
Botulism, gravy, chili sauce - Canada: recall 20060926.2748
...................................ll/mj/lm

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