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There are many types of foodborne diseases in this world we live in today. Some may make us feel uncomfortable and lethargic but some can also leave us aching for medical attention. Foodborne diseases are illnesses resulting from the consumption of contaminated food, usually by pathogenic bacteria, viruses, and parasites and also chemical or natural toxins such as poisonous mushrooms (Centres for Disease Control and Prevention, 2004). Anyone from our grandparents to our next door neighbour can get these diseases. Foodborne illnesses are usually arisen from poor food storage and unsuitable food handling and preparations. Pathogens or agent causing foodborne diseases can easily contaminate the food that would be distributed to thousands of people, causing them to fall sick. Different pathogen cause different illnesses, for example, the bacteria Salmonella that is found in raw and undercooked meat, dairy product and seafood can cause a person to suffer from Salmonellosis. Next, the virus Hepatitis A can make its victim to have inflammation of the liver (Minnesota Dept. of Health, 2010). Symptoms range from an upset stomach, abdominal cramps, nausea and vomiting, diarrhoea, fever to dehydration, an upset stomach being the mild symptom and dehydration being the severe symptom (Weinberg, 2010). Botulism is a type of foodborne disease which can cause flaccid paralysis of muscles if consumed food is contaminated by the Clostridium botulinum bacteria.
Picture 1: Clostridium botulinum bacteria
The bacteria in Picture 1, the Clostridium botulinum contaminates, usually canned foods, by releasing neurotoxins that is generally known as the botulinum toxins produced by the bacterium itself. There are seven different types of neurotoxins that this bacterium produces which are types A to G but the A, B, E and rarely F neurotoxins are the most common to cause flaccid paralysis in humans (Davis, 2012). Clostridium botulinum releases bacterial spores that are widespread in nature and is ordinarily found in soil and dust. These bacterial spores rarely cause problems because they cannot grow if they are exposed to oxygen. Due to the fact that the neurotoxins are produced anaerobically, Clostridium botulinum mostly contaminates canned food where oxygen is removed to preserve the food. The bacterium can easily grow and reproduce if the factory supervisors do not make sure that the canned foods are heated at 80Â°C for more than 10 minutes. Refrigeration alone cannot kill Clostridium botulinum. Canned food is not the only source of botulism. There are also certain foods that need to be packaged in vacuum packaging and modified atmosphere packaging where oxygen is also removed as a method of preservation. The difference between canning and vacuum and modified atmosphere packaging is that these methods do not involve a firm thermal process designed to destroy the spores of Clostridium botulinum. The bacterium can easily enter the packaging before it is sealed tightly and neurotoxins would contaminate the food (Chong, 2010). The toxin of this bacterium can enter the human body in three ways; by ingestion of toxin from food, by contamination of wounds by the bacterium and by colonization in the digestive tract of infants and adults. Colonization occurs more often in infants than in adults. Botulism cannot be transmitted from a person to another (Sobel, 2005).
The world's first outbreak of botulism was reported in Germany. In 1793, 13 residents of Wildbad acquired the disease by eating tainted cans of sausages. Since then, the graph of botulism in Germany decreases but they were still outbreaks along the way (Gideononline.com, 2012). In March 2006, home-canned bamboo shoots contaminated with Clostridium botulinum in Northern Thailand had affected 209 villagers, of who 134 were hospitalized and the remainder requiring mechanical ventilation. It got so out of control that Thailand had to declare a state of emergency and international relations were called (Ungchusak et. al., 2006). One of the largest outbreaks of botulism in America began on March 28, 1977, when a Mexican restaurant in Pontiac served hot sauce made out of improperly home-canned jalapeno peppers. The first case was reported 3 days later and eventually 58 Michiganders and one person visiting from Ohio were severely sick though fortunately there were no deaths. It was then discovered that the canners used proper lids, jars and rings but did not reboil some jars after it was filled. After a few days it was filled, some jars exploded but it was dismissed ignorantly (Meyer, 2011). In England, people were being advised not to eat certain jars of Loyd Grossman korma sauce after two people in Scotland were diagnosed with botulism in 2011. Luckily, after further investigations, only one can was found to be contaminated (BBC News UK, 2011). According to the data of the prevalence of botulism in America from 1990 - 2000, out of 263 cases of 160 foodborne botulism events, 39% cases and 58 events happened in Alaska. The case fatality rate was 4% (Sobel et. al., 2004). Foodborne botulism carries an overall worldwide mortality rate of 5 - 10% (Fenicia, 2011).
Picture 2: 14 year old boy with botulism.
A botulism victim will experience blurred or double vision, drooping eyelids, trouble breathing, slurred speech, dry mouth and difficulty in swallowing and muscle weakness prior to 18 hours to 36 hours of digesting the botulinum toxin, though it depends on the amount of toxin he or she may have swallowed. Some might experience the symptoms from a few hours to a few days (Mayo Clinic, 2012). If you developed these symptoms after eating canned food, see a doctor immediately. As you can see in Picture 2, the boy has drooping eyelids and facial muscle failure.The botulinum toxin mainly affects the nervous system. In severe cases of botulism, the victims can be paralysed and paralysis can be fatal especially when the breathing muscles are involved. It takes a large amount of toxin digested to develop neurological symptoms like double vision, facial weakness, speech slurring and muscle weakness that goes down the body, first the shoulders, then the arms and eventually the feet a few hours after digesting botulinum toxin. In normal cases, neurological symptoms are most likely to rise a day or two after the consumption (New York State Department of Health, 2011). Another type of botulism, that is the infant botulism, happens when babies below a year old consume honey contaminated with Clostridium botulinum spores. The spores will then colonize in the digestive trait and releases its toxin. The symptoms are almost identical to the foodborne botulism but infants with botulism will be lethargic, constipated and would be feeding poorly. It is very important to see a doctor or a medical personnel when one develops any symptom of botulism, regardless the severity.
There is no vaccine for botulism though researches are at an advance stage. Early detection treatment involves an injection of an antitoxin which is made from horse serum. The antitoxin can lessen the severity and duration of the symptoms of botulism by neutralising the toxin that has not bound itself to the nerve endings. Unfortunately, the antitoxin has a few life-threatening side effects such as serum sickness and anaphylaxis. Due to the side effects, the antitoxin cannot be used constantly and cannot be given to infants. For people who have severe cases of botulism that leave them with respiratory failure and paralysis, they are given a breathing machine called a ventilator. The ventilator will help them to breathe as they cannot breathe on their own for weeks, depending on the severity. They would also require intensive medical treatments and nursing care. Physicians may also try to remove the contaminated food that is still in the stomach by inducing vomiting or an enema. The paralysis will slowly improve after several weeks as new nerves can grow to replace those that were killed (Schoenstadt, 2009). Patients who survive an incident of botulism poisoning may have shortness of breath and fatigue for years and a long-time therapy may be required. To prevent oneself from accidentally consuming food contaminated with Clostridium botulinum's neurotoxin, we should consider boiling the food in cans for 10 minutes before eating it to ensure safety. The bacterium dies at high temperatures (Centres for Disease Control and Prevention, 2012). The government should implement clean environment in factories handling canned food and regular check-ups. If a factory is caught handling food improperly, their license should be revoked or surrendered to the government.
As you can see, we cannot run away from foodborne illnesses. However, we can always prevent ourselves from consuming food contaminated with bacterium and viruses that would harm us. For botulism, never buy canned food that had expired or cans that are in bad shape for example, cans with dents. If you are unlucky, the minute you realise that you may be a victim of botulism, go to the hospital immediately for help and also file a report so that the government can issue a release to warn the nation and take steps of prevention like finding the source of the contaminated food. Never give infants below the age of one, honey, as the honey might contain Clostridium botulinum spores. It is easy to prevent foodborne illnesses. Never take anything for granted and always make sure the food we eat is clean and cooked. Proper food storage is very important in preventing foodborne diseases. Remember, a little step goes a long way.