Public Health, Administration
For many providers, botulism and its resulting toxin are typically only thought of for medicinal benefits; however, in Arctic communities, type E botulism has been a daily risk for millennia. This unpredictable and deadly disease can sicken families quickly with vague symptoms challenging to diagnose, especially by an unprepared clinician. Botulism can present with subtle complaints like nausea, dry mouth, and a slight cough but may progress to paralysis and death rapidly. Time from exposure to onset of symptoms can be as long as 30 days, making recollection, containment, and identification of the causative agent and food source much more difficult. To reduce the risk to the patient of long-term sequelae from botulism toxicity, providers must conduct a thorough history, consider botulism in the differential diagnosis, and identify the proper public health sources to assist in the testing and treatment of the patient. Botulism antitoxin cannot reverse the effects of the toxin on the patient’s nervous system. Still, it can bind any free toxin and prevent further damage, increasing the odds of a patient’s survival and recovery. Definitive botulism diagnosis depends on testing the patient's food source or stomach contents. It can take days, so treatment must be based on the provider's suspicion based on symptoms and the patient's history.
Mackiernan MC. Recognition of Botulism Poisoning – an Arctic Case. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2023; 5(2).
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