Botulism: Treatment Overview for Clinicians
- Prompt diagnosis and early treatment are essential.
- Botulinum antitoxin should be administered as soon as possible. Antitoxin does not reverse paralysis but arrests its progression.
- Medical care providers who suspect botulism in a patient should immediately call their state health department’s emergency 24-hour telephone number.
- The state health department will contact CDC to report suspected botulism cases, arrange for a clinical consultation by telephone and, if indicated, request release of botulinum antitoxin. State health departments should call the CDC 24-hour telephone number at 770-488-7100. The call will be taken by the CDC Emergency Operations Center, which will page the Foodborne and Diarrheal Diseases Branch medical officer on call.
- Before administration of antitoxin, skin testing should be performed for sensitivity to serum or antitoxin.
- After skin testing, administration of one vial of antitoxin IV is recommended. There is no need to re-administer the antitoxin since the circulating antitoxins have a half-life of 5-8 days.
- Meticulous intensive care should be exercised, including monitoring of respiratory function and when required, artificial ventilation.
- Recovery follows the regeneration of new neuromuscular connections.
- 2-8 weeks duration of ventilatory support may be required in more severe cases.
- Based on limited information, there is no indication that treatment of children, pregnant women, or immunocompromised persons with botulism should differ from standard therapy.
- Clinicians caring for patients with suspected botulism should immediately contact the organizations and officials listed below:
- Hospital epidemiologist or infection control practitioner
- Local and state health departments. If not available, contact the Centers for Disease Control and Prevention at 770-488-7100 (24/7).
- Consult your local telephone operator or the “government listings” section of your telephone book for phone numbers of the CDC or ASTHO websites: