A childhood-onset intestinal toxemia botulism during chemotherapy for relapsed acute leukemia.

BACKGROUND: Botulism is a potentially fatal infection characterized by progressive muscle weakness, bulbar paralysis, constipation and other autonomic dysfunctions. A recent report suggested that cancer chemotherapy might increase the risk for the intestinal toxemia botulism in both adults and children. CASE PRESENTATION: We report a 5-year-old boy, who developed general muscle weakness, constipation, ptosis and mydriasis during the third induction therapy for relapsed acute myeloid leukemia. He had recent histories of multiple antibiotic therapy for bacteremia and intake of well water at home. Repeated bacterial cultures identified Clostridium botulinum producing botulinum neurotoxin A. Botulinum toxin A was isolated from his stools at 17, 21, and 23 days after the onset. Symptoms were self-limiting, and were fully recovered without anti-botulinum toxin globulin therapy. CONCLUSION: This is the second report of a pediatric case with cancer chemotherapy-associated intestinal toxemia botulism. Our case provides further evidence that the immunocompromised status due to anti-cancer treatments increases the risk for the development of botulism at all ages in childhood.

A Case of Adult Intestinal Toxemia Botulism During Prolonged Hospitalization in an Allogeneic Hematopoietic Cell Transplant Recipient.

We report a laboratory-confirmed case of adult intestinal toxemia botulism in an allogeneic hematopoietic stem cell transplantation (allo-HCT) recipient. Onset of symptoms occurred within the hospitalized setting, making this case particularly unique. Botulism may have arisen because of significant intestinal disruption and compromise, and not directly from immune compromise.

Estudo retrospectivo de surtos de botulismo no Brasil e no mundo

A distribuição do botulismo é mundial, com casos esporádicos ou surtos familiares, em geral, relacionados à produção e à conservação de alimentos de maneira inadequada. As intoxicações alimentares constituem um dos significantes problemas de saúde pública. O botulismo é uma doença grave, causada pelo Clotrisdium botulinum e deve ser considerado emergência médica e de saúde pública. De ocorrência súbita, caracteriza-se por manifestações neurológicas seletivas, de evolução dramática e elevada mortalidade, entre 30 e 65%. Devido a importância do botulismo como um problema de saúde pública, é indispensável relatar que o maior perigo de contaminação está nos alimentos preparados de forma artesanal, principalmente em conservas caseiras.

The distribution of botulism is worldwide, with sporadic cases or outbreaks family usually related to production and conservation of food improperly. The food poisoning is one of the significant public health problems. Botulism is a serious illness caused by Clostridium botulinum should be considered a medical emergency and public health. The sudden occurrence characterized by neurological manifestations selective evolution of dramatic and high mortality between 30 and 65%. Due to the importance of botulism as a public health problem, it is essential to report that the greatest danger of contamination in food is prepared by hand, especially in home canning.

Two-family outbreak of botulism associated with the consumption of smoked ribs in Sichuan Province, China.

BACKGROUND: On September 22, 2013, two patients from Sichuan Province, China presented with symptoms of food-borne botulism, a rare but fatal illness caused by the consumption of foods containing Clostridium botulinum neurotoxins. METHODS: Investigators reviewed the medical charts and food consumption histories, and interviewed patients and family members. Food samples and clinical specimens were tested for botulinum toxin and neurotoxin-producing Clostridium species by standard methods. RESULTS: The first two index cases presented with cranial neuropathies and flaccid paralysis, and required mechanical ventilation. There were 12 confirmed outbreak-associated cases. Botulinum toxin type A was identified in the smoked ribs, and all of the patients had consumed the smoked ribs from the same local restaurant. The smoked ribs contained no added salt, sugar, or preservative. Botulinum toxin production likely resulted from the cold-smoking preparation method and inappropriate refrigeration. CONCLUSIONS: Smoked ribs produced by a local restaurant, contaminated with type A botulism, was the contributor to this outbreak. The supervision of food safety should be strengthened to prevent future outbreaks in China.

Outbreak of wound botulism in people who inject drugs, Norway, October to November 2013.

In October and November 2013, four cases of wound botulism were confirmed in people who inject drugs (PWID) in Norway. Two additional cases are suspected. Because of the international distribution pathways for heroin ­ the likely source of the outbreak ­ healthcare workers and public health authorities in other countries should remain vigilant for wound botulism in PWID. This outbreak serves as a reminder that countries should ensure access to botulinum antitoxin in case of outbreak situations.

Development of highly sensitive chemiluminescence enzyme immunoassay based on the anti-recombinant H(C) subunit of botulinum neurotoxin type A monoclonal antibodies.

Botulinum neurotoxins (BoNTs) are the most poisonous substances ever known. The early detection of these toxins could bear more time for appropriate medical intervention. The standard method for detecting BoNTs is the mouse bioassay, which is time consuming (up to 4 days) and requires a large number of laboratory animals. The immunologic detection methods could detect the toxins within a day, but most of these methods are less sensitive compared with the mouse bioassay due to the lack of high-affinity antibodies. Recently, the recombinant H(C) subunit of botulinum neurotoxin type A (rAH(C)) was expressed as an effective vaccine against botulism, indicating that the rAH(C) could be an effective immunogen that raises the monoclonal antibody (mAb) for detecting BoNT/A. After immunized BALB/c mice with rAH(C), 56 mAbs were generated. Two of these mAbs were selected to establish a highly sensitive sandwich chemiluminescence enzyme immunoassay (CLEIA), in which FMMU-BTA-49 and FMMU-BTA-22 were used as capture antibody and detection antibody, respectively. The calculated limit of detection (LOD) based on molecular weight of rAH(C) and BoNT/A reached 0.45 pg mL(-1). This CLEIA can be used in the detection of BoNT/A in matrices such as milk and beef extract. This method has 20-40 fold lower LOD than that of the mouse bioassay and takes only 3 h to complete the detection, indicating that it can be used as a valuable method to detect and quantify BoNT/A.

Intestinal toxemia botulism in 3 adults, Ontario, Canada, 2006-2008.

Five cases of intestinal toxemia botulism in adults were identified within an 18-month period in or near Toronto, Ontario, Canada. We describe findings for 3 of the 5 case-patients. Clinical samples contained Clostridium botulinum spores and botulinum neurotoxins (types A and B) for extended periods (range 41-61 days), indicative of intestinal toxemia botulism. Patients' clinical signs improved with supportive care and administration of botulinum antitoxin. Peanut butter from the residence of 1 case-patient yielded C. botulinum type A, which corresponded with type A spores found in the patient's feces. The food and clinical isolates from this case-patient could not be distinguished by pulsed-field gel electrophoresis. Two of the case-patients had Crohn disease and had undergone previous bowel surgery, which may have contributed to infection with C. botulinum. These cases reinforce the view that an underlying gastrointestinal condition is a risk factor for adult intestinal toxemia botulism.

Persistent extraradicular infection in root-filled asymptomatic human tooth: scanning electron microscopic analysis and microbial investigation after apical microsurgery.

INTRODUCTION: Procedural accidents have a negative effect on healing and might contribute to the persistence of infections in inaccessible apical areas, requiring surgical intervention. This report describes a case of persistent apical periodontitis of a lower left first molar associated with the sinus tract and a periapical lesion that required nonsurgical endodontic retreatment and apical surgery for resolution. METHODS: The tooth had received endodontic treatment 3 years ago and had to be retreated using the crown-down technique with chemical auxiliary substance (2% chlorhexidine gel), foramen patency, and enlargement and was filled in a single appointment. The occlusal access cavity was immediately restored with composite resin. After 1 month, it could be observed that the sinus tract persisted and, radiographically, the lesion remained unaltered. Therefore, endodontic microsurgery was indicated. Apical microsurgery was performed under magnification with the use of a dental operating microscope including apicectomy, root end with ultrasound, and sealing with mineral trioxide aggregate. A microbiological sample was collected from the apical lesion. The resected distal root apex was observed by scanning electron microscopy. RESULTS: The following species were detected: Actinomyces naeslundii and Actinomyces meyeri, Propionibacterium propionicum, Clostridium botullinum, Parvimonas micra, and Bacteroides ureolyticus; scanning electron microscopic analysis revealed bacterial biofilm surrounding the apical foramen and external radicular surface. Gutta-percha overfilling at the apex because of a zip caused during initial endodontic treatment could be observed. A 6-month follow-up showed apparent radiographic periapical healing, which progressed after 24 months. CONCLUSION: Gram-positive anaerobic bacteria and extraradicular biofilm seem to participate in the maintenance of persistent periapical pathology, and endodontic retreatment followed by periapical microsurgery proved to be a successful alternative in the resolution of persistent extraradicular infections.

Detection and confirmation of Clostridium botulinum in water used for cooling at a plant producing low-acid canned foods.

Our laboratory tested water samples used for cooling low-acid canned foods at a canning facility under investigation by the U.S. Food and Drug Administration. We used an enzyme-linked immunosorbent assay with digoxigenin-labeled antibodies (DIG-ELISA) and real-time PCR as screening methods and confirmed the presence of neurotoxin-producing Clostridium botulinum in the samples by mouse bioassay.

Survival of radio-marked mallards in relation to management of avian botulism.

Avian botulism outbreaks are frequently perpetuated by type C toxin produced by Clostridium botulinum proliferating in decomposing bird carcasses and consumption of toxic maggots from these carcasses by healthy birds. Therefore, removing bird carcasses has been advocated for disease management because availability of toxic maggots should be reduced, increasing duck survival. However, this management is expensive, and its effect on waterfowl mortality under field conditions is unknown. We radio-marked 419 molting mallards on 11 lakes in western Canada during July-August 1999-2001 and monitored them for 30 days, testing whether survival was higher on lakes with carcass removal. Botulism occurred on 10 lakes. On five carcass removal lakes, greater-than-normal effort was made to conduct early, thorough surveillance and immediately remove carcasses; on six nonremoval lakes, no carcasses were removed. In 1999, estimated 30-day survival probabilities ranged from 0.149 (95% CI=0.065-0.304) on one large lake with carcass removal to 0.466 (95% CI=0.270-0.674) and 0.618 (95% CI=0.443-0.767) on two nonremoval lakes. As a result, we conducted work on smaller wetlands thereafter, reasoning that any management benefit would be easier to detect. In 2000, estimated 30-day survival probabilities were 0.313 (95% CI=0.143-0.556) and 0.794 (95% CI=0.609-0.905) on two carcass removal lakes versus 0.525 (95% CI=0.362-0.682) and 0.743 (95% CI=0.564-0.866) on two nonremoval lakes. In 2001, botulism was detected on two nonremoval lakes where survival probabilities were 0.845 (95% CI=0.630-0.946) and 0.942 (95% CI=0.778-0.987), and on one removal lake where survival probability was 1.0 (95% CI=0.99-1.0), but not detected on the other removal lake where no marked birds died from botulism (1.0, 95% CI=0.99-1.0). Survival tended to be higher on lakes with lower carcass density, but when data were organized by carcass removal versus nonremoval, mallard survival was not consistently greater on lakes where carcasses were removed.

Botulism in Brazil, 2000-2008: epidemiology, clinical findings and laboratorial diagnosis / Botulismo no Brasil, 2000-2008: epidemiologia, achados clínicos e diagnóstico laboratorial

Botulism is a rare and potentially lethal illness caused by Clostridium botulinum neurotoxin. We describe the findings of a laboratorial investigation of 117 suspected cases of botulism reported to the surveillance system in Brazil from January 2000 to October 2008. Data on the number and type of samples analyzed, type of toxins identified, reporting of the number of botulism cases and transmission sources are discussed. A total of 193 clinical samples and 81 food samples were analyzed for detection and identification of the botulism neurotoxin. Among the clinical samples, 22 (11.4 percent) presented the toxin (nine type A, five type AB and eight with an unidentified type); in food samples, eight (9.9 percent) were positive for the toxin (five type A, one type AB and two with an unidentified type). Of the 38 cases of suspected botulism in Brazil, 27 were confirmed by a mouse bioassay. Laboratorial botulism diagnosis is an important procedure to elucidate cases, especially food-borne botulism, to confirm clinical diagnosis and to identify toxins in food, helping sanitary control measures.

Botulismo é uma doença rara e potencialmente letal, resultante da ação de uma neurotoxina produzida pelo Clostridium botulinum. No presente estudo, estão descritos os resultados da investigação laboratorial de 117 casos suspeitos de botulismo notificados ao sistema de vigilância, ocorridos no Brasil no período de janeiro de 2000 a outubro de 2008. Os dados obtidos sobre as fontes de transmissão, os tipos de toxina identificados e de amostras analisadas serão discutidos. Foram analisadas 193 amostras clínicas e 81 amostras de alimentos para detecção e identificação de neurotoxina botulínica. Entre as amostras clínicas, 22 (11,4 por cento) amostras apresentaram resultado positivo para toxina (nove do tipo A, cinco do tipo AB e em oito o tipo não foi identificado) e entre as amostras de alimentos, oito (9,9 por cento) foram positivas (cinco do tipo A, uma do tipo AB e em duas o tipo não foi identificado). Dos 38 casos considerados positivos para botulismo, 27 foram confirmados pelo bioensaio em camundongo. O diagnóstico laboratorial de botulismo é importante para elucidação dos casos, principalmente de botulismo alimentar, para confirmação dos diagnósticos clínicos e identificação das toxinas nos alimentos, provendo subsídios para as medidas de controle sanitário.

Linden flower (Tilia spp.) as potential vehicle of Clostridium botulinum spores in the transmission of infant botulism / El té de tilo como vehículo potencial de esporas de Clostridium botulinum en la transmisión del botulismo infantil

Infant botulism is an intestinal toxemia caused principally by Clostridium botulinum. Since the infection occurs in the intestinal tract, numerous food products have been investigated for the presence of C. botulinum and its neurotoxins. In many countries, people use linden flower (Tilia spp) tea as a household remedy and give it to infants as a sedative. Therefore, to help provide a clear picture of this disease transmission, we investigated the presence of botulinum spores in linden flowers. In this study, we analyzed 100 samples of unwrapped linden flowers and 100 samples of linden flowers in tea bags to determine the prevalence and spore-load of C. botulinum. Results were analyzed by the Fisher test. We detected a prevalence of 3% of botulinum spores in the unwrapped linden flowers analyzed and a spore load of 30 spores per 100 grams. None of the industrialized linden flowers analyzed were contaminated with botulinum spores. C. botulinum type A was identified in two samples and type B in one sample. Linden flowers must be considered a potential vehicle of C. botulinum, and the ingestion of linden flower tea can represent a risk factor for infant botulism.

El botulismo del lactante es una toxiinfección causada, principalmente, por Clostridium botulinum. Debido a que esta infección ocurre en el tracto intestinal, la presencia de esta bacteria y sus neurotoxinas ha sido investigada en numerosos alimentos. En muchos países se utiliza el té de tilo (Tilia spp.) como sedante natural, el que se administra incluso a los lactantes. A fin de contribuir al esclarecimiento de la transmisión de esta enfermedad, se investigó la prevalencia y la carga de esporas botulínicas en esta hierba. Se analizaron 100 muestras de tilo comercializado a granel y 100 muestras de tilo industralizado en “saquitos”. Los resultados de prevalencia fueron analizados por el test de Fisher y la carga de esporas por la técnica del número más probable. Se halló una prevalencia de esporas de C. botulinum del 3% en el tilo comercializado a granel, con una carga de 30 esporas/100 g de hierba. En tanto, ninguna de las muestras en saquitos acusó la presencia del patógeno. Se identificaron tres cepas de C. botulinum, dos tipo A y una tipo B. En virtud de estos resultados, el tilo podría considerarse un potencial vehículo de esporas de C. botulinum y la administración de sus infusiones a menores y lactantes, un riesgo para la transmisión de la enfermedad.

Phenotypic characterization of Clostridium botulinum strains isolated from infant botulism cases in Argentina / Caracterización fenotípica de cepas de Clostridium botulinum aisladas de casos de botulismo del lactante en Argentina

Infant botulism is the most common form of human botulism; however, its transmission has not been completely explained yet. Some of the most recognized potential sources of Clostridium botulinum spores are the soil, dust, honey and medicinal herbs. In Argentina, 456 cases of infant botulism were reported between 1982 and 2007. C. botulinum type A was identified in 455 of these cases whereas type B was identified in just one case. However, in Argentina, types A, B, E, F, G, and Af have been isolated from environmental sources. It is not clearly known if strains isolated from infant botulism cases have different characteristics from strains isolated from other sources. During this study, 46 C. botulinum strains isolated from infant botulism cases and from environmental sources were typified according to phenotypic characteristics. Biochemical tests, antimicrobial activity, and haemagglutinin-negative botulinum neurotoxin production showed uniformity among all these strains. Despite the variability observed in the botulinum neurotoxin's binding to cellular receptors, no correlation was found between these patterns and the source of the botulinum neurotoxin. However, an apparent geographical clustering was observed, since strains isolated from Argentina had similar characteristics to those isolated from Italy and Japan, but different to those isolated from the United States.

El botulismo del lactante es la forma más común del botulismo humano; sin embargo, su forma de transmisión no ha sido totalmente explicada. El suelo, el polvo ambiental, la miel y algunas hierbas medicinales son potenciales fuentes de esporas de Clostridium botulinum. Entre 1982 y 2007 se informaron en Argentina 456 casos de botulismo del lactante, 455 casos debidos al serotipo A y uno al serotipo B. Sin embargo, los serotipos A, B, E, F, G y Af han sido aislados de suelos y otras fuentes en Argentina. No se conoce si las cepas aisladas de casos de botulismo del lactante poseen características diferentes de las cepas aisladas de otras fuentes. Durante este estudio se caracterizaron 46 cepas de C. botulinum. Las pruebas bioquímicas y de sensibilidad a los antimicrobianos y la producción de neurotoxina botulínica hemaglutinina-negativa mostraron uniformidad entre estas cepas. A pesar de la variabilidad observada respecto de la unión de la neurotoxina a receptores celulares, no se observó una correlación entre estos patrones de unión y la fuente de aislamiento. Sin embargo, se observó una aparente agrupación geográfica, ya que las cepas aisladas en Argentina tuvieron características similares a las observadas en las cepas aisladas en Italia y Japón, pero diferentes de las que se registraron en las cepas aisladas en los Estados Unidos.

Botulismo infantil: comunicación de un caso y revisión del tema / Infant botulism: case-report and literature review

Background: Infant botulism is a rare and potentially lethal neurological disease produced by the ingestion of a neurotoxin secreted by Clostridium botulinum, causing diffuse paralysis. Objective: Describe the first case in Chile since the establishment of an obligatory report and describe the diagnosis, clinical presentation and outcome. Case-report: A 2 months-old male with 48 hours of poor feeding and swallowing, weak cry, listlessness and constipation. He was admitted for hospitalization with probable sepsis and required tracheotomy due to apnea with failed endotracheal intubation, requiring mechanical ventilation for 150 days and hospitalization during 180 days. The diagnosis was confirmed by isolating Clostridium botulinum toxin from stool. Conclusion: The diagnosis of infant botulism requires a high suspicion index and the treatment includes intensive care monitorization with general support.

El botulismo infantil es una enfermedad infrecuente que ha sido confirmada sólo en menores de un año, se produce por ingestión de esporas de clostridium botulinum que producen una neurotoxina in vivo, la cual se absorbe y es responsable de la parálisis flácida descendente aguda característica de esta enfermedad. Objetivo: Presentación del primer caso descrito desde que la notificación es obligatoria en Chile y revisión del tema. Caso clínico: Lactante de 2 meses. Dos días previo al ingreso presenta succión débil, hiporeactividad y llanto disfónico, consultando en Servicio de Urgencia y decidiéndose su hospitalización. Estudio: hemograma, PCR, neuroimagenes, EEG LCR, EMG normales y toxicológico negativo. Se confirma Clostridium botulinum productor de la toxina botulínica tipo A. Requirió ventilación mecánica a través de traqueotomía por 150 días y es dado de alta a los 180 días. Conclusión: El diagnóstico requiere de un alto índice de sospecha, el tratamiento es de soporte evitando las complicaciones.

Contaminación microbiológica y actividad antimicrobiana del azúcar de caña cristalizado sobre algunos agentes de interés médico en Costa Rica

Microbiological contamination and antimicrobial activity of cristalised cane sugar on some medically important microorganisms in Costa Rica. Unrefined cristalised cane sugar, obtained after the filtration and evaporation of sugar cane juice, is a nutritional product of traditional consumption in Costa Rica and other Neotropical countries. It has been used in the topic treatment of infected wounds, with satisfactory results even with some antibiotic-ressistant bacteria. We studied the microbiological quality of 50 commercial samples. The analyses included total aerobic and anaerobic bacteria plate count; aerobic and anaerobic spore count; mold and yeast count; total and fecal coliforms; and presence of Clostridium botulinum. The antimicrobial effect was tested for Staphylococcus aureus (ATCC 25923), S. epidermidis (UCR 2902), Pseudomonas aeruginosa (ATCC 9027), Escherichia coli (ATCC 25922), Salmonella enteritidis (ATCC 13076), Listeria monocytogenes (ATCC 19116) and Aspergillus niger (Asni 06). Most of the samples (76 %) presented counts lower than 100 CFU/g especially for sporulated forms (90 % lower than 20 CFU/g), the mold and yeast count was higher (38 % higher than 102 CFU/g), demonstrating the importance of these microorganisms in the spoilage of the product; 76 % of the samples presented fecal contamination; C. botulinum was not isolated with the methodology employed. No inhibitory effect was observed for A. niger, but all samples han an inhibitory effect over the other species, especially for P. aeruginosa and S. aureus. Rev. Biol. Trop. 56 (2): 431-437. Epub 2008 June 30.

La tapa de dulce o panela es un producto alimenticio de consumo tradicional, típico de países neotropicales, obtenido de la filtración y evaporación del jugo de la caña de azúcar. Además de su uso clásico como endulzante, en Costa Rica y otras partes del mundo se ha utilizado para el tratamiento tópico y empírico de heridas infectadas, con resultados satisfactorios, aún en infecciones por bacterias resistentes a diversos antibióticos. A fin de valorar el riesgo o beneficio de esta práctica, se evaluó la calidad microbiológica de 50 muestras de tapa de dulce de producción nacional obtenidas en trapiches, mercados y supermercados. Se realizaron recuentos bacterianos aerobios y anaerobios, de bacterias esporuladas y no esporuladas y de hongos y levaduras, se determinó el número de coliformes totales y fecales, la presencia de Clostridium botulinum y se evaluó el efecto antimicrobiano de este producto sobre algunos patógenos: Staphylococcus aureus (ATCC 25923), S. epidermidis (UCR 2902), Pseudomonas aeruginosa (ATCC 9027), Escherichia coli (ATCC25922), Salmonella enteritidis (ATCC 13076), Listeria monocytogenes (ATCC 19116) y Aspergillus niger (Asni 06). La mayoría de las muestras (76%) presentaron recuentos bacterianos menores de 100 UFC/g, especialmente de esporulados (90% menos de 20 UFC/g), y recuentos de hongos y levaduras elevados (20% mayores a 100 UFC/g). Un alto porcentaje de las muestras presentó contaminación fecal (76%, NMP/g desde 3 hasta 460). No se logró aislar C. botulinum en ninguna de las muestras. Todas las muestras del producto concentrado desarrollaron halo de inhibición sobre los cultivos, principalmente sobre P. aeruginosa y S. aureus; pero no se observó ningún tipo de inhibición sobre A. niger.

Honey for nutrition and health: a review.

Due to the variation of botanical origin honey differs in appearance, sensory perception and composition. The main nutritional and health relevant components are carbohydrates, mainly fructose and glucose but also about 25 different oligosaccharides. Although honey is a high carbohydrate food, its glycemic index varies within a wide range from 32 to 85, depending on the botanical source. It contains small amounts of proteins, enzymes, amino acids, minerals, trace elements, vitamins, aroma compounds and polyphenols. The review covers the composition, the nutritional contribution of its components, its physiological and nutritional effects. It shows that honey has a variety of positive nutritional and health effects, if consumed at higher doses of 50 to 80 g per intake.

Pré-compostagem de cadáveres de bovinos acometidos pelo botulismo / The effect of composting cattle carcasses on botulinum spores and toxin content

Foram pré-compostados, em células individuais e isoladas, cinco cadáveres de bovinos acometidos pelo botulismo com a finalidade de monitorar a presença de esporos de Clostridium botulinum e de toxina botulínica antes e após o processo de decomposição em leira estática com fonte de carbono. O diagnóstico da intoxicação nos animais foi baseado nas características clínico-patológicas, epidemiológicas ou laboratoriais. Dos cinco bovinos com evolução clínica crônica de botulismo, cujos cadáveres foram pré-compostados, três foram acometidos pela toxina tipo D, um pelo complexo CD e um dos animais foi negativo na tentativa de detecção da toxina e de esporos da bactéria nas vísceras pelo bioensaio e neutralização em camundongo. O processo de pré-compostagem foi realizado em leira estática, com o uso de material carbonáceo umidificado como substrato e esquartejamento do animal, vedado individualmente com lona plástica e sem aeração por um período de 50 dias. A temperatura das leiras foi monitorada durante o período e oscilou de 40,5-52,4ºC. Após a abertura das leiras, pôde-se constatar a completa decomposição de todo material mole, com redução significativa do seu peso (de 26,5-44,5 por cento), restando apenas os ossos. Não foi detectado esporo ou toxina botulínica no interior dos ossos (n=5 para cada cadáver). Nas 200 amostras examinadas do homogeneizado restante (n=40 para cada cadáver), em apenas duas amostras de uma leira foram detectados esporos de C. botulinum tipo C, enquanto que todas foram negativas para a tentativa de detecção da toxina botulínica pelo bioensaio em camundongo. Da forma como foi avaliado o processo de pré-compostagem de bovinos mortos pela intoxicação botulínica não contribuiu para a proliferação de C. botulinum.

Five carcasses of cattle that died from botulism were composted in individual isolated beds with the purpose of monitoring the effect on spores of Clostridium botulinum and of botulinum toxin. The diagnosis of botulinum poisoning was based on clinical and pathological, epidemic and/or laboratorial characteristics. Of the five bovines with clinical signs of chronic botulism, three were affected by the type D toxin, one by the CD complex, and one was negative for toxin and spores of C. botulinum in the viscera using a mouse bioassay. The composting process was carried out in beds with carcasses cut up and mixed with sawdust as a carbon source. They were kept anaerobic under a plastic sheet for 50 days. The temperature of the beds was monitored during the period and oscillated from 40.5 to 52.4ºC. After this time, soft tissue had complete decomposed with a significant loss of weight (26.5-44.5 percent). The remaining bones no longer contained spores or botulinum toxin in the 5 samples taken from each carcass. Only 2 of the 200 samples of homogenized remaining (40 for each carcass) contained spores of C. botulinum type C. All samples were negative for botulinum toxin using the mouse bioassay. Composting carcasses of cattle that died from botulism eliminated botulinum spores and toxin from the remains.

Rapid geographical clustering of wound botulism in Germany after subcutaneous and intramuscular injection of heroin.

BACKGROUND: Wound infections due to Clostridium botulinum in Germany are rare and occur predominantly in heroin injectors, especially after subcutaneous or intramuscular injection of heroin ("skin popping"), which is contaminated with spores of C. botulinum. We report a rapid geographical clustering of cases in Germany in a region between Cologne, Bonn, and Aachen with wound botulism and consecutive systemic C. botulinum intoxication in intravenous drug users (IDUs) within 6 weeks in October and November 2005. PATIENTS: A group of 12 IDUs with wound botulism after "skin popping." RESULTS: Clinical data were available in 11 (92%) of 12 patients; in 7 (58%) of the 12 cases, there was cranial nerve involvement including mydriasis, diplopia, dysarthria, and dysphagia, followed by progressing symmetric and flaccid paralysis of proximal muscles of the neck, arms, trunk, and respiratory muscles. Mechanical respiratory support was necessary. Five of the IDUs were treated with antitoxin, but mechanical respiratory support could not be avoided. The mean ventilation duration was 27.4 days (range 6-77 days). In 4 patients (33%), mechanical ventilation could be avoided; two were treated with antitoxin. CONCLUSIONS: This report describes rapid geographical clustering of wound botulism with severe respiratory complications in IDUs after "skin popping," which has not previously been reported either in Germany or any other European country. Based on these observations and those in other European countries, we conclude that there is a trend towards "skin popping," suggesting a change in injection practices in IDUs. Secondly, we conclude that the total number of cases with wound botulism is likely to increase because "skin popping" is the main risk factor.

Botulismo em aves domésticas - Gallus gallus domesticus relato de caso / Botulismo en aves domésticas Gallus gallus domesticus ? relato de caso / Botulism in domestic birds (Gallus gallus domesticus) ? case report

Botulismo é uma enfermidade que provoca uma paralisia fatal, causada pela toxina do Clostridium botulinum. O botulismo é observado na maioria das espécies avícolas, exceto os abutres, os quais são resistentes. A doença manifesta-se nas aves, apresentando os seguintes sinais clínicos: pescoço flácido incapaz de sustentar a cabeça, a qual apoia-se no piso, desprendimento das penas e paralisia flácida das asas. A toxina C, produzida pelo Clostridium botulinum, é a responsável pela doença. O presente trabalho relata casos de botulismo em aves domésticas, ocorridos na região de Conquista ? MG

Botulism is a fatal paralyses caused by the Clostridium botulinum toxin. It is observed in the majority of the avian species except vultures, which are resistant. The disease appears in birds and presents the following clinical signs: flaccid neck incapable of supporting the head, which is supported on the ground, dropping feathers, and flaccid paralysis involving the wings. Toxin-C, which is produced by Clostridium botulinum, is responsible for the disease. The present work relates botulism cases in birds, occurred in the region city of Conquista, MG, Brazil

Botulismo es una enfermedad que provoca una parálisis fatal, causada por la toxina del Clostridium botulinum. El botulismo es observado en la mayoría de las especies avícolas, excepto los buitres, los cuales son resistentes. La enfermedad se manifiesta en las aves, presentado los siguientes señales clínicos: cuello flácido incapaz de sostener la cabeza, apoyándose en el suelo, caída de las plumas y parálisis flácida de las alas. La toxina C, producida por el Clostridium botulinum, es La responsable por la enfermedad. Esta investigación relata casos de botulismo en aves domésticas, ocurridos en la región de Conquista ? MG