Botulism
Bacteria hiding in preserved foods that can poison and paralyze
Overview
Botulism is a rare but serious illness caused by a poison, or “botulinum toxin,” made by bacteria called Clostridium botulinum. This toxin attacks the body’s nervous system, and it can make a person weak or unable to move.
Alaska has one of the country's highest rates of botulism from foods. This type of poisoning can happen after people eat foods that have not been aged or fermented safely. This makes it more likely the bacteria will make its poison.
Public Health Emergency: Report Immediately
Public Health Emergency: Report Immediately
Providers and laboratories must report this condition immediately.
To report a Public Health Emergency
- Business Hours (8 a.m.-4:30 p.m.): 907-269-8000
- After Hours: 800-478-0084
For more information, visit Report a Health Condition
Symptoms & Diagnosis
Symptoms of botulism usually appear within 12-36 hours after eating food that contains the toxin, but it can also occur as early as six hours or as late as 10 days after exposure. The way symptoms show up, how quickly, and how severe they are, depend on many factors like how much toxin has been eaten.
Symptoms may include:
- Difficulty swallowing
- Double vision
- Dry mouth
- Trouble talking or hoarse voice
- Blurred vision
- Drooping eyelids
- Facial paralysis
- Trouble Breathing or shortness of breath
- Constipation, diarrhea, or vomiting (in early illness)
- Fever (not common)
Diagnosis is based on a medical history and physical exam. Botulism can be confirmed by a lab test. However, treatment does not wait on test results, as they can take several weeks.
- Do not use plastic, glass, or sealed plastic bags to age foods
- Age and store foods at a cold temperature, ideally below 37 degrees Fahrenheit
- Do not eat food if you do not know whether it was safely canned, preserved, or fermented
- When in doubt, throw it out. You cannot see, taste, or smell the toxin that causes botulism!
Treatment
Botulism is a medical emergency. If you have signs and symptoms, get emergency care right away. If not treated, symptoms can get worse. If botulism weakens muscles that help you breathe, this can lead to death.
Prevention
If you prepare or eat traditional Alaska Native foods, the food safety tips below may reduce the risk of getting botulism.
- Boil food for at least 10 minutes, or cook food at 176 degrees Fahrenheit or higher
- Do not count on freezing, as this will not destroy the poison
- Wash your hands, containers, and food
- Use salt to preserve dried fish
For providers
Reporting
Reporting
Providers and laboratories must report this condition immediately.
To report a Public Health Emergency
- Business Hours (8 a.m.-4:30 p.m.): 907-269-8000
- After Hours: 800-478-0084
For more information, visit Report a Health Condition
Treatment
Treatment
Early intervention with Botulism Antitoxin (BAT) can stop progression of the toxin’s effects.
When botulism is suspected:
- You must consult with DOH Epidemiology immediately to determine if treatment with BAT is indicated
- When treatment is indicated, Epidemiology will inform Alaska State Laboratories, so testing can proceed
- Collect specimens for testing before treating with BAT
Sample collection for lab testing
Sample collection for lab testing
Botulinum neurotoxin is detected in the laboratory in clinical specimens or suspect food samples. Alaska State Public Health Laboratories (ASPHL) will only test specimens from patients after ensuring they are being treated with the botulinum antitoxin (BAT).Specimens for Botulism testing include:
- Pre-antitoxin serum: 10 mL minimum
- It is critical that 20 mL of blood be drawn prior to the administration of HBAT. The time the HBAT is given is required on the Anchorage Lab Request form. Be certain the actual time of blood draw appears on the tubes and Anchorage Lab Request form.
- Stool: 10 g minimum
- Collect stool as soon as possible. Package without transport media. Ten grams is about the size of a walnut.
- Gastric Content: 20 mL minimum
- Collect gastric contents in a sterile, leak-proof container.
- Food: 10 mL oil or 10 g of solid material minimum
- Leave food in original containers if possible. Package in sterile, leak-proof containers.
Shipping samples for lab testing
Shipping samples for lab testing
Before shipping: Call ASPHL at 907-334-2100
All samples must be:
- Clearly labeled
- Placed in a leak-proof container
- Sealed with parafilm (please use duct tape for sealing oil samples)
- Placed in a sealable plastic bag with absorbent material
- Placed in second sealable plastic bag with completed Anchorage Lab Request form
- Packed as Biological Substance, Category B, according to IATA and DOT shipping regulations
- Shipped independently of other specimens for testing
Send Botulism samples to:
SPECIAL PATHOGENS
Alaska State Public Health Laboratories
5455 Dr. Martin Luther King Jr. Avenue
Anchorage, AK 99507
Botulism forms and documents
Botulism forms and documents
- BAT Admin Botulism Prescribing Information and Package insert
- Clinical Guidelines for Diagnosis and Treatment of Botulism
Botulism-related documents older than 25 months can be found on the State of Alaska Library Archives website.