Clostridium botulinum is a bacterium that thrives in anaerobic environments. Botulism toxin is most commonly produced by contaminated food containers that have been improperly preserved. Off the grid, canning foods will be an integral part of survival; the family medic must enforce the safe preparation of food if they’re to keep people healthy.

The bacteria that make botulinum toxin acts by blocking nerve function, which leads to paralysis. It’s found in many places but, thankfully, it’s a rarity these days in natural settings. These pathogens make “spores” that act like protective coatings. Spores allow the bacteria to survive in even the most hostile environments. Spores don’t always produce toxin when accidentally ingested, however; certain conditions must prevail, such as:

• Settings where there is little or no oxygen.
• Certain temperatures (different types become active at different temperatures).
• A high moisture index.
• Low salt, acid, and sugar levels.

There are several kinds of botulism. They are:  

FOODBORNE: Foodborne botulism occurs about 18-36 hours after ingesting contaminated or improperly prepared foods. Pickled foods that lack the right formula of brine, as well as smoked fish stored at high temperatures and poorly canned foods present a major risk. Store-bought foods are more unlikely to contain toxin.

WOUND-RELATED:  Bacteria may contaminate a wound and make toxins. People who inject drugs have a higher chance of infection. It may also be seen after traumatic injuries or, rarely, surgical procedures.

INFANTILE: The bacteria may get into a baby’s intestines and cause illness.

IATROGENIC: Iatrogenic means “physician-caused”. Botulism may occur from cosmetic injections of toxin for wrinkles or migraine headaches, though this is rare if administered properly.

INTESTINAL COLONIZATION: Like infantile botulism, spores can cause bacteria to grow in intestines of adults.

All of the above types of botulism can be fatal: Once, the death rate was 50 percent, but it’s currently about 5 percent in modern times. In any case, it should be considered a medical emergency.

The muscle weakness in botulism is due to nerve damage that usually starts high in the “cranial nerves,” a group of nerves that control important functions like eye movements and facial muscles. Common symptoms include:

• Blurred vision
• Double vision
• Drooping eyelids
• Slurred speech
• Problems swallowing
• Lightheadedness
• Difficulty breathing
• Muscle weakness

All of the above happens without losing mental capacity or developing fever.

Botulism is one of the reasons to avoid giving raw honey (which may contain Clostridia spores) to infants less than one year. If infected, they develop “floppy baby syndrome,” where poor muscle tone and lethargy are common signs. An antitoxin is available in modern times, but off the grid, a severe case may be fatal.

For cases of foodborne botulism, doctors sometimes clear out the digestive system by inducing vomiting and giving medications to induce bowel movements. Metronidazole is an antibiotic sometimes used in infected wounds that is available in veterinary equivalents for survival scenarios. In some cases, dead and dying tissue may require surgical removal by debridement.

The FDA has approved an antitoxin for certain botulism variants; it’s known as Botulism Antitoxin Heptavalent (serotypes A, B, C, D, E, F, G) or BAT. BAT is indicated as an intravenous treatment for adults and children following exposure to the neurotoxin.

If you’re a canning pro, you already know to follow safe procedures as recommended by the Department of Agriculture. For others, here’s the complete guide to safe canning:

https://nchfp.uga.edu/publications/publications_usda.html

Low-acid foods, while good for reflux symptoms like heartburn, are the most likely to be contaminated with botulinum toxin. These include:

• Asparagus
• Green beans
• Beets
• Corn
• Potatoes

The CDC suggests reducing the chance of botulism by:

• Refrigerating homemade oils infused with garlic or herbs and throwing away any unused oils after 4 days.
• Keeping potatoes that have been baked while wrapped in aluminum foil hot (at temperatures above 140°F) until they are served, or refrigerating them with the foil loosened.
• Refrigerating any canned or pickled foods after you open them.

In survival, it’s not just the availability of food that’s important. The medic must be sure that food is safe to eat if they’re to succeed when everything else fails.

Joe Alton MD

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