Botulism

=Botulism in Canned Food and Botox Injections=

By Andrew Chen and Jason Howze

May 15, 2009


 * Abstract:** Botulism is the name of a paralytic disease that is cased by the very potent neurotoxins produced by the bacterium //Clostridium botulinum. // This bacterium can be encountered by humans from a variety of sources, but two common sources that we will be exploring are botulism from canned goods and from botox injections. In the case of food borne botulism, the toxin presents itself as a danger to humans, while in the case of botox it is a medical tool used for a variety of procedures. This is the strange paradox that is presented by //C. botulinum//, and we will explore these contradictory properties of the bacterium. Botulism in canned foods will be presented by Jason Howze, and botox injections will be presented by Andrew Chen.

=Botulism in Canned Food=

**Introduction:** Botulism is an uncommon but very dangerous disease that can result from the ingestion of the toxin produced by //C. botulinum. // It can be treated with with early recognition of symptoms and early administration of the antitoxin, however severe cases can mean illness that lasts for several months, most of which may require mecahnical ventilation(Bioterrorism:Botulism). Because of the potential for such a debilitating illness, and the prevalence of canned foods, this makes it an important topic to be informed about. This risk is greater from home canned foods, and as such it is of particular importance to understand the proper procedures for canning foods and recognizing signs of spoilage that could indicate the presence of the toxin (Ensuring Safe Canned Foods).

**Discussion:** //C. botulinum // is a bacterium that we encounter on a regular basis. The spores of the bacterium are "ubiquitous in the environment" (Sobel et al) and therefore are present on the surfaces of many foods that humans consume. However, the botulism disease is only found when a unique set of circumstances are present that allow for the creation of the botulinum toxin. This means is there is little danger from the bacterium unless the toxin is created prior to consumption of food items. The most common food sources that create the anaerobic environment for the bacterium are canned foods and fermented foods.

As stated above, one of the key criteria for allowing the production of botulinum toxins is an anaerobic environment of less than two precent oxygen. There are more conditions that must be met as well for growth to occur. The //C. botulinum // bacterium also requires a low-salt, moist environment that has low acidity, with a pH of greater than 4.6. The bacterial growth is most likely at a temperature range of 40-120 degrees Fahrenheit, and inhibited at lower temperatures. The spores are not killed by low temperatures, but remain dormant until brought to a higher temperature. In fact, the spores are active until heated to a temperature of 249 degrees Fahrenheit, at which point they can no longer produce toxins(Sobel et al).

One of the most likely ways that the average American will encounter botulism is in the consumption of home canned goods, so it is important to understand the process of canning and considerations for safety. Canning is simply the preservation of food by protecting it from oxidation, one of the main causes of food spoilage. The home-canner is able to do this by placing foods in an airtight container, then sterilizing the contents through the use of heat. This is where one of the potential errors can be made, putting the consumers of the canned goods at risk. Since the environment is being changed to a favorable condition for //C. botulinum//, you must prevent it from producing toxins. It is crucial to know the correct method of processing the particular food that is being canned. Some foods, such as pickles, tomato sauce, and jelly are not at a high risk for producing botulinum toxin due to their acidic or salt properties and can safely be processed in boiling water. However, many vegetables, meats and other low acid foods require higher temperatures that can only be obtained by using a pressure cooker. It is vital to know the correct processing methods before making home canned foods. After completion of the canning process, it is also important to watch for signs of fermentation or contamination. Ensure that the lids have sealed to the mouth of the jar, and store in a cool dry place. Before consuming, check for lids that have come unsealed and bubbling or swelling containers, which are all warning signs of bacterial growth. By following the guidelines for sterilization and processing foods, it is possible to use cans as safe means to store food for future enjoyment.(Ensuring Safe Canned Foods)

=__Botulism in Botox Injections__=

 purified for commercial use in cosmetics. Production of pharmaceutical injections of Botox is used for eliminating lines of the forehead. Botox is not limited to cosmetic use as injections are also applied in important spastic or autonomic neuromuscular disorders. In any case, the unapproved and misuse of Botox can lead to contraction of Botulism. The remarkable applications of this toxin are appropriately overshadowed by prevalence of the Botulism disease. Therefore, this is an important topic to be informed about because it gives insight to the beneficial effects of Botox.
 * Introduction**: Botulism is a very deadly disease caused by toxin C. botulinum. Surprisingly, the toxin is extracted and


 * Discussion:** Purified botulism toxin is the first bacterial toxin to be used as a medicine. FDA licensed botulinum toxin as Oculinum in December 1989 for treating two eye conditions--blepharospasm and strabismus (misaligned eyes)--characterized by excessive muscle contractions. (Vangelova) We are all familiar with this toxin as it is now known as **Botox**.

Outcome?
 * How is Botox made?

* What are we looking @?

Small doses of the toxin are injected into the affected muscles. As happens with botulism, the toxin binds to the nerve endings, blocking the release of the chemical acetylcholine, which would otherwise signal the muscle to contract. The toxin thus paralyzes or weakens the injected muscle but leaves the other muscles unaffected. The injections "block extra contraction [of the muscle] but leave enough strength for normal use," says Barbara Karp, M.D., deputy clinical director of the National Institutes of Health's National Institute of Neurological Disorders and Stroke. (Vangelova) 



**Blepharospasm** before injection with Botox---> -Inability to open eyes due to abnormal muscle contractions

Treatment:

-injections produced functional improvement in spastic diplegia among children with cerebral palsy (that is a neuromuscular condition of hypertonia and spasticity in the muscles of the lower human body) -cervical dystonia to reduce the severity of abnormal head position and neck pain - cosmetic purposes( Allergan, Inc) 

Disclaimer:  <span style="font-family: 'Arial','sans-serif';"> <span style="font-size: 12pt; font-family: 'Arial','sans-serif'; mso-fareast-font-family: 'Times New Roman';">Understanding the procedures of Botox or any medical procedure for that matter is extremely important. Asking questions, receiving treatment from qualified doctors, knowing the side effects are necessary especially when dealing with a serious toxin such as Botulism. The FDA is concerned that Botox has the potential for being abused. The ASAPS ( <span style="font-size: 12pt; font-family: 'Arial','sans-serif'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN; mso-bidi-font-weight: bold;">American Society for Aesthetic Plastic Surgery) <span style="font-size: 12pt; font-family: 'Arial','sans-serif'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN;"> <span style="font-size: 12pt; font-family: 'Arial','sans-serif'; mso-fareast-font-family: 'Times New Roman';">recently reported that unqualified people are dispensing Botox in salons, gyms, hotel rooms, home-based offices, and other retail venues. In such cases, people run the risks of improper technique, inappropriate dosages, and unsanitary conditions. "Botox is a prescription drug that should be administered by a qualified physician in an appropriate medical setting” (Lewis)

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 * Literature Cited:**

(2008, March 11). Bioterrorism: Botulism. Retrieved April 21, 2009, from University of Maryland Medical Center Web site: http://www.umm.edu/bioterrorism/botulism.htm

Ensuring Safe Canned Foods. Retrieved April 23, 2009, from National Center For Home Food Preservation Web site: http://www.uga.edu/nchfp/how/general/ensuring_safe_canned_foods.html

Jahn, Reinhard (2006, April 28). Neuroscience: A Neuronal Receptor for Botulinum Toxin. //Science//, //Vol. 312. no. 5773//, 540-541.

Sobel, J, Tucker , N, Sulka , A, McLaughlin , J, & Maslanka , S (2004). Foodborne botulism in the United States, 1990–2000. Emerg Infect Dis [serial on the Internet]. Retrieved April 23, 2009,from http://www.cdc.gov/ncidod/eid/vol10no9/03-0745.htm.

Tortora, G, Funke, B, Christine, C (2008). Microbiology: An Introduction. San Francisco, CA: Benjamin Cummings.

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<span style="font-size: 110%; color: rgb(0,0,0); font-family: Arial, Helvetica, sans-serif;">Botulism. Revised August 2002, retrieved May 2 2009, World Health Organization Fact sheet N°270 []

<span style="font-size: 110%; font-family: Arial, Helvetica, sans-serif;">(Apr 18, 2002). FDA approves cosmetic use of botulinum toxin (CIDRAP News) From http://www.cidrap.umn.edu/cidrap/content/bt/botulism/news/botox.html

<span style="font-size: 110%; color: rgb(0,0,0); font-family: 'Times New Roman',Times,serif;">Allergan, Arnon, Bjornson, Chertow, Myobloc, Willis. (2001,2006,2007) Use of Therapeutic Botulinum Toxin (2009) Retrieved April 30 2009, from CIDRAP, Center for Infectious Disease Research & Policy

<span style="font-size: 12pt; font-family: 'Arial','sans-serif';"> <span style="font-size: 10pt; line-height: 115%; font-family: 'Arial','sans-serif';">Lewis, Carol. July-August 2002. Botox Cosmetic: A Look at Looking Good- [|U.S. Food and Drug Administration], FDA Consumer magazine

Tortora, G, Funke, B, Christine, C (2008). Microbiology: An Introduction. San Francisco, CA: Benjamin Cummings. Retrieved, April 30 2009,

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