Biological Weapons --
Botulism



Clostridium botulinum is a group of bacteria, commonly found in soil. They grow best with little oxygen. The bacteria form spores which allows them to survive dormant until the right conditions come along for growth. There are 7 types of botulism but only 4 make humans sick.

The three main kinds of botulism are:

1)
Foodborne botulism - caused by eating foods that contain botulism.

2)
Wound botulism - caused by toxin produced from a wound infected with Clostridium botulinum.

3)
Infant botulism - caused by eating spores of the bacteria, which then grow in the intestines and release toxin.

Though rare, all forms can be fatal and are considered medical emergencies. On average, 110 cases are reported in the U.S. yearly.

Terrorists have already attempted to use botulinum toxin as a bioweapon. Aerosols were dispersed at multiple sites in downtown Tokyo, Japan, and at US military installations in Japan on at least 3 occasions between 1990 and 1995 by the Aum Shinrikyo. These attacks failed, apparently because of faulty microbiological technique, deficient aerosol-generating equipment, or internal sabotage. The perpetrators obtained their C botulinum from soil that they had collected in northern Japan.
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Symptoms




Double or blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Infants with botulism appear lethargic, feed poorly, are constipated, and have a weak cry and poor muscle tone.

These are all symptoms of the muscle paralysis caused by the bacterial toxin. Untreated, symptoms may cause paralysis of arms, legs, trunk and respiratory muscles.

In
foodborne botulism, symptoms generally begin 18 - 36 hours after eating a contaminated food, but can occur as early as 6 hours to 10 days.

How does it spread?





Ingestion, inhalation, or absorption through eyes or break in the skin can cause profound intoxication and death.

Aerosol released botulinum toxin could incapacitate or kill 10% of persons within 0.3 miles downwind or it could be show up in deliberately contaminated food.


Diagnosis Special tests performed at some state health department labs and the CDC are needed to confirm a diagnosis since it mimics other diseases.

Respiratory failure and paralysis may require a breathing machine for weeks plus intensive medical care. After several weeks, paralysis slowly improves. If diagnosed early, foodborne and wound botulism can be treated with an antitoxin, which can prevent symptoms from worsening. Antitoxin is not routinely given to infants. Instead induced vomiting or enemas are used. Wounds should be treated, usually surgically, to remove the source of the toxin-producing bacteria.

Treatment
Specifics on treatment can be found here

Vaccine
Along with state health depts., the CDC maintains intensive surveillance for botulism in the U.S.

Every case of Foodborne botulism is treated as a public health emergency. If antitoxin is needed, it can be quickly delivered to a physician anywhere in the country.

Skin should be tested for hypersensitivity before equine antitoxin is given.

Mortality
Botulism can result in death due to respiratory failure. In the last 50 years, patients who die from botulism have dropped from 50% to 8%.

Patients who survive this poisoning may be tired and shortness of breath for years. Long-term therapy may be needed.

Sources:

CDC; http://www.bt.cdc.gov/
Federation of American Scientists; http://www.fas.org/nuke/intro/bw/agent.htm
CBS Bioterrorism Interactive; http://cbsnews.cbs.com/

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Holly Deyo, E-mail: hollydeyo@standeyo.com
URL: http://standeyo.com/News_Files/NBC/Bio.Bugs.Botulism.html