How to Spot Botulism Symptoms Before It’s Too Late—Plus Life-Saving Prevention Tips
An infectious disease expert helps put minds at ease about this rare condition
This week, the FDA and CDC expanded a recall to include all unexpired ByHeart powdered baby formula, after the brand was likely linked to 31 cases of botulism in infants as young as 16 days old. The good news: Every affected baby has survived so far. Still, the outbreak has left many people feeling uneasy—even those without children. So, should you be worried about botulism symptoms?
Yes and no. “Botulism in adults is a sporadic but potentially devastating disease,” says foodborne illness expert Steven Goldberg, MD, who helps lead nationwide pathogen testing programs for HealthTrackRx. Keep reading to learn what causes the condition, which botulism symptoms to look out for, plus how to protect yourself and loved ones from getting sick in the first place.
What is botulism and how does it happen?
Botulism is a rare but serious condition caused by toxins from bacteria called Clostridium botulinum. In babies, spores of the bacteria (which can hide in honey, soil or even dust) grow into toxin-spewing bacteria in their immature GI tracts. Adult digestive and immune systems kill off the spores, and adults only get sick when actual bacteria gets in their bodies either by mouth (foodborne botulism) or through a wound (wound botulism). It’s most often caused by contaminated foods, especially improperly canned or preserved foods.
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In fact, the most common sources of foodborne botulism include home-canned foods (“especially low-acid foods like asparagus, beets, chiles, corn and green beans,” says Dr. Goldberg), home-fermented foods, home-preserved meat, garlic stored in oil at room temperature and foil-wrapped baked potatoes left at room temperature. And if someone you love is an addict who injects illegal drugs, that’s another significant risk factor.
How botulism can be life-threatening
In the United States, about 150 to 180 babies get botulism each year, “and 60 to 70 adults contract the disease yearly,” says Dr. Goldberg. That means roughly one adult per 4 million. Adults are actually about as likely to be struck by lightning as they are to get botulism.
That said, botulism toxins are among the most virulent scientists have ever studied. They attack the connection between our nerve cells and muscle fibers, causing nerve dysfunction and paralysis, including paralysis of muscles that allow us to breathe. (This botulinum toxin is used in tiny amounts in Botox injections to temporarily paralyze muscles causing wrinkles, migraines and eye twitching.)
An antitoxin is crucial to stop progression of the condition (or, alternately, surgical cleaning and other therapy if botulism develops in a wound or after use of a tainted needle).
While treated infants have a less than 1 percent mortality rate and tend to recover well, that’s not always the case with adults. Even with treatment, adult botulism is considered a medical emergency and often leads to lingering or permanent complications (like fatigue, respiratory difficulties and difficulty lifting things). Treated botulism in adults is fatal anywhere from five to 10 percent of the time; untreated, it’s fatal up to 70 percent of the time. So you definitely want to know the botulism symptoms to look for.
Botulism symptoms in adults
Dr. Goldberg says the following symptoms typically appear 12 to 36 hours after an adult is exposed to botulism, but they can happen at any time between six hours and 10 days.
- GI issues like nausea, vomiting and abdominal pain, which may occur before the neurological symptoms
- Vision problems, including double vision or drooping of one or both eyes
- Difficulty speaking or slurred speech
- Trouble swallowing
- Breathing difficulties
- Paralysis or muscle weakness that starts at the top of the body and moves downward.
Sometimes, GI symptoms like nausea, vomiting and abdominal pain occur before the neurological symptoms. Botulism doesn’t cause a fever, a key way to distinguish its symptoms from other conditions. The antitoxin is most effective if administered within 48 hours of becoming symptomatic, so if you see signs, seek medical help immediately.
Botulism symptoms in infants
In babies, the earliest symptoms can be subtle and happen gradually over a period of up to 30 days, says Dr. Goldberg. The sooner a child is treated, the better the outcome is likely to be. Watch for:
- Constipation
- Difficulty feeding
- A weak cry
- Decreased facial expression
- Loss of head control
- Difficulty breathing
If your baby has consumed ByHeart infant formula and has any of these signs, seek immediate help. Notice concerning botulism symptoms in a baby who has not had the recalled formula? While botulism in infants is rare, trust your instincts and call your pediatrician if you sense something is wrong.
How to reduce your risk of botulism at home
Basically, you want to make your life inhospitable to C. botulinum. If it never grows, it can’t get inside you and cause harm. The number one way to do that is with smart food processing, storage and preparation.
“Proper refrigeration is a critical barrier to toxin production in many processed foods,” says Dr. Goldberg. So if you have garlic in oil or make foil-wrapped potatoes, store them in the fridge. And remember that just because you’ve done something a million times without getting sick doesn’t make it safe. The goal is to prevent that rare instance when you become very ill.
If you preserve food at home, you want to follow recipes tested and approved by a reputable source like the National Center for Home Food Preservation. This ensures that all the food you can or cure “gets sufficient temperature and pressure to destroy spores,” says Dr. Goldberg.
Also key for home-preserved or store-bought food: Always discard food in bulging, swollen or leaking containers. The same goes for anything that has a foul odor when you open it, spurts liquid when you open it, or has visible mold or discoloration.
The bottom line on botulism
“The current [botulism] outbreak risk is limited to infants exposed to ByHeart powdered formula,” notes Dr. Goldberg. “Adult foodborne risk is not increased by this event.” So there’s no cause for panic. Be smart about food safety and be vigilant for botulism symptoms. And keep in mind, botulism is uncommon, and you and your family are likely safe.
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