NCJ Number
191224
Journal
Journal of the American Medical Association Volume: 278 Issue: 5 Dated: August 6, 1997 Pages: 433-435
Date Published
1997
Length
3 pages
Annotation
This paper examines precautions taken on a global scale to deal with outbreaks of botulism.
Abstract
Botulism is a neuroparalytic disease cased by a neurotoxin produced from an anaerobic spore-forming bacterium known as Clostridium botulinum. Reports of terrorist groups stockpiling the toxin that can produce the lethal disease has raised concerns about global preparedness for an international episode of botulism poisoning. The Centers for Disease Control and Prevention (CDC) maintain intensive surveillance for cases of botulism in the United States. When foodborne, wound, or adult infectious botulism is suspected, antitoxin is released from CDC quarantine stations located in major cities. The CDC has an agreement with the Pan American Health Organization to supply botulism antitoxin to other countries in the Western Hemisphere, with the exception of Canada, which has its own supply. The U.S. surveillance and antitoxin release program depends on the maintenance of a sufficient supply of antitoxin. The CDC contracts for a guaranteed supply of antitoxin each year and the amount ordered varies minimally from year to year. There is no reliable source of antitoxin elsewhere in the world. As many as 17 countries, such as Iraq, are suspected of either including or developing biological agents in the weapons programs. The toxin can be spread through the use of explosive weapons or spraying from aircraft. Supportive care thought the rapid mobilization of mechanical ventilators would be the primary means of caring for patients exposed to botulism toxin. Antitoxin administration is effective in preventing the progression of illness and in shortening the duration of ventilatory failure in severe cases of botulism. Countries outside of the Western Hemisphere may be unprepared for either a foodborne outbreak or a botulism terrorism attack since there is no coordinated system for antitoxin release. A program similar to the U.S. Botulism Surveillance System could be adopted elsewhere in the world. An ideal system would have multinational funding and be coordinated through an international organization. Three to five antitoxin release sites could be designated throughout the world with a laboratory and technical support for each region. Such a program would improve international surveillance for botulism cases and serve as an early warning system for either a foodborne outbreak or an intentional terrorist attack.