Botulism

A disease caused by potent protein NEUROTOXINS produced by CLOSTRIDIUM BOTULINUM which interfere with the presynaptic release of ACETYLCHOLINE at the NEUROMUSCULAR JUNCTION. Clinical features include abdominal pain, vomiting, acute PARALYSIS (including respiratory paralysis), blurred vision, and DIPLOPIA. Botulism may be classified into several subtypes (e.g., food-borne, infant, wound, and others). (From Adams et al., Principles of Neurology, 6th ed, p1208)

Also Known As:

Networked: 1444 relevant articles (74 outcomes, 79 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Botulism
2.	Tetanus
3.	Lambert-Eaton Myasthenic Syndrome (Lambert-Eaton Syndrome)
4.	Anthrax
5.	Poisoning

Experts

1.	Johnson, Eric A: 41 articles (06/2021 - 09/2003)
2.	Tepp, William H: 32 articles (01/2021 - 09/2003)
3.	Smith, Leonard A: 29 articles (10/2021 - 03/2004)
4.	Pellett, Sabine: 28 articles (06/2021 - 04/2008)
5.	Barr, John R: 24 articles (03/2020 - 10/2005)
6.	Kalb, Suzanne R: 24 articles (03/2020 - 10/2005)
7.	Janda, Kim D: 22 articles (04/2022 - 10/2005)
8.	Smith, Theresa J: 22 articles (10/2021 - 03/2004)
9.	Singh, Bal Ram: 21 articles (01/2021 - 03/2004)
10.	Marks, James D: 20 articles (10/2021 - 12/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Botulism:

1.	AntitoxinsIBA 08/17/2010 - "The best treatment for botulism includes serotype-specific antitoxins, which are most effective when administered early in the course of the intoxication. " 01/01/2018 - "However, a recent meta-analysis of antitoxin efficacy in human botulism cases over the past century concluded that a statistically significant reduction in mortality is associated with the use of type E and type A antitoxin, but not with type B antitoxin. " 02/01/2016 - "The toxic effects of this hybrid-like BoNT were completely eliminated by existing serotype A antitoxins, including those contained in multivalent therapeutic antitoxin products that are the mainstay of human botulism treatment. " 01/01/2003 - "Early antitoxin treatment in wound botulism results in better outcome." 01/01/2018 - "The only approved therapeutic for botulism is antitoxin. "
2.	VaccinesIBA 06/01/2020 - "Further studies should focus on vaccine adjustments to ensure continued humoral protection against botulism." 01/03/2014 - "For BoNT D, the titers were greater than those measured for the commercial vaccine, which induced titers of 5±0 and 2.85±1.35 against the respective serotypes, suggesting that this chimera is effective against cattle botulism. " 02/04/2013 - "We have previously shown that an adenovirus vectored vaccine delivered intramuscularly or intranasally was effective in protection against botulism in a mouse model. " 06/01/2012 - "This review describes the issues and progress towards the production of a vaccine against botulism that will be effective against natural BoNT variants." 03/01/2009 - "An adenoviral vector-based mucosal vaccine is effective in protection against botulism."
3.	Botulinum Toxins (Botulinum Toxin)IBA 06/01/2004 - "These new avenues include improved methods of preventing and treating botulism and additional novel uses of botulinum toxin as a therapeutic agent. " 01/01/2022 - "In an effort to reduce animal testing required by the gold standard method of botulinum neurotoxin detection, the mouse bioassay, many technologies have been developed to detect and characterize the causative agent of botulism. " 01/01/2017 - "A detailed molecular understanding of botulinum neurotoxin (BoNT)/host-cell-receptor interactions is fundamental both for developing strategies against botulism and for generating improved BoNT variants for medical applications. " 01/01/2020 - "This study revealed novel details of population structure/diversity and established relationships between whole-genome lineage, botulinum neurotoxin subtype variant, association with foodborne botulism, epidemiology, and geographical source. " 04/01/2015 - "A series of botulism challenge studies were conducted to determine if botulinum toxin would be produced in mussels (Mytilus edulis) inoculated with non-proteolytic Clostridium botulinum spores and held under modified atmosphere (MA) packaging conditions at normal (4 °C) and abusive (12 °C) temperatures. "
4.	NeurotoxinsIBA 01/01/2022 - "Currently, the gold standard for neurotoxin detection in cases of clinical botulism is the mouse bioassay. " 11/01/2020 - "botulinum and its neurotoxin genes, improved pathogen detection and discrimination), and support enhanced risk assessments and the prevention of botulism." 07/01/2023 - "This study sought to determine duration of fecal excretion of Clostridium botulinum organisms and neurotoxin after onset of infant botulism in 66 affected infants. " 12/01/2022 - "This study evaluated canned fish samples for botulism neurotoxin (BoNT)-producing clostridia contamination and can bulging through microbiological contaminant growth. " 11/06/2014 - "Clostridium botulinum is important for food safety and studies of neurotoxins associated with human botulism. "
5.	Botulinum AntitoxinIBA 02/01/2001 - "The exception is botulism, for which botulinum antitoxin is highly efficacious if used early in the course of illness. " 08/01/2017 - "The distinction can be difficult but is important as early initiation of botulinum antitoxin is associated with improved patient outcomes in cases of botulism. " 01/01/2017 - "Effective treatment of infant botulism on day 13 after symptom onset with human botulism antitoxin." 12/27/2017 - "We searched Global Health, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Medline databases from inception to May 2015 for studies published on botulism or botulinum antitoxin use during pregnancy and the postpartum period, as well as the Centers for Disease Control and Prevention National Botulism Surveillance database. " 08/31/2023 - "Equine botulinum antitoxin is one of the most popular countermeasures for human botulism. "
6.	NitritesIBA 10/01/1978 - "The potential danger of botulism from cured meats is a major factor in the argument over use of nitrites as meat curing agents. " 07/01/1984 - "Department of Agriculture (USDA) lowered the permissible amount of nitrite in cured meats to that level considered necessary for botulism protection. " 11/01/1981 - "Reduced amounts of nitrite in curing can provide less protection against botulism, and subsequent investigations have examined solutions to this situation. " 09/01/1979 - "Botulism Control by Nitrite and Sorbate in Cured Meats: A Review 1." 08/01/1981 - "Currently it has received increased attention as a potential replacer of nitrite for botulism control in processed meat products. "
7.	SaltsIBA 01/01/2022 - "Here we report on the first international outbreak of foodborne botulism caused by commercial salt-cured, dried roach (Rutilus rutilus). " 11/08/2019 - "Notes from the Field: Botulism Type E After Consumption of Salt-Cured Fish - New Jersey, 2018." 08/26/1992 - "Outbreak of type E botulism associated with an uneviscerated, salt-cured fish product--New Jersey, 1992." 07/24/1992 - "Outbreak of type E botulism associated with an uneviscerated, salt-cured fish product--New Jersey, 1992." 10/05/2012 - "During October 2-4 2011, eight maximum security inmates at the Utah State Prison in Salt Lake County were diagnosed with foodborne botulism. "
8.	ToxoidsIBA 07/01/2000 - "We tested the efficacy of a single dose of Botumink toxoid for protecting wild green-winged teal (Anas crecca) during botulism epizootics caused by Clostridium botulinum type C. " 01/03/2014 - "Vaccination of cattle with a recombinant bivalent toxoid against botulism serotypes C and D." 04/01/2006 - "Protective effect of botulinum C/D mosaic toxoid against avian botulism." 07/01/2000 - "Fewer immunized ducks were affected with botulism than control ducks, indicating that a single dose of Botumink toxoid could increase the survival of ducks during epizootics. " 01/01/1985 - "Vaccination of four groups of pheasants with partially purified C1 toxoid effectively protected them against type C botulism. "
9.	AntibodiesIBA 01/01/2020 - "LD50/2.5 µg of antibodies, and was effective both prophylactically and therapeutically in the mouse model of botulism. " 01/01/2017 - "The developed antibodies will be used for preventive and therapeutic intervention of type 'E' botulism." 12/01/2016 - "To counter bio-threat and naturally-occurring botulism cases, well-tolerated antibodies by humans that neutralize BoNTs are relevant. " 04/01/2010 - "Because of the high potency of BoNT, development of diagnostic and therapeutic antibodies for botulism requires antibodies of very high affinity. " 01/05/2007 - "Botulism is treated with polyclonal antibodies produced in horses that are associated with a high incidence of systemic reactions. "
10.	incobotulinumtoxinAFDA Link 06/01/2018 - "Based on clinical reports suggesting that elevated Ca2+ signaling promotes symptomatic relief from botulism, we identified seven candidate drugs that modulate presynaptic Ca2+ signaling and assessed their ability to reverse BoNT/A-induced synaptic blockade. " 01/01/2021 - "To our knowledge, this study represents the first research to investigate the pulmonary transcriptional responses of aerosolized BoNT/A exposure; the results may provide new insights in elucidating the molecular mechanism for pulmonary inhaled botulism and highlight the potential therapeutic application of BoNT/A in mitigating inflammatory conditions." 01/01/2020 - "In ex vivo studies, 3,4-DAP restored end-plate potentials and twitch contractions of diaphragms isolated from mice at terminal stages of BoNT serotype A (BoNT/A) botulism. " 06/23/2021 - "A readily available treatment that abrogates BoNT/A's toxicity and longevity is a necessity in the event of a widespread BoNT/A attack and for clinical treatment of botulism, yet remains an unmet need. " 01/01/2021 - "BoNT Serotype A (BoNT/A) is the most studied serotype as it is responsible for most human botulism cases, and its formulations are extensively utilized in clinics for therapeutic and cosmetic applications. "

Therapies and Procedures

1.	Therapeutics 11/01/2016 - "The result of this process underscores the potential of mathematical modelling at the cellular level, as a means of creating opportunities in developing new strategies that could be used to prevent botulism; and potentially contribute to improved methods for the production of toxin that is used for therapeutics." 02/01/2007 - "These analyses contribute to the understanding of the evolution and phylogeny within this species and assist in the development of improved diagnostics and therapeutics for the treatment of botulism." 08/09/2021 - "This study demonstrates that receptor-binding inhibitors have the potential to serve as next generation therapeutics for botulism, and therefore the assay developed may facilitate discovery of new anti-BoNT countermeasures." 11/15/2011 - "In addition to determining in vitro inhibition abilities of a panel of mAbs against BoNT/B1-/B5, this work has determined B12.2 and 2B18.2 to be the best mAbs for sample preparation before Endopep-MS. These mAb characterizations also have the potential to assist with mechanistic studies of BoNT/B protection and treatment, which is important for studying alternative therapeutics for botulism." 10/01/1970 - "Experimental studies on the serum therapy of type E botulism: the relationship between the amount of toxin in the blood and the effect of antitoxic serum."
2.	Length of Stay 02/01/2014 - "It is indicated in children with clinically diagnosed infant botulism, before diagnostic confirmation, and has been shown to lead to a significant reduction in intensive care unit and hospital stay for these patients. " 02/02/2006 - "Prompt treatment of infant botulism type A or type B with BIG-IV was safe and effective in shortening the length and cost of the hospital stay and the severity of illness." 01/01/2018 - "Since licensure, 1192 patients in 48 states and Washington, DC, have been treated with BIG-IV. The use of BIG-IV since its licensure in 2003 treated approximately 93% of US patients with laboratory-confirmed infant botulism, and prevented >65 years in hospital stay and >$85 million in hospital charges from occurring. " 01/01/2017 - "Infant botulism cases have demonstrated a significant increase in hospitalization charges over the years despite reduced length of stay. " 01/01/2007 - "The diagnosis of food borne botulism was established in 10th day of hospital stay, when the most symptoms were not present. "
3.	Chinese Traditional Medicine (Traditional Chinese Medicine) 01/01/2006 - "Toosendanin (TSN), a triterpenoid derivative extracted from a Chinese traditional medicine, has been demonstrated to be an effective cure for experimental botulism. " 12/04/2003 - "Toosendanin (TSN), a triterpenoid derivative extracted from Chinese traditional medicine, has been demonstrated to be an effective cure for experimental botulism. "
4.	Injections 06/01/2019 - "Two patients with muscle stiffness were treated with botulism injections and improved their shoulder range of motion. " 05/01/2020 - "Conventional treatments include medication, botulism injections, and surgical intervention. " 11/22/2006 - "Botulism in 4 adults following cosmetic injections with an unlicensed, highly concentrated botulinum preparation." 01/01/2023 - "For companies with a policy, the most frequently covered nonsurgical treatments were biofeedback (n = 23 [92%]) and botulism toxin injections (n = 61 [88%]). " 01/01/2018 - "Less common techniques like prolotherapy, platelet rich plasma injections and botulism toxin injections are also discussed."
5.	Artificial Respiration (Mechanical Ventilation) 10/01/2020 - "From April 2017 through May 2017, 10 patients in the Sacramento area were hospitalized with laboratory-confirmed botulism; 7 required mechanical ventilation, and 1 died. " 03/01/2020 - "Length of mechanical ventilation and PICU stay has decreased among children with botulism. " 01/01/2020 - "Among 113 (69.8%) patients with a final diagnosis of botulism, those treated early (≤2 days) spent fewer days in the hospital (5 vs 15.5 days), in the intensive care unit (ICU) (4 vs 12 days), and on mechanical ventilation (6 vs 14.5 days) than those treated late (>2 days), respectively. " 01/01/2019 - "This ad hoc analysis aimed to estimate and compare costs associated with hospitalization, intensive care unit stay, and mechanical ventilation for patients with botulism administered BAT product treatment early or late. " 01/01/2017 - "In conducting a subgroup analysis of the 'KID database, the youngest patients with infantile botulism (≤1.9 months) displayed the highest average number of procedures during their hospitalization (P < .001) and the highest rate of mechanical ventilation (P < .001), compared with their older counterparts. "