Treatment for botulism will depend on which type of botulism you have, although in all cases you will need to be admitted to hospital. If botulism is not treated quickly, it is likely to be fatal.
It can take 10 days to several months for someone to fully recover from the botulinum toxin.
Food-borne and wound botulism
Treatment for food-borne and wound botulism will require immediate admission to hospital. If you are having difficulty breathing because the toxin has spread to your lungs, you may be attached to a ventilator (an artificial breathing machine that moves oxygen-enriched air in and out of your lungs).
You may also be given fluids and nutrients through an intravenous drip (a tube is placed directly into a vein in your arm).
Antitoxins
Botulism will need to be treated with injections of antitoxins. Antitoxins are antibodies (proteins produced by the body) that can neutralise a specific toxin, in this case the clostridium botulinum toxin.
The antitoxins are created by exposing horses to a form of botulism that they are immune to. This exposure produces antibodies, which are harvested and used to create an antitoxin. Antitoxins work by blocking the effects of the toxin on the nervous system (the nerves, brain and spinal cord).
Antitoxins should be given as soon as possible. It is not necessary to wait for test results confirming the presence of the clostridium botulinum bacteria or toxin. A diagnosis of botulism based on your symptoms is enough to start treatment.
A case of botulism will need to be reported to the Health Protection Agency (HPA) by the doctor who diagnoses you. The HPA will then provide the antitoxin.
The antitoxin will help prevent your symptoms from getting any worse, but it will not cure any paralysis that the toxin has already caused. If one dose of antitoxin is not enough, you may be given a second dose after 24 hours.
Food-borne botulism
In some cases of food-borne botulism, medicines may be used to induce vomiting (being sick) in order to remove all particles of infected food from your body. Enemas (an injection of fluid into the large intestine) may also be used for this purpose because they encourage you to empty your bowels.
Wound botulism
If the infection has been caused by wound botulism, the infected wound and possibly a surrounding area of skin will need to be surgically removed. The process for doing this is called debridement. Removing the area surrounding the wound is necessary in order to stop any further toxins being produced. In some cases, this may lead to scarring.
You may also be given antibiotics (medicines to treat an infection that is caused by bacteria) to prevent any further infections.
Infant botulism
Infant botulism tends to be less serious than other types of botulism. This is because the levels of toxins that are released by the bacteria are lower than in other forms of the condition. However, the condition still requires emergency medical treatment in order to prevent breathing difficulties occurring.
Babies with infant botulism will be placed in an incubator (a clear, enclosed cot) that will keep them warm and protect them from secondary infection. Artificial ventilation may be required to assist their breathing, and they may also be fed intravenously (though a tube placed directly into a vein).
Infant botulism can be successfully treated using a medicine known as botulinum immunoglobulin (which has the brand name BabyBIG). Botulinum immunoglobulin is created by taking samples of human blood that contain a high level of infant botulism-immune antibodies (proteins that fight infections).
Most babies will respond quickly to treatment, and they should be well enough to leave hospital within two-and-a-half weeks. Any paralysis may last for a few weeks, but babies grow new nerve endings, so they should make a full recovery.
Therapeutic uses of botulinum toxin
Miniscule amounts of botulinum toxin are used in several medical procedures. Beauty treatments are one of the best known applications of botulinum toxin. For example, injections of the toxin are sometimes used to remove the appearance of wrinkles by temporarily paralysing the facial muscles. This procedure is commonly known as 'botox'.
Botulinum toxin is also sometimes used to treat muscle disorders, excessive sweating and, more recently, migraines.
