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Treatment of Botulism

People suffering from botulism may have to have their breathing maintained artificially by a breathing machine (ventilator) through a tube passed into the windpipe until the effect of the toxin has passed off, sometimes for as long as 4 weeks.

Large doses of botulinum antitoxin are given directly into a vein and repeated at 12- or 24-hour intervals as necessary. Unfortunately, once the toxin has bound to an acetylcholine receptor site, antitoxin can’t do any good at that site. The drug guanidine hydrochloride helps to reverse the blockage at the junction between the nerves and the muscle cells.

Botulism sometimes causes such a severe drop in blood pressure from slackening of the arteries and changes in blood acidity that only infusion of fluids or transfusion of blood can save life. Since Clostridium botulinum can reproduce in the intestine, antibiotics may be given. Sometimes a washout of the bowel is also done in the hope of removing unabsorbed toxin.

The overall death rate for botulism is 50-70% per cent. Those who survive the respiratory paralysis may recover completely.

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