Prevention of botulism depends on proper sterilization and sealing of food at the time of canning. Fortunately, the toxin is heat-labile, and heating food to 100°C for 15 minutes just prior to serving generally makes it safe to eat. One cannot rely on a spoiled smell, taste, or appearance to detect contamination, because such changes are not always present. The disease is treated by the intravenous administration of antitoxin as soon as possible after the diagnosis is made. The antitoxin, however, only neutralizes toxin circulating in the bloodstream, and the nerves already affected by it recover slowly, over weeks or months. Enemas, gastric washing, and surgical removal of dirt and dead tissue from infected wounds help remove any unabsorbed toxin. Artificial respiration may be required for prolonged periods.
The main features of botulism are presented in table 26.4.
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