Editing Botulinum toxin (section)

==Role in disease==
{{Main|Botulism}}

Botulinum toxin produced by ''[[Clostridium botulinum]]'' (an anaerobic, gram-positive bacterium) is the cause of botulism.<ref name=Shukla2004/><ref>{{Cite web |title=Botulism |url=https://www.who.int/news-room/fact-sheets/detail/botulism |access-date=2023-05-18 |website=www.who.int |language=en}}</ref><ref>{{Cite web |date=2021-06-01 |title=About Botulism {{!}} Botulism {{!}} CDC |url=https://www.cdc.gov/botulism/general.html |access-date=2023-05-18 |website=www.cdc.gov |language=en-us}}</ref> Humans most commonly ingest the toxin from eating improperly canned foods in which ''C.&nbsp;botulinum'' has grown. However, the toxin can also be introduced through an infected wound. In infants, the bacteria can sometimes grow in the intestines and produce botulinum toxin within the intestine and can cause a condition known as [[floppy baby syndrome]].<ref>{{cite web |url=https://www.cdc.gov/botulism/definition.html |title=Kinds of Botulism |publisher=U.S. [[Centers for Disease Control and Prevention]] (CDC) |access-date=4 October 2016 |archive-date=5 October 2016 |archive-url=https://web.archive.org/web/20161005195008/http://www.cdc.gov/botulism/definition.html |url-status=live }}</ref> In all cases, the toxin can then spread, blocking nerves and muscle function. In severe cases, the toxin can block nerves controlling the respiratory system or heart, resulting in death.<ref name=Montecucco2005/>

<!--Diagnosis & Treatment-->
Botulism can be difficult to diagnose, as it may appear similar to diseases such as [[Guillain–Barré syndrome]], [[myasthenia gravis]], and [[stroke]]. Other tests, such as brain scan and spinal fluid examination, may help to rule out other causes. If the symptoms of botulism are diagnosed early, various treatments can be administered. In an effort to remove contaminated food that remains in the gut, enemas or induced vomiting may be used.<ref name=CDCTreat>{{cite web |url=https://www.cdc.gov/botulism/testing-treatment.html |access-date=5 October 2016 |title=Botulism – Diagnosis and Treatment |publisher=U.S. [[Centers for Disease Control and Prevention]] (CDC) |archive-date=5 October 2016 |archive-url=https://web.archive.org/web/20161005200323/http://www.cdc.gov/botulism/testing-treatment.html |url-status=live }}</ref> For wound infections, infected material may be removed surgically.<ref name=CDCTreat/> Botulinum antitoxin is available and may be used to prevent the worsening of symptoms, though it will not reverse existing nerve damage. In severe cases, mechanical respiration may be used to support people with respiratory failure.<ref name=CDCTreat/> The nerve damage heals over time, generally over weeks to months.<ref>{{Cite web |title=Botulism - Diagnosis and treatment |url=https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266 |access-date=1 November 2023 |website=Mayo Clinic |archive-date=1 November 2023 |archive-url=https://web.archive.org/web/20231101010856/https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266 |url-status=live }}</ref> With proper treatment, the case fatality rate for botulinum poisoning can be greatly reduced.<ref name=CDCTreat/>

Two preparations of botulinum antitoxins are available for treatment of botulism. Trivalent (serotypes A, B, E) botulinum [[antitoxin]] is derived from equine sources using whole [[antibodies]]. The second antitoxin is [[heptavalent botulism antitoxin|heptavalent botulinum antitoxin]] (serotypes A, B, C, D, E, F, G), which is derived from equine antibodies that have been altered to make them less immunogenic. This antitoxin is effective against all main strains of botulism.<ref>{{cite journal |vauthors = Barash JR, Arnon SS |title = A novel strain of Clostridium botulinum that produces type B and type H botulinum toxins |journal = The Journal of Infectious Diseases |volume = 209 |issue = 2 |pages = 183–191 |date = January 2014 |pmid = 24106296 |doi = 10.1093/infdis/jit449 |doi-access = |title-link = doi }}</ref><ref name=BotH/>