The fatality rate for botulinum poisoning 1950-1996 was 15.5%, compared with approximately 60% over the last 50 years. Death is usually secondary to respiratory failure due to paralysis of respiratory muscles, so treatment consists of antitoxin administration and artificial respiration, are excreted or metabolized by the neurotoxins. If initiated in time, these treatments are very effective, although antisera not affect BoNT polypeptides that have already entered cells. Occasionally, functional recovery may take several weeks to months or longer.
There are two primary botulinum antitoxin is available for the treatment of botulism. Trivalent (A, B, E) botulinum antitoxin from horses to use sources of whole antibodies (Fab & Fc portions) are derived. The antitoxin is available from the local health department via the CDC in the USA.The second antitoxin is heptavalent (A, B, C, D, E, F, G) Botulinum Antitoxin which is derived from "despeciated" equine IgG antibodies, which had the Fc portion cleaved off leaving the F (ab ') 2 servings. This is a less immunogenic antitoxin that effective against all known strains of botulism where not contraindicated. This is from the United States Army is available. On 1 June 2006, the United States Department of Health and Human Services awarded $ 363 million contract with Cangene Group for 200,000 doses of heptavalent botulinum antitoxin over five years for the Strategic National Stockpile delivery to the beginning in 2007.


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