Botulism is a specific type of food poisoning. Botulism is caused by the toxin (poison) produced by Clostridium botulinum, a germ which is related to the tetanus germ and prevalent everywhere. The botulism germ grows in anaerobic (no oxygen) environments (such as in tightly closed jars that were not properly sterilized). Its toxin can be destroyed if it is heated for ten minutes at 82° Ñ Botulism poisoning is primarily caused by improperly prepared canned or preserved foods that have not been adequately heated before they’ve been eaten. The foods most likely to cause poisoning are seafood, mushrooms, meat, and vegetables. The toxin and germs are undetectable. Foods contaminated with botulism look, smell, and taste normal.
With improvements in commercial food preparation and the decline in home canning in the first half of the 20th century, botulism had become a rare illness. With the increased interest in home canning and “natural” foods (those without preservatives), botulism is threatening a comeback.
Adults and children past infancy can be poisoned by botulism only if they eat food in which the botulism germ has already formed the toxin. Recent cases of fatal botulism among infants, however, suggest that the botulism germ can grow in an infant’s immature intestines to form the dangerous toxin within the infant’s body. The only natural food so far identified as a source of botulism germs for infants is honey. Therefore, you should not give honey to an infant. However, other raw or improperly cooked foods may eventually be identified as potential sources of the germ.
Signs and symptoms
Symptoms of botulism are nausea; vomiting; diarrhea; abdominal pain followed in 12 to 48 hours by double vision; dilated pupils; and difficulty speaking, swallowing, and breathing. There is no fever and no loss of awareness or alertness. Death may result.
Suspect botulism if your infant develops symptoms within a week of eating raw or home-prepared foods. Suspect the disease if more than one member of your family develops similar symptoms after eating the same prepared food. If symptoms of stomach or intestinal upset are followed by paralysis that starts at the eyes and moves downward, botulism may be the cause. Home diagnosis, however, is totally unreliable. Consult your doctor immediately if possible symptoms of botulism occur.
Home care
None. Call your doctor immediately if you suspect botulism.
Precautions
• Do not give babies unwashed, unpeeled raw foods or improperly cooked foods.
• Do not give honey to infants.
• Do not use foods in damaged or dented store-bought cans. Damaged cans may have developed leaks through which the botulism germ can enter the food.
• When canning or preserving foods at home, follow preparation and sterilization directions carefully.
Medical treatment
Diagnosis is made by cultures of the food eaten, stomach contents, and stools and by identifying the toxin in the patient’s blood. Treatment includes injection of the antitoxin (a substance that counteracts the effects of the poison). Stomach washing, laxatives and enemas, possibly antibiotics, and hospitalization may be necessary. Immunization to prevent botulism is available, but only for persons at high risk.
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Many manufacturers now provide nutritional information on food packages. These may be useful in planning the diet for the person with diabetes.
Here are two examples of package labels:
1. An individual serving may be described.
Nutriment composition per serving one serve as described on packet
Protein 3 g
Fat 2g
Carbohydrate 15 g
Kcals 90
Kjoules 378
From this label one serve would be equal to one carbohydrate exchange.
1. The description may refer to a certain amount of the food. Nutrient composition per 100 g of prepared food.
Protein 4g
Fat 6g
Carbohydrate 22 g
Kcals 158
Kjoules 664
From this label l00 g of food would provide approximately 1 1/2 carbohydrate exchanges. If an average serve weighs approximately 30 g, then it will provide 1/2 carbohydrate exchange.
This information helps you work out the number of carbohydrate exchanges per serve. Not all foods labeled in this way are suitable for regular use as they may have high sugar content. It is also important to read the ingredients labeling. Ingredients by law are listed in decreasing order. Inclusion of ingredients such as sugar, glucose, dextrose, and honey in large amounts may mean that the product should not be used under normal circumstances.
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