That spoonful of honey or that unopened jar of canned food may not be as innocent as it looks. Spores may be hidden in it that could lead to a rare disease called botulism. You even need to be careful how you’re cooking your baked potatoes or you may be increasing your likelihood of developing botulism (more on that later!). By knowing the risks and what you can do to prevent it, you can protect your family from this serious illness.
What Is Botulism?
Botulism is a severe illness that is thankfully very rare. (1) There are three main forms of botulism:
- Food-borne botulism, which is the original form of the disease that was first documented by researchers. Every year, there are less than 1,000 cases of food-borne botulism in the entire world.
- Infant botulism, which typically only affects children ages 7 days to 11 months. Since the first case of infant botulism was discovered in the 1970s, there have been just over 1,000 cases in the United States total.
- Wound botulism, which is only reported one to three times per year in the United States.
Signs and Symptoms
After being exposed to the toxins that cause botulism, if illness sets in, it usually occurs within three days of exposure. (2) However, this is by no means a standard outcome. In some cases, people have exhibited botulism symptoms in as little as four hours, while in other cases, people didn’t show signs and symptoms until eight days later.
While there are theoretically three forms of botulism classified by either how the disease was contracted (for example, via food or an open wound) or by the age of the person affected, the signs and symptoms of botulism are the same regardless of the “type” of botulism you have. (3)
Botulism causes symptoms like:
- Changes in vision, including double vision and blurred vision, which may contribute to dizziness.
- Drooping eyelids and mouth.
- Problems in and around the mouth, including slurred speech, difficulty swallowing and dry mouth.
- General muscle weakness.
- Difficulty breathing, which you may confuse with chest congestion.
Because infants are less in control of their body movements to begin with, it can be a little harder to notice. In general, infants with the disease are referred to as “floppy.” (4) They might seem less active, weak or lethargic, may change their eating patterns or stop eating (which may also cause constipation), will show poor movement control or muscle tone, and may have a weaker cry.
No matter the type of botulism or the person’s age, all botulism cases will end in paralysis if the disease is not treated immediately by medical professionals. This paralysis can affect the entire body — not just your arms or legs — and can even paralyze the muscles you need in order to breathe.
Thus, any time you suspect you or someone you love might be affected by botulism, seek immediate, urgent help from your doctor.
Causes and Risk Factors
All botulism cases can be traced back to a bacteria called Clostridium botulinum, which produces a chemical poison known as the botulinum toxin. (5) Botulinum is one of the most deadly, most powerful toxins in the world, (6) so much so that some countries’ militaries use it as a potential chemical weapon.
The toxin prevents your muscles from working properly (thus creating symptoms like slurred speech or drooping eyelids).
To contract botulism, you must be exposed to the bacteria’s spores and resulting toxin. While the bacteria spores are present all around you, the bacteria only become active and start producing poison in the right environment.
One of the most common and well-researched risk factors is from food contaminated by the bacteria. Specifically, botulism from canned foods. Almost all cases of food-borne botulism are caused by home-canned food. (7) The food, water and low-oxygen environment is exactly what the bacteria needs to start making botulinum.
Canned goods containing low-acidic foods (foods with a pH of 4.7 or higher) are the greatest risk factor. That’s because these foods aren’t acidic enough to kill and prevent the bacteria from growing and reproducing. Common low-acidic foods that are at a greater risk of being infected by the botulinum toxin include:
- Green beans
- Any type of meat
- Fish, shellfish and other seafood
In addition to potatoes’ low acidity, there is another reason why these spuds are linked to an increased risk of botulism: wrapping them in aluminum foil. It’s not the aluminum foil that causes botulism, but when potatoes are wrapped in foil this creates a low-oxygen environment where botulism-causing bacteria (Clostridium botulinum) can thrive. The risk is greatest when baked potatoes are left in this foil while cooling down or when they are stored in the refrigerator in foil. (8) So if you know anyone still cooking their baked potatoes in aluminum foil, please tell them to beware!
When an adult ingests the inactive bacteria spores (which, unlike when they’re in canned goods, aren’t growing and making toxins), the adult’s mature digestive system gets rid of the inactive spores without causing any health risks to the adult.
The same is not true for infants, who have immature digestive systems and lower immunity to a wide range of illnesses. A baby’s digestive system has yet to mature to the point where it can handle bacteria spores. Thus, if an infant ingests the spores, the bacteria activates within them, starts to reproduce and grow, and begins making botulinum. (9)
When can babies have honey? One of the main risk factors for exposing young children to the Clostridium botulinum bacteria is honey. Honey, especially raw honey, is a potential source for bacteria spores. This is why babies who are under a year in age should never be given any kind of honey, even if it’s just a drop or two to sweeten their food or make their soother/pacifier more appealing. (10)
Botulism related to a wound is exceedingly rare, even for this already very rare disease. (11) It occurs when the Clostridium botulinum bacteria infects an open wound and begins to grow and produce botulinum directly in the wound.
One of the main risk factors for wound-related botulism is the use of injected drugs. Because the skin barrier is broken repeatedly throughout the day to inject drugs, there are essentially dozens of chronic wounds across the skin’s surface. This presents more opportunities for botulism meaning a higher risk of infection.
If you suspect a botulism case, it’s imperative that you rush immediately to your doctor for medical treatment. There is no home treatment for this rare but very serious and deadly illness.
To diagnose botulism, your doctor will review your symptoms with you. However, other diseases and medical situations (such as a droopy face caused by a stroke) may also present similar symptoms. To verify that you’re being affected by the botulinum toxin, your doctor may do a:
- Brain scan
- Extract fluid from your spine for analysis
- Conduct tests that review how your nerves and muscles are functioning
Conventional treatment requires the use of an antitoxin drug. (12) When you’re being poisoned by botulinum, the toxin is attacking your body’s nerves and muscles. The antitoxin prevents this from happening and stops the ongoing damage caused by botulinum.
However, the antitoxin doesn’t reverse any current damage to your body caused by botulinum. It simply stops the toxin from continuing to affect you. Thus, people with botulism often spend weeks or even months in the hospital under close medical supervision as they recover and heal.
Depending on how long your body was poisoned, you may need:
- Physical therapy as the paralysis slowly improves.
- Breathing assistance, such as being hooked up to a ventilator machine, if chest congestion paralysis sets in in the muscles that you need to breathe.
- Assistance eating if your mouth, tongue and/or throat are affected
How to Prevent Botulism
The disease is rare thanks to modern medicine, up-to-date food safety practices, and a better understanding of what the Clostridium botulinum bacteria need to thrive. Don’t give the bacteria a second chance. Use the following botulism prevention strategies to help prevent botulism and keep the spores from having the opportunity to reproduce, spread and make their toxins.
1. Be Cautious When Home Canning
Canning food at home can be a rewarding way to preserve food you’ve grown in your garden, ensure you’re feeding your family the healthiest food possible, and building a relationship with where your meals come from. However, home canning is also one of the most common risk factors in botulism.
If you choose to can food, clean the food thoroughly, use a steam pressure canner at 240 degrees Fahrenheit, using a boiling water bath during the canning process, and consider only canning acidic foods. (13)
It’s also important to note that canning practices change over the years as new research reveals new safety protocols. If your parents or grandparents taught you how to can or passed on their equipment to you, make sure you’re using the latest food safety and canning advice from the USDA or CDC.
2. Sanitize Your Food
Before eating canned food, especially if it’s been processed in someone’s home, boil it. This is true even if there are no signs that the food has spoiled, and is especially important if it’s a low-acidic food like canned green beans.
Boiling is a simple safety precaution. The high heat will naturally and safely inactivate any toxins. (14) Fill a saucepan with water and boil the can for at least 10 minutes. If you live at an altitude above 1,000 feet, increase the boiling time by 60 seconds for every additional 1,000 feet in elevation.
3. Practice Good Food Hygiene
Keep your kitchen food preparation areas sanitized and clean. To naturally sanitize your food preparation surfaces, spritz white vinegar on your counters, cutting boards, etc., and let it soak for 10 minutes. Alternatively, a more effective natural solution is 3 percent hydrogen peroxide left on for 10 minutes. (15)
After cooking or after opening a canned item, don’t leave your food out at room temperature. Refrigerate it promptly, and discard it if it’s been left out for two or more hours. (16)
Avoid using aluminum foil to bake potatoes. And even if you don’t wrap your potato in aluminum foil (which I don’t recommend), you still should not let it sit out at room temperature for over four hours. Ideally, eat the potato after baking it or store it in the refrigerator to eat later. (17)
4. Take a Probiotic
One reason infants are more susceptible to botulism is because their immature gut does not have the full range of beneficial bacteria that adults have, which helps the body to eliminate invading bacteria. According to a report published in the Eurasian Journal of Medicine, “the infant intestinal tract lacks protective bacterial flora and Clostridium-inhibiting bile acids, which allows the C. botulinum to flourish and produce the toxin that causes disease.” (18)
By maintaining the strength of your gut bacteria, you may help reduce your risks of botulism. There have even been lab tests that suggest Lactobacillus acidophilus and other common beneficial bacteria found in probiotic supplements may bind with the toxin that causes botulism and help prevent it from causing as much harm. (19)
Besides taking a probiotic supplement, you can boost your gut health by:
- Eating fermented foods such as miso, kimchi or yogurt.
- Staying hydrated.
- Eating fiber-rich foods that help improve digestion and feed your beneficial bacteria.
5. Change Your Food Storage
Botulism spores start to reproduce and grow when there is little to no air circulation. The next time you’re packing up your leftovers for the fridge, consider not using an airtight glass or plastic dish. (20) A bowl covered in parchment paper allows more air flow and oxygen exchange, which can help lower botulism risks.
Years ago, many people who contracted botulism died. Thanks to a better understanding of the disease and its treatment, it is now less fatal. That doesn’t decrease the importance of proper food hygiene and immediate treatment if botulism is suspected.
If you notice any symptoms, especially after eating canned food, contact a doctor immediately. Don’t wait to see if it’s “just a stomach bug.”
- It’s caused by the Clostridium botulinum bacteria, which is present all around you in dust and in dirt.
- When the bacteria are given the right conditions (food, moisture, and little to no air), they begin to reproduce and make the toxin botulinum.
- Botulinum is one of the most poisonous toxins in history and affects your nerve and muscle functioning.
- Botulism symptoms include droopy eyelids, slurred speech, and difficulty swallowing.
Immediate medical attention is necessary in any and all botulism poisoning. If left untreated, botulism will paralyze you and prevent you from breathing. Your doctor will administer an antitoxin to keep the toxin from continuing to damage your muscles and nerves.
5 Botulism Prevention Tips
While there are no home treatments for botulism, there are things you can do at home to help prevent the disease:
- Use the latest canning research if you do homemade canning, including cleaning your food, using a steam pressure canner at the right temperature setting, and using a boiling water bath.
- Sanitize canned food before eating it by boiling it for at least 10 minutes, depending on your home’s elevation.
- Practice good food hygiene by keeping your kitchen clean and refrigerating food promptly.
- Maintain strong gut health.
- Store food in non-airtight containers.