Type-H botulism toxin: Simply sniffing it at a dose of 13-billionths of a gram can be lethal
A single gram of crystalline toxin, evenly dispersed and inhaled, can kill more than one million people. (source)
When we talk about botulism we usually think about very young children eating contaminated honey, someone getting sick from improperly home canned food or botox injections. Well botulism can live in soil and can infect wounds…it is also a very decent candidate for bio-terrorism and bio-warfare.
There are three main kinds of botulism:
Food borne botulism
Food-borne botulism occurs when a person ingests pre-formed toxin that leads to illness within a few hours to days. Food-borne botulism is a public health emergency because the contaminated food may still be available to other persons besides the patient. It is commonly caused by eating incorrectly processed home canned food or using blown or damaged cans of commercially canned food. Botulism thrives in anaerobic conditions which is why good home canning practices and not using damaged commercially canned food is so important.
Symptoms begin within 6 hours to 10 days (most commonly between 12 and 36 hours) after eating food that contains the toxin.
Symptoms of botulism include:
- double vision
- blurred vision
- drooping eyelids
- slurred speech
- difficulty swallowing
- dry mouth
- muscle weakness that moves down the body, usually affecting the shoulders first, then the upper arms, lower arms, thighs, calves, etc.
- Paralysis of breathing muscles can cause a person to stop breathing and die, unless assistance with breathing (mechanical ventilation) is provided.
Occurs in a small number of susceptible infants each year who harbor C. botulinum in their intestinal tract or contract the disease from foods such as raw honey which is known to harbour the bacteria.
Wound botulism is uncommon and occurs when wounds are infected with C. botulinum that secretes the toxin. The bacteria can live in soil and this is often a way the bacteria enters the wound.
Botulism is not spread from one person to another. Food-borne botulism can occur in all age groups.
Anti-toxin is required to treat all types of botulism and quick treatment is required to prevent the creeping paralysis and death. Most countries keep a central supply of anti-toxin that can be dispatched in the event of an outbreak. Recovery can take many months and breathing difficulties may not fully resolve. Antibiotics will also be prescribed in some cases though protocols differ on the usefulness of the drugs outside of treating wound botulism. You can read an excellent overview of botulism here.
Botulism as a bio-agent
Quite simply it’s easy to prepare, easy to transport and is so lethal its classed as a Category A bio-agent. The categories are defined by the CDC as follows:
Bio-terrorism Agent Categories
Bio-terrorism agents can be separated into three categories, depending on how easily they can be spread and the severity of illness or death they cause. Category A agents are considered the highest risk and Category C agents are those that are considered emerging threats for disease.
These high-priority agents include organisms or toxins that pose the highest risk to the public and national security because:
- They can be easily spread or transmitted from person to person
- They result in high death rates and have the potential for major public health impact
- They might cause public panic and social disruption
- They require special action for public health preparedness.
These agents are the second highest priority because:
- They are moderately easy to spread
- They result in moderate illness rates and low death rates
- They require specific enhancements of CDC’s laboratory capacity and enhanced disease monitoring.
These third highest priority agents include emerging pathogens that could be engineered for mass spread in the future because:
- They are easily available
- They are easily produced and spread
- They have potential for high morbidity and mortality rates and major health impact.
So concerned is the CDC that it lists FIVE related Botulism and bio-terrorism resources regarding public health management responses on it’s information for health care workers page.
It seems inconceivable that something that small could kill one million people if it was dispersed in the correct fashion.
Sadly there are several other Category A bio-agents we need to be aware of. Some I’ve covered and the rest I will be working my way through in the days to come. In the meantime here’s a list:
- Bacillus anthracis (anthrax)
- Clostridium botulinum toxin (botulism)
- Yersinia pestis (plague)
- Variola major (smallpox) and other related pox viruses
- Francisella tularensis (tularemia)
- Viral hemorrhagic fevers/Arenaviruses
- Hantaviruses causing Hanta Pulmonary syndrome, Rift Valley Fever, CrimeanCongoHemorrhagic Fever
- Marburg agents
Just to complete the ruination of your day I strongly suggest you read this:
A newly discovered botulinum toxin, now the eighth family of the protein to be discovered by scientists, has been called the deadliest substance ever known. Because no antidote has yet been created, the gene sequence behind the protein remains a secret, as the researchers who discovered it fear it could fall into the wrong hands.
The new toxin has been classified as botulinum toxin H. Up until its discovery, scientists had established botulinum toxins A-G, which all have corresponding antidotes to protect infected people from developing a potentially lethal case of botulism. The root bacteria, Clostridium botulinum, has the devastating ability to block acetylcholine production — the chemical that enables muscle function — and render the sufferer paralyzed, a condition that often leads to death.
The new type H toxin was found in the feces of a child with the disease, according to Stephen Arnon and his colleagues at the California Department of Public Health in Sacramento. They reported their results this week. The toxin is so deadly, in fact, that simply sniffing it at a dose of 13-billionths of a gram can be lethal. Worse, an injection of only 2-billionths of a gram can kill. For comparison, arsenic, one of the most popular fatal poisons, is lethal at only one-tenth of a gram.
Traditional antibodies were only mildly effective at degrading the toxin, and no protective effects were observed when experimenters administered types A-G antibodies to mice or rabbits with the type H toxin.
This is the first time scientists have withheld the gene sequence of a newly discovered substance. Normal protocol dictates researchers publish the data in a public database, called GenBank, but because the toxin is so lethal, it was decided the move was too risky. (source)
In an increasingly unstable world it pays to stay as far ahead of the crowd as we can. Knowledge about how these diseases present, and what treatment is required may help us deal with an outbreak and cope with the aftermath of such an outbreak, be it natural, accidental or deliberate. Like most pathogens if it doesn’t get inside you it can’t affect you but with something invisible that you can inhale if you are ‘in the zone’ it’s all but impossible to avoid. If you are elsewhere then the answer is to stay indoors and eat the food and drink the water that you have stashed, avoiding fresh food that may be contaminated until the outbreak is over.
If you pull a tin out of the larder that is blown, rusted or damaged in any way dump it, it simply isn’t worth the risk. If you home can your food follow the processing times religiously, the lives of your family are at stake if you don’t.
Raw honey is known to give rise to infantile botulism, don’t give babies and toddlers honey in any form. Follow the age guidelines in your country.
Just pray that it’s only the small natural outbreaks we have to contend with.
Here are a few other major threats we face: