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Botulism is a rare and potentially fatal illness caused by botulinum toxin, a substance produced by the bacterium Clostridium botulinum. The disease begins with weakness, trouble seeing, feeling tired, and trouble speaking. This may then be followed by weakness of the arms, chest muscles, and legs. The disease does not usually affect consciousness or cause a fever.
Botulism can occur in a few different ways. The bacterial spores that cause it are common in both soil and water. They produce the botulinum toxin when exposed to low oxygen levels and certain temperatures. Food-borne botulism happens when food containing the toxin is eaten. Infant botulism happens when the bacteria develops in the intestines and releases the toxin. This typically only occurs in children less than six months old, as protective mechanisms develop after that time. Wound botulism is found most often among those who inject street drugs. In this situation spores enter a wound and, in the absence of oxygen, release the toxin. It is not passed directly between people. The diagnosis is confirmed by finding the toxin or bacteria in the person in question.
Prevention is primarily by proper food preparation. The toxin, though not the organism, is destroyed by heating it to more than 85 °C (185 °F) for longer than 5 minutes. Honey can contain the organism, and for this reason honey should not be fed to children under 12 months. Treatment is with an antitoxin. In those who lose their ability to breathe on their own, mechanical ventilation, potentially for months, may be required. Antibiotics may be used for wound botulism. Death occurs in 5 to 10% of people. Botulism can affect many other animals.