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May stop additional isolation when:
N/A
Symptoms
Ptosis, generalized weakness, dizziness, dry mouth and throat, blurred
vision and diaplopia, and dsyphagia followed by symmetrical descending
flaccid paralysis, and respiratory failure.
Comments:
A toxin mediated disease characterized by symmetrical, descending, weakness
or paralysis. A ubiquitous soil contaminate. It is a not an uncommon
contaminate of vegetables and can multiply in improperly processed
foods with low acid content. Home canning of low acid foods should
be discouraged. Honey is also potentially contaminated and should
not be given to infants < 1 year old. Potential for use as a
biological weapon (aerosol).
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Incubation Period
1 – 5 days
Period of Communicability
Not transmitted person to person
Cohort (Inf. with Inf./Exp. with Exp./Non-Exp. with Non-Exp.)
Not Required
Transport Issues
None
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Who’s susceptible
General: Infants less than six months (94%) are unable to mount an
appropriate cellular immune response to prevent colonization of the
gut with botulinum. Adults with altered GI flora also at risk.
Who’s exposed
Those who eat contaminated food. If used as a biological weapon,
aerosol is suspected route.
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Exclusion of symptomatic personnel from duty
Yes, until fit to work.
Exclusion of exposed susceptible personnel from duty
Not Required
Isolation of exposed susceptible asymptomatic patients
Not Required
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Prophylaxis for exposed
Administration of antitoxin: 2 vials of trivalent equine botulinum
antitoxin. Call the CDC at (404)-639-3670. Transfer of patient to
ICU and surveillance to initiate respiratory support if needed.
Must weigh risk of serum sickness against risk of exposure – early
administration of antitoxin (1-2 days) is best. Heptavalent
antitoxin for serogroups A – G is available from the Department of
Defense (Not FDA approved).
Treatment for ill
Same as Prophylaxis listed above
Military/Institutional Populations Special Issues
Surveillance to evaluate the possibility of a food-borne outbreak
should be instituted immediately. Assessment of the possibility of
aerosolized botulinum as a biological weapon should be made.
Bioterrorist attack is unlikely to be foodborne.
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