CLOSTRIDIUM BOTULINUM

Prepared for NZFSA by ESR Ltd. 1 Issued July 2010
Clostridium botulinum is one of the most important pathogens associated with food. The organism forms spores that are
resistant to many common food process controls. Botulinal neurotoxins (BoNT) produced by vegetative cells of this Gram
positive, anaerobic bacterium are among the most potent biological neurotoxins known. Foodborne botulism is a very severe intoxication, historically caused by eating preserved low acid, low oxygen foods (e.g. canned vegetables, meat and fish) in which C. botulinum had grown and produced BoNT.
More information: http://www.foodsafety.govt.nz/elibrary/industry/Clostridium_Botulinum-Neurotoxins_Produced.pdf
 

Articles - Botulism

1. An Assessment of Nurses' Knowledge of Botulism
By Bork, Christopher E.; Rega, Paul P. Public Health Nursing. Mar/Apr2012, Vol. 29 Issue 2, p168-174
Abstract:  To assess nurses' knowledge of botulism, a Centers for Disease Control Category A bioterrorism agent, one case of which constitutes an emergency. Design The study utilized survey research. Sample The cluster sample included 1,414 registered nurses. 
Results The mean percentage of correct answers for the sample was 25.95%, with a standard deviation ( SD) of ±19.89%. Only 90 (6.3%) achieved 60% or more correct. Educational preparation, experience, specialty/area of practice and whether nurses had a class in disaster medicine were also examined and although differences were noted, none of these factors accounted for a score of 60% or above. Conclusions The results of this study indicate the need for an assessment of the current education nurses receive about botulism.[ABSTRACT FROM AUTHOR] .

2. Botulism Questionnaire: A tactical tool for community use in a mass casualty incident
By Burkholder-Allen, Kelly; Rega, Paul; Bork, Christopher; Budd, Churton. Nursing & Health Sciences. Dec2009, Vol. 11 Issue 4, p374-377
Abstract:  A botulism-induced mass casualty incident has the potential to severely compromise a community's health-care infrastructure, based upon its lethality, rare occurrence, and duration of symptoms, which require extensive support and care. Although early recognition and treatment with antitoxin or botulism immunoglobulin are essential to the effective management of this type of an incident, the two major challenges in recognition and treatment are the hundreds, if not thousands, of casualties or potential casualties requiring rapid screening and the fact that most clinicians remain ignorant of the management of botulism. The purpose of this article is to present the Botulism Questionnaire, which will assist with the screening of casualties, provide educational and diagnostic cues for clinicians and the lay public, and create a layer of protection for the health-care infrastructure. The applications of this questionnaire in various formats, the numerous points of distribution, and the variety of platforms from which it can be launched will be explored.[ABSTRACT FROM AUTHOR] .

3. Foodborne Botulism in Canada, 1985-2005
By Leclair, Daniel; Fung, Joe; Isaac-Renton, Judith L.; Proulx, Jean-Francois; May-Hadford, Jennifer; Ellis, Andrea; Ashton, Edie; Bekal, Sadjia; Farber, Jeffrey M.; Blanchfield, Burke; Austin, John W. Emerging Infectious Diseases. Jun2013, Vol. 19 Issue 6, p961-968. 8p
Abstract:  During 1985-2005, a total of 91 laboratory-confirmed outbreaks of foodborne botulism occurred in Canada; these outbreaks involved 205 cases and 11 deaths. Of the outbreaks, 75 (86.2%) were caused by Clostridium botulinum type E, followed by types A (7, 8.1%) and B (5, 5.7%). Approximately 85% of the outbreaks occurred in Native communities, particularly the Inuit of Nunavik in northern Quebec and the First Nations population of the Pacific coast of British Columbia. These populations were predominantly exposed to type E botulinum toxin through the consumption of traditionally prepared marine mammal and fish products. Two botulism outbreaks were attributed to commercial ready-to-eat meat products and 3 to foods served in restaurants; several cases were attributed to non-Native home-prepared foods. Three affected pregnant women delivered healthy infants. Improvements in botulism case identification and early treatment have resulted in a reduction in the case-fatality rate in Canada.[ABSTRACT FROM AUTHOR] .

Articles - Staffing Levels

4. RCN guidance defines safer level of children's nurses on wards
Nursing Children & Young People. Jul 2013, Vol. 25 Issue 6, p5-5 (1/3p)
Abstract: The article reports on the Royal College of Nursing's (RCN) guidance which established safe staffing levels for children and young people's nurses in Great Britain..

5. Are NHS trusts finally getting the message about safe staffing levels?
By Keogh, Kat. Nursing Standard. 6/12/2013, Vol. 27 Issue 41, p12-13
Abstract: Faced with evidence of declining nurse numbers and high-profile failures in care quality, some NHS organisations are taking action. Kat Keogh reports.[ABSTRACT FROM AUTHOR] .

6. Safe staffing: critical to care
Australian Nursing Journal. May 2013, Vol. 20 Issue 10, p26-29 (4p)
Abstract: The article reports on research which has investigated the benefits of proper nurse-patient ratios in hospitals and discusses the work that the Australian Nursing Federation is doing to have safe staffing levels for nurses and midwives implemented in Australian health care facilities. Safe staffing ratios which have been mandated in the state of California in the U.S. and in several Australian states are discussed..

Articles - Nursing Older people [Journal]

7. Pain is under-recognised and treated in older people
By Triggle, Nick. Nursing Older People. Jun 2013, Vol. 25 Issue 5: p6-7
Abstract: The article discusses the poor control of pain in older people, and highlights the guidance on management of pain produced by the British Pain Society (BPS) and British Geriatrics Society (BGS). It states that older people do not always report pain and there is a lack of evidence on success of drug interventions in managing pain. Also presented is a summary of guidance on managing pain which include information on complementary therapy, psychological interventions, and drugs to be used.

8. Raising awareness to support people with dementia in hospital
By Duffin, Christian. Nursing Older People. Jun 2013, Vol. 25 Issue 5, p14-17
Abstract: One quarter of patients in UK hospitals has dementia and the number is growing. This article explores initiatives at Guy's and St Thomas' NHS Foundation Trust in London to raise staff awareness of dementia and highlight what good care of all older patients should involve. The aim is that all 12,500 staff will watch Barbara's Story, a film devised by a nurse at the trust about a woman with dementia and her experiences during a hospital visit, and attend related training sessions. Older people's wards at the trust have also been refurbished to create a dementia-friendly environment.

9. Factors that contribute to the diversion of patients from long-term care
By Lees, Liz; Dowling, Ciara; Day, Mary. Nursing Older People. Jun 2013, Vol. 25 Issue 5, p19-24
Abstract: This service evaluation aimed to identify the factors at an interim care unit that contributed to the diversion of patients from long-term care to care at home. Patients and relatives cited having extra time in the unit to adjust, with staff encouragement and persistence to tackle their main problems, in addition to achieving seamless care at home and the ability to envisage a life after hospital. The staff workshops revealed attitudes that supported patient empowerment, shared decision making and patient-centred solutions.

10. Assessment and management of patients with acute red eye
By Watkinson, Sue. Nursing Older People. Jun 2013, Vol. 25 Issue 5, p27-35
Abstract: This article provides an overview of the role of the nurse in the assessment and management of five ocular conditions that give rise to an acute red eye in older people. The conditions discussed are acute closed angle glaucoma, acute iritis, acute conjunctivitis, herpes zoster ophthalmicus and bacterial corneal ulcer.

Journal - Table of Contents

11. From Journal of Infection Prevention July 2013
Editorial
11A. The only constant in infection prevention is change…
Report
11B. Publication of the IPS audit and surveillance competences
Peer Reviewed Articles
11C. A systematic evaluation of a peracetic-acid-based high performance disinfectant
11D. An international survey of bacterial contamination and householders’ knowledge, attitudes and perceptions of hygiene
Opinion/Comment
11E. Outbreak Column 9: Endoscopy-related outbreaks

Conferences

12. Determinants of Health and Wellbeing workshop
Date:  20th September, 2013.
Venue: Dunedin
More information: www.hauora.co.nz/workshops.html

13. 16th Annual Australasian Nurse Educators Conference 2013
Venue: Te Papa, Wellington
Date: 9 - 11 October 2013
More information: http://www.nursed.ac.nz/

News - National

14. Botulism: what you need to know
Botulism is one of the most lethal forms of food poisoning. The bacteria, which grow best without oxygen, live and multiply very quickly in preserved and canned foods. The most common cause of botulism is poorly processed foods which are then vacuum sealed. But despite this, botulism is very rare in New Zealand. Capital & Coast District Health Board infectious diseases specialist Dr Tim Blackmore said that in the Fonterra case given the time since the contamination and that no cases had been reported, it was unlikely the bacteria would still pose a risk
http://www.stuff.co.nz/waikato-times/business/9003438/Botulism-
what-you-need-to-know

15. Spotlight on future of housing for elderly
Taranaki Daily News - 5 August 2013
Housing for some of New Plymouth's elderly residents is set for a shake-up that could result in the sale of 145 council-owned units valued about $11.9 million. New Plymouth District Council Housing for the Elderly programme is under the spotlight as part of ongoing attempts to save money, but no decision on the units' future is likely until after public consultation next year
http://www.stuff.co.nz/taranaki-daily-news/news/9001845/Spotlight
-on-future-of-housing-for-elderly

News - International

16. Fonterra finds botulism bacteria in dairy ingredient
New Zealand's Fonterra , the world's largest dairy exporter, said on Saturday it had found bacteria which can cause botulism in some of its dairy products, prompting Chinato recall affected products New Zealand authorities said they were holding back some widely used infant formula products from supermarket shelves
http://www.worldbulletin.net/?aType=haber&ArticleID=114511

17. Electronic cigarettes: How they work, how they're regulated and who smokes them
Calgary Herald - 4 August 2013
The battery-powered devices made of plastic or metal heat a liquid nicotine solution, creating vapour that users inhale. Some models are disposable, and some are designed to be refilled with cartridges containing what enthusiasts call "smoke juice." Some e-cigarettes are made to look like a real cigarette with a tiny light on the tip that glows like the real thing.
http://www.calgaryherald.com/health/Electronic+cigarettes+they+
work+theyre+regulated+smokes+them/8748268/story.html

18. Research contradicts claim private health rebates reduce health costs
The Age - July 31, 2013
The savings produced by cutting the private health insurance rebate would be greater than the increase in public hospital spending such a change would cause, and the rebates should be removed, according to a paper to be released on Wednesday.
http://www.theage.com.au/federal-politics/federal-election-
2013/research-contradicts-claim-private-health-rebates-reduce-
health-costs-20130731-2qyaa.html