New Discoveries in Toxins from Gram-Positive Bacteria, Clostridium botulinum

Due to neurotransmitter release inhibition, human botulism causes flaccid paralysis and suppression of some gland secretions, most notably salivary secretions. Clostridium botulinum can produce botulinum neurotoxins. They currently have at least seven serotypes and more than 40 subtypes. The symptoms of all types of food-borne botulism are similar, and the time or severity of the disease varies, depending on the kind of toxins and the amount of toxin absorption. Symptoms of food-borne botulism appear within 12–72 h after eating contaminated food. In inhalation botulism, symptoms begin to appear about 72 h after exposure. Botulism causes flaccid paralysis that starts in the head and neck muscles and progresses to the powers of the trunk and limbs. Initial symptoms include difficulty swallowing or speaking, difficulty seeing, double vision, or blurred vision. For proper patient management, quick laboratory confirmation of botulism is necessary. The most direct technique to diagnose botulism is to look for BoNT in the patient’s sera. There is no preventive medicine available for susceptible people to botulinum toxin. A toxoid vaccine against the toxin exists but takes too long to induce immunity for immunity to be applicable after exposure to a toxin. The toxoid vaccine needs a long time to stimulate immunity. Every case of botulism is also a public health emergency and requires an immediate report of the suspected case to the Ministry of Health or national agencies.