The Neurotoxin of Botulinum as One of the Extremely Lethal Substances on the Face of Earth - Essay Example

? 19th June History of Botulism: Botulism was first recognized as a disease in 1735.That was first time that botulism was linked with German sausage. Some people acquired food poisoning as a result of eating sausage, and were thus said to have gained botulism. The name for this disease has been derived from the Latin name of sausage. The name botulism was first devised by a German physician named Muller in 1870 (MedicineNet 1). In 1895, clostridium botulinum bacteria were isolated for the first time. In 1944, Dr. Edward Schantz isolated a neurotoxin that the bacteria produced. Between 1949 and 1950, it was found that the toxin, called as BoNT A blocked the neuromuscular transmissions by obstructing the flow of acetylcholine from the motor nerve terminals. Why should we learn about Botulism? Botulism toxin is indeed, one of the deadliest and most toxic substances that are known in the contemporary age. Alongside its consideration as a weapon in biology, botulism toxin has also been made use of for the treatment of numerous medical problems. Dr. Scott made use of this toxin in 1980 to correct the deviation of eye in a condition known as strabismus. The US Food and Drug Administration (FDA) approved BoNT-A i.e. BOTOX in 1989 as a means to treat young patients suffering from blepharospasm, strabismus, and hemifacial spasm. It was in 2002 when the use of BOTOX was approved by FDA to remove the frown lines and wrinkles. Various ways of cosmetic improvements were realized with the use of BOTOX. The neurotoxin of botulinum is one of the extremely lethal and virulent substances on the face of Earth. I nanogram per kg of botulinum neurotoxin is quite sufficient to take the life of one individual. According to the estimates of many scientists, as many as 1 million people can be killed with the injection of just 1 gram of the botulinum neurotoxin (MedicineNet 2). Its extreme toxicity has made the botulinum neurotoxin suitable for use in weapons of bioterrorism and biowarfare. A person who suffers from botulism needs to be treated in emergency. The most dangerous form of botulism is the food-borne type. Botulism was more common in the past than in the present. Positive changes in the preparation, storage and consumption of food have allowed people to improve the hygiene of their food and they are able to avoid getting the disease. Home processing and canning of food has reduced the yearly cases of botulism for millions in the past to only 1000 in number in the present age all over the world. In US, no more than 110 cases of this disease are encountered on a yearly basis of which, the disease is acquired through food poisoning in 25 per cent of the cases, 72 per cent of the cases are those of infant botulism, and wound botulism accounts for no more than 3 per cent (MedicineNet 3). Consumption of contaminated food-borne botulism can infect two or more people with the disease simultaneously. Of all the types of botulism, cases of wound botulism have increased in number particularly in California. This is because of people’s tendency to use black-tar heroin. According to the Centers for Disease Control, number of cases diagnosed for the food-borne botulism remained potentially the same from 1950 to 1996, i.e. almost 9.7 cases per year. However, the number of fatalities resulting from botulism poisoning decreased from 60 per cent in the initial half of the 20th century to 15 per cent in the later. Quick administration of the antitoxin and improvements in the respiratory and supportive intensive care has brought about this decrease according to CDC (Severs). What is Botulism? Botulism is a very seriuous form of illness which causes the muscles to be paralyzed. Botulism (from Latin botulus, "sausage") is a rare but serious paralytic illness caused by a nerve toxin, botulin, that is produced by the bacterium Clostridium botulinum. Botulin is the most potent known toxin, blocking nerve function and leading to respiratory and musculoskeletal paralysis. (“What Is Botulism?”). The main cause of botulism is neurotoxin, which is often known as botulinum toxin. This toxin is secreted by the bacterium called as Clostridium botulinum. Some people refer to this bacterium as C baratii or C butyricum. The neurotoxins produced by Clostridium botulinum is of seven distinct types, ranging from type A to type G, though the types that most often make humans suffer from flaccid paralysis are type A, type B, type E, and occasionally type F. Type C, type D, and type G are the main cause of disease in birds and animals. They are also susceptible to acquiring flaccid paralysis like humans. Most species of Clostridium produce just one kind of neurotoxin. Nevertheless, impact of type A, type B, type E, or type F is necessarily the same upon every patient. This disease does not transmit from the patient to others. Botulism is only acquired by injecting toxin into the body or inhaling it. Sometimes, Clostridium grows into an individual’s wounds or intestines. The toxin thus released may instigate botulism in the individual. Types of Botulism: Botulism can be classified into three types depending upon the way in which it is acquired by an individual. The three types are food-borne botulism, infant botulism, and wound botulism. They are discussed below: 1. Food-borne botulism – is acquired through consumption of foods containing botulinum neurotoxin. 2. Infant botulism – is acquired by an infant upon consumption of the botulinum bacteria. Once it finds its way to the infant’s intestine, the bacteria cultivate there and generate the neurotoxin. 3. Wound botulism – is acquired when a wound captures bacteria Clostridium botulinum. The bacteria produce neurotoxin which causes disease. In addition to these types of botulism, three more types have been identified, though they are very rare to be seen. First of the three is the adult intestinal colonization which may occur in adolescents and adults who have abnormal bowels. Intestinal infection caused by Clostridium botulinum is extremely rare in adults and is typically linked with abdominal surgical procedures. Injection botulism is the second type of botulism that occurs in people who have inadequately large amount of therapeutic neurotoxin injected in their body. Such neurotoxins include but are not limited to Dysport, BOTOX, and Myobloc. Inhalation botulism is the third type of botulism. As the name implies, this type of botulism is usually acquired by inhaling neurotoxins. Personnel working in the laboratory occasionally end up inhaling the neurotoxins and thus acquire this type of botulism. The six types of botulism discussed above are all fatal in nature. Botulism’s Effect on the Body: The botulinum neurotoxin works by paralyzing the nerves. This saps the muscles’ ability to contract. This may happen as a result of the entrance of botulinum neurotoxin into the nerve cells. The neurotoxin interferes changes the pattern of acetylcholine release as a result of which, muscle can not be stimulated enough to contract. The neurotoxin’s influence upon the neuromuscular junction becomes permanent until the regeneration of a new axon by the nerve which is not exposed to the neurotoxin. It takes quite a lot of time for an individual to recover from botulism. About Clostridium Botulinum: It is a bacteria that is usually found in soil everywhere. Clostridium botulinum are thought to be anaerobic in nature, which tells that their concentration is most in low oxygen regions. These bacteria are rod-like in shape and they develop spores in order to survive in dormant state. They hibernate until the conditions become conducive for their growth. Symptoms of Botulism: Some of the most common symptoms of botulism are blurred vision, double vision, slurred speech, drooping eyelids, dry mouth and problem in swallowing. Botulism may also cause muscle weakness in the patient along with constipation. Upon examining the patient, the doctor may find that the deep tendon reflexes such as the reflexes of knee-jerk are fainted or non-existent. Infants suffering from botulism become weak, constipated, tired, floppy, and do not eat much. Their muscle tone is poor and they make weak cry. The first and the foremost symptom in a vast majority of infected infants is constipation. The symptoms of paralyzed muscles are only initial symptoms which may become worse if adequate treatment is not given on time. If left untreated, the disease may paralyze one or more organs of the body. This is generally visualized as a descending paralysis of legs, arms, muscles and trunk. In the case of food-borne botulism, it takes from 18 to 36 hrs for the symptoms to show up after the contaminated food has been consumed. However, in some cases, it may take the symptoms as long as 10 days to appear after the consumption of food. Diagnosis of Botulism: Botulism may be easily predicted by the physical examination of the patient and his/her history, though much more information is required to diagnose the disease because there are several diseases like Guillain-Barre syndrome, stroke and myasthenia gravis whose symptoms quite resemble those of botulism. In order for a doctor to be sure that a patient is suffering from botulism, it is imperative that the patient is made to undertake several tests that include but are not limited to spinal fluid examination, brain scan, tensilon test, and nerve conduction test. However, if a doctor suspects botulism because several members of the same family show up with symptoms of botulism after consuming the same food, then the doctor should take samples for a mouse inoculation test. In such a case, the patients should be given immediate treatment of the botulism antiserum. Such tests help the doctor tell botulism from E.coli, tetanus and Salmonella. The quickest and the most obvious way of diagnosing botulism is identification of botulinum neurotoxin in the stool, serum, or blood of the patient. A doctor can achieve that by injecting the stool or serum of the patient into the mice’s peritoneal cavity and treating an equal amount of the sample with multivalent antitoxin that would then be injected into other mice. If the mice injected with antitoxin-treated serum survive and others that were injected with untreated serum expire, this would be a clear indication of botulism. This procedure is known as the mouse inoculation test. Treatment of Botulism: If timely diagnosed, both wound botulism and the food-borne botulism can be treated with the help of an antitoxin whose function is to obstruct the neurotoxin’s action that circulates in the patient’s blood. “The trivalent antitoxin (effective against three neurotoxins: A, B, and E) is dispensed from quarantine stations by the U.S. government's Centers for Disease Control and Prevention (CDC)” (MedicineNet 5). The antitoxin keeps the disease from worsening, though the patient may take many weeks to recover. In order to remove the source of bacteria that produce toxin in the wounds, wounds may need to be treated with surgery. To treat infant botulism, antitoxin is not given in a routinely fashion. A product containing immune globulins is given to infants diagnosed with botulism. If the botulism causes respiratory failure in the patient along with paralysis, the patient should be given the treatment with a breathing machine or ventilator for some weeks. Meanwhile, the patient should be provided with intensive care. After few weeks of treatment, the patient starts to feel better as the axons are regenerated in the nerves and the paralysis improves. “[R]ehabilitation may be necessary to counteract the damage done to swallowing and speech functions” (Mohrman). A protein, Botox is derived from botulinum A which is injected under skin to make wrinkles disappear (Palmbush). This protein makes the muscle under skin paralyzed. Prevention of Botulism: “Theoretically, the disease might be avoided by preventing exposure to spores. Since honey and corn syrup are sources of Clostridium spores, they should not be fed to infants less than 1 year old” (“Infant botulism – Prevention”). Success Stories: Nicholas Jameson from Minneapolis was only four months old when he acquired botulism. Nicholas had had trouble breathing on the Memorial Day. Having realized this, Samantha, his mother immediately took Nicholas to the Children’s Hospital in Minneapolis. After thorough examination and some tests, doctors diagnosed Nicholas with botulism. Timely treatment helped Nicholas come out of the disease and he has continued to live. Only after a week of treatment, Nicholas’s condition started to improve miraculously. Dr. Ken Maslonka, who is the Head of the “Pediatric Intensive Care Unit” at the Children’s Hospital in Minneapolis exclaimed, “He came off the ventilator much faster than any of us thought he would for sure” (Clark). The family is still worried how come their infant acquired such a deadly disease. After much thought, they reached the conclusion that the baby boy would have acquired the disease from the soil while the family had been gardening in the backyard only few days ago. However, Samantha was not sure how that might have happened since Nicholas never played with the dirt. She later theorized that Nicholas might have inhaled the bacterium as it would have become air-borne because of her hasty digging. Botulism had almost taken is life. It is, undoubtedly, Nicholas’s new life! Conclusion: Botulism is a deadly disease whose victims are adolescents and young adults. It may be acquired through contaminated food, or interaction of wounds with soil. Sometimes, the bacteria are inhaled through air. The disease was more common in the past than present because people have generally improved their eating habits over the course of time. The neurotoxin paralyzes the muscles and may cause death if the necessary treatment is not taken in time. Owing to the dangerous nature of this disease, people must learn about it and take precautionary measures to avoid getting it. Works Cited: Clark, Marler. “A Botulism Story With A Happy Ending.” 9 Jun. 2008. Web. 19 Jun. 2011. . “Infant botulism – Prevention.” University of Maryland Medical Center. 2011. Web. 19 Jun. 2011. . MedicineNet. “Botulism.” 2011. Web. 19 Jun. 2011. . Mohrman, Jon. “What Is Botulism Food Poisoning?” 2011. Web. 19 Jun. 2011. . Palmbush, Courtney. “What is Botulism Toxin?” 2011. Web. 19 Jun, 2011. . Severs, Elaine. “What Are the Causes of the Reduction in Botulism?” 2011. Web. 19 Jun. 2011. . “What Is Botulism?” 25 May 2005. Web. 19 Jun. 2011. . Read More