Botulism historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.
Overview
Clostridium botulinum botulism was named In 1870 by Muller (German physician). In 1895 Clostridium botulinum was first isolated by Emile Van Ermengem and It was in 1949 when Burgen's group discovered that botulinum toxin blocks neuromuscular transmission.
Historical Perspective
The German physician and poet Justinus Kerner called botulinum toxin sausage poison, or Canadian bacon pathogen as this bacterium often causes poisoning by growing in badly handled or prepared meat products. He first conceived a possible therapeutic use of botulinum toxin. In 1870, Muller (another German physician) coined the name botulism, from Latin botulus = sausage. In 1895, Emile Van Ermengem first isolated the bacterium Clostridium botulinum. In 1944, Edward Schantz cultured Clostridium botulinum and isolated the toxin, and, in 1949, Burgen's group discovered that botulinum toxin blocks neuromuscular transmission.
United States
All data regarding botulism antitoxin releases and laboratory confirmation of cases in the US are recorded annually by the Centers for Disease Control and Prevention and published on their website.[1]
- 1971 Bon Vivant botulism case On July 2, 1971, the U.S. Food and Drug Administration (FDA) released a public warning after learning that a New York man had died and his wife had become seriously ill due to botulism after eating a can of Bon Vivant vichyssoise soup.
- Between March 31 and April 6, 1977, 59 individuals developed type B botulism. All ill persons had eaten at the same Mexican restaurant in Pontiac, Michigan and all had consumed a hot sauce made with improperly home-canned jalapeño peppers, either by adding it to their food, or by eating a nacho that had had hot sauce used in its preparation. The full clinical spectrum (mild symptomatology with neurologic findings through life-threatening ventilatory paralysis) of type B botulism was documented.[2]
- In April 1994, the largest outbreak of botulism in the United States since 1978 occurred in El Paso, Texas. Thirty persons were affected; 4 required mechanical ventilation. All ate food from a Greek restaurant. The attack rate among persons who ate a potato-based dip was 86% (19/22) compared with 6% (11/176) among persons who did not eat the dip (relative risk [RR] Å 13.8; 95% confidence interval [CI], 7.6–25.1). The attack rate among persons who ate an eggplant-based dip was 67% (6/9) compared with 13% (24/189) among persons who did not (RR Å 5.2; 95% CI, 2.9–9.5). Botulism toxin type A was detected from patients and in both dips. Toxin formation resulted from holding aluminum foil-wrapped baked potatoes at room temperature, apparently for several days, before they were used in the dips. Food handlers should be informed of the potential hazards caused by holding foil-wrapped potatoes at ambient temperatures after cooking.[3]
- Beginning in late June 2007, 8 people contracted botulism poisoning by eating canned food products produced by Castleberry's Food Company in its Augusta, Georgia plant. It was later identified that the Castleberry's plant had serious production problems on a specific line of retorts that had under-processed the cans of food. These issues included broken cooking alarms, leaking water valves and inaccurate temperature devices, all the result of poor management of the company. All of the victims were hospitalized and placed on mechanical ventilation. The Castleberry's Food Company outbreak was the first instance of botulism in commercial canned foods in the United States in over 30 years.
- One person died, 21 cases were confirmed, and 10 more were suspected in Lancaster, Ohio when a botulism outbreak occurred after a church potluck in April 2015. The suspected source was a salad made from home-canned potatoes. [4]
United Kingdom
The largest recorded outbreak of foodborne botulism in the United Kingdom occurred in June 1989. A total of 27 patients were affected; one patient died. Twenty-five of the patients had eaten one brand of hazelnut yogurt in the week before the onset of symptoms. This yogurt contained hazelnut conserve sweetened with aspartame rather than sugar. Control measures included the cessation of all yogurt production by the implicated producer, the withdrawal of the firm's yogurts from sale, the recall of cans of the hazelnut conserve, and advice to the general public to avoid the consumption of all hazelnut yogurts.[5]
Botulinum Toxin as a Therapy
By 1973, Alan B Scott, MD, of Smith-Kettlewell Institute used botulinum toxin type A (BTX-A) in monkey experiments, and, in 1980, he officially used BTX-A for the first time in humans to treat strabismus. In December 1989, BTX-A (BOTOX) was approved by the US Food and Drug Administration (FDA) for the treatment of strabismus, blepharospasm, and hemifacial spasm in patients over 12 years old. The cosmetic effect of BTX-A was initially described by ophthalmologist Jean Carruthers and dermatologist Alastair Carruthers, a husband-and-wife team working in Vancouver, Canada, although the effect had been observed by a number of independent groups. On April 15, 2002, the FDA announced the approval of botulinum toxin type A (BOTOX Cosmetic) to temporarily improve the appearance of moderate-to-severe frown lines between the eyebrows (glabellar lines). BTX-A has also been approved for the treatment of excessive underarm sweating. Botulinum Toxin Type B (BTX-B) received FDA approval for treatment of cervical dystonia on December 21, 2000. Trade names for BTX-B are Myobloc in the United States, and Neurobloc® in the European Union.The acceptance of BTX-A use for the treatment of spasticity and muscle pain disorders is growing, with approvals pending in many European countries and studies on headaches (including migraine), prostatic symptoms, asthma, obesity and many other possible indications are ongoing.
Botox is manufactured by Allergan Inc (U.S.) for both therapeutic as well as cosmetic use. The formulation is best stored at cold temperature of 2-8 degrees Celsius. Dysport is a therapeutic formulation of the type A toxin developed and manufactured in the UK and which is licensed for the treatment of focal dystonias, symptoms of cerebral palsy, and certain cosmetic uses in many territories world wide.
Cost of Botox
The price of cosmetic Botox treatment varies widely based upon procedure, region, and other factors. A typical Botox injection will cost somewhere in the range of low to mid 100's. The variation will depend on where in the country the procedure is being done, how much of a demand there is for Botox in that region, and the availability of the injection. Some treatments may also cost more based on the specific treatment, for example, around a patient's eyes. This region will require more than 1 injection and will have a higher overall cost. Many people will continue to use receive Botox treatment over a long period of time, which will produce a large total financial cost. {{#ev:youtube|RI7FVOBKTXM}}
References
- ↑ "National Case Surveillance: National Botulism Surveillance | CDC National Surveillance". Cdc.gov. 2013-06-25. Retrieved 2014-02-12.
- ↑ Terranova, William; Breman, Joel G.; Locey, Robert P.; Speck, Sarah (1978). "Botulism type B: epidemiologic aspects of an extensive outbreak". American Journal of Epidemiology. 108 (2): 150–6. PMID 707476.
- ↑ Angulo, F. J.; Getz, J.; Taylor, J. P.; Hendricks, K. A.; Hatheway, C. L.; Barth, S. S.; Solomon, H. M.; Larson, A. E.; Johnson, E. A.; Nickey, L. N.; Ries, A. A. (1998). "A Large Outbreak of Botulism: The Hazardous Baked Potato". Journal of Infectious Diseases. 178 (1): 172–7. doi:10.1086/515615. PMID 9652437.
- ↑ "1 dead in botulism outbreak linked to Ohio church potluck". CNNWIRE. CNN. 28 April 2015. Retrieved 19 July 2015.
- ↑ O'Mahony, M; Mitchell, E; Gilbert, RJ; Hutchinson, DN; Begg, NT; Rodhouse, JC; Morris, JE (1990). "An outbreak of foodborne botulism associated with contaminated hazelnut yoghurt". Epidemiology and Infection. 104 (3): 389–95. PMC 2271776. PMID 2347382.