The second antitoxin, heptavalent (A,B,C,D,E,F,G) botulinum antitoxin, is derived from "despeciated" equine IgG antibodies which have had the Fc portion cleaved off leaving the F(ab)2 portions. This less immunogenic antitoxin is effective against all known strains of botulism where not contraindicated. Prognosis
The paralysis caused by botulism can persist for 2 to 8 weeks, during which supportive care and ventilation may be necessary to keep the person alive. Botulism can be fatal in 5% to 10% of people who are affected. However, if left untreated, botulism is fatal in 40% to 50% of cases.Infant botulism typically has no long-term side effects but can be complicated by treatment-associated adverse events. The case fatality rate is less than 2% for hospitalized babies. Epidemiology
Globally, botulism is fairly rare, with approximately 1,000 identified cases yearly. United States
In the United States an average of 145 cases are reported each year. Of these, roughly 65% are infant botulism, 20% are wound botulism, and 15% are foodborne. Infant botulism is predominantly sporadic and not associated with epidemics, but great geographic variability exists. From 1974 to 1996, for example, 47% of all infant botulism cases reported in the U.S. occurred in California.Between 1990 and 2000, the Centers for Disease Control and Prevention reported 263 individual foodborne cases from 160 botulism events in the United States with a case-fatality rate of 4%. Thirty-nine percent (103 cases and 58 events) occurred in Alaska, all of which were attributable to traditional Alaska aboriginal foods.
Retrobulbar bleeding, also known as retrobulbar hemorrhage, is when bleeding occurs behind the eye. Symptoms may include pain, bruising around the eye, the eye bulging outwards, vomiting, and vision loss.Retrobulbar bleeding can occur as a result of trauma to the eye, surgery to the eye, blood thinners, or an arteriovenous malformation.In those with significant symptoms lateral canthotomy with cantholysis is indicated. This is recommended to be carried out within two hours. The condition is rare. == References ==