Botulism antitoxin for patients with signs and symptoms of
human
foodborne or wound botulism is released to physicians by CDC from
its
quarantine stations located throughout the United States. Any
health-care provider requesting botulism antitoxin should first
contact his/her state health department. A list of daytime and
24-hour telephone numbers (if available) is published to assist
those
seeking botulism antitoxin (Table 2). If the state health
department
is unreachable during nights or on weekends, CDC may be called at
(404) 329-2888 (24-hour number)
When botulism is suspected, a careful food history, especially
for
home-canned vegetables or fruits, should be sought, and the
suspected
food items, saved. Stool and serum should be obtained from
patients
with possible botulism and refrigerated. Electromyography should
be
done using repetitive stimulation at 40 Hz or greater. When
indicated, cerebrospinal fluid should be examined for white blood
cells and protein, and a Tensilon challenge test should be done.
The
patient's vital capacity should be monitored. The results of these
tests are helpful in evaluating the need for botulism antitoxin.
Reported by Enteric Diseases Br, Div of Bacterial Diseases, Center
for
Infectious Diseases, CDC.
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