Preventing Botulism: Food, Wounds, Infants and Injections

Many cases of botulism can be prevented. Here is how, for each kind.

Foodborne botulism

Where it comes from

The common sources are homemade foods that were canned, preserved or fermented improperly. Store-bought foods are occasionally contaminated too. In Alaska, most foodborne botulism has come from fermented fish and other aquatic animals.

Newer sources have been found as well: chopped garlic in oil, canned cheese sauce (such as nacho cheese), carrot juice, and potatoes baked in foil — plus store-bought products stored improperly.

How to prevent it

Canning

• Follow safe home-canning instructions carefully, and take special care with low-acid foods, which are commonly linked to botulism. They include all fresh vegetables, figs, meat, poultry, fish, seafood and some tomatoes.
• Pressure canning is the only recommended method for low-acid foods.
• Store canned food properly.

Before eating

• Boil for 10 minutes — adding 1 minute for every extra 1,000 feet of elevation — before eating:
• • home-canned tomatoes and foods containing them;
  • all low-acid home-canned foods;
  • all home-fermented Alaska Native foods.
• Prepare Alaska Native foods by traditional methods.

Storing

• Refrigerate canned or pickled foods once the jar is open.
• Refrigerate homemade oils made with garlic or herbs, and throw them away after 4 days.
• Keep potatoes baked in foil at 140 °F or hotter until served, or refrigerate them at 40 °F or colder with the foil loosened so air can reach them.

Don't drink pruno, the homemade alcohol some people make in jails and prisons.

If in doubt, throw it out

• Don't eat food if you don't know whether it was safely canned, preserved or fermented.
• Don't eat home-canned or store-bought food if the food or its container shows signs of contamination.

You cannot see, smell or taste botulinum toxin, and even a small taste of contaminated food can be deadly.

Wound botulism

People who inject illicit drugs, such as black tar heroin, are more likely to get wound botulism, and so are people who have had a traumatic injury, such as a motorcycle crash, or surgery.

• Keep wounds clean.
• Get medical care quickly if a wound looks infected — red, swollen, painful, warm, or oozing pus or other fluid — or if you have a fever.
• Remember that a wound can cause botulism even if it does not look infected.
• Not injecting illicit drugs prevents wound botulism.

Infant botulism

The bacteria live in soil and dust, and can be found inside homes — on floors, carpets and countertops — even after cleaning. Infant botulism happens when spores get into a baby's intestines, grow and make toxin. Sadly, most cases cannot be prevented.

What is known: honey is not safe for babies, because it can contain the bacteria.

• Don't give honey to a child under 1 year old — including honey pacifiers or other products made with honey. Several babies in Texas got infant botulism after using honey pacifiers.

Iatrogenic botulism

This can happen when too much botulinum toxin is injected, for cosmetic reasons such as wrinkles or medical ones such as migraines.

• Ask whether your provider is licensed and trained to give the injection. Your state may have a look-up tool for licences — and, where required, for the setting, such as a spa or clinic.
• Ask whether the product is FDA-approved and from a reliable source.
• If in doubt, don't get the injection.

Adult intestinal colonization

Also called adult intestinal toxemia, this is a very rare kind of botulism; people whose health conditions affect the gut may be at higher risk. Only a handful of people have been diagnosed with it, and scientists do not fully understand how it happens. It may resemble infant botulism, which cannot be prevented.

Sources

• Centers for Disease Control and Prevention, "Botulism Prevention." https://www.cdc.gov/botulism/prevention/index.html
• Further guidance: the USDA Complete Guide to Home Canning; CDC's pages on home-canned foods, Alaska Native foods, pruno, injection drug use and wound botulism, and botulinum toxin injections.
• Rewritten in hubnx's own words.