Case Study 11

The hot zone project notes
Case study 11
      Infectious diseases are the terrorists of the natural world. Most of them, though, quite frankly, aren't very good at inspiring terror. The common cold? An annoyance, but not a terror. The chicken pox? Itchy, but not terrifying. Even a nasty flu is rarely more than acute unpleasantness. But then there are the few that really stand out, the diseases that make us all a little more appreciative of our health and a little more respectful of the microbial world.
Today we are going to talk about botulism. Botulism is the handiwork of the common soil bacteria Clostridium botulinum. The bacteria can be spread through food contaminated with the bacteria or its spores, or through an open wound.
      Once in the body, the bacteria start producing the toxin and things get messy. Within a day or two, neurological symptoms appear, including slurred speech, blurred vision and trouble breathing. Muscles get weaker, reflexes stop working, limbs get paralyzed. Eventually, the diaphragm and other breathing muscles stop working, causing death. Antitoxin and antibiotics can halt the disease's progress, if administered in time, but it can take months to fully recover from the paralysis.
      Mary Goodright was a mom of two strong healthy boys that were real active in football and mostly all sports. She is 32 and has a wonderful husband. They lived in Fort Collins, Colorado. One night, Mary's husband took her out to dinner for their anniversary. They went to this fancy restaurant, Mary's favorite place. They go there every year for their anniversary and Mary didn't love anything better than to go eat sea food for their anniversary.
      Mary ordered an entree of caviar and her husband ordered crab legs. Next they shared a triple chocolate chocolate cake. Mary had a wonderful time, it couldn't have been any better. The very next day was busy for Mary, it was a Monday. Mary drop of the kids at school, pick up a coffee at Starbucks, and headed for work. She work for a realtor company, she was the secretary and she loved everything about work. When she showed up for work she went to the bathroom to freshen up a bit. When she walked in she felt really nauseous, she thought she was seeing double, and it was really blurry.
      Her boss notice something was wrong, Mary thought it was just food poisoning. Mary's boss asked if she was ok, but Mary couldn't stop vomiting. Something was really wrong thought Mary's boss, so she called Mary's husband. When he showed up Mary was still in the bathroom just laying on the floor. She was pale and looked really weak. Mary said to called the ambulance, but all her husband herd was gibberish. But he could make out call, so that's exactly what he did.
When they got to the hospital the doctor had no idea what to say. Mary looked even worse than what she did at the company. When the doctor looked at Mary he thought that she had Myasthenia Gravis which also causes weakness and eyelid drooping. The doctor decided that she might have a really bad case of Myasthenia Gravis, so he decided to test for just Myasthenia Gravis. As he was about to leave the room Mary started making a lot of noise moving around on the bed. She was having a stroke, which is one of the signs of botulism. As the nurses we're taking care of Mary as best as they could, he told her husband that it would be best to run some test for both.
      They decided to do a brain test, spinal fluid examination, nerve conduction test, and a tensilon test for Myasthenia Gravis. After the tests came back, it was positive that she had a serious case of Botulism and they needed to get her on some antibiotics quick. They put her on a antitoxin that blocks the action of neurotoxin circulating in the blood. The CDC was the only place that offered the treatment so the flew Mary there and started her treatment in a quarantine station. They did the treatment for many weeks but nothing was getting better. She had no side effects to the treatment, its just the disease kept her so nauseous that she couldn't keep the medicine down.
      Mary's family had a decision to make, either stop the treatment or let their mom live in quarantine for the rest of her life with the medication. Mary was paralyzed from the waste down, she could barely write but that's the only way she could communicate. She left it up to her trusting husband for what to do. Mary started reflecting back on her wonderful life she remembers the births of her two boys, her marriage, her childhood, and everything that was important to her. Her husband told the nurses to shut everything down and let her die in peace, and that she would like that.
      He told her what he was doing and that he was sorry, but when he looked at Mary with his tear felt eyes she was shaking her head no. Like she understood like it was her time to go, that the disease and the medicine fighting against each other was to much for her body. After saying his goodbye, her husband went home to his boys. The next day he got a phone call, Mary has passed. The botulism eventually went and paralyzed her whole body through the night. It was on the move, nothing they could have done would have helped. Mary now rests in peace.
      The investigation on Mary was difficult but the figured out it was in the caviar she ate the big before. One of the most common ways to get botulism is in canned food that's not canned properly. They tested Mary's husband but he was negative. Other serious cases came up from the same restaurant, but it was different foods the people ate. No serious defense was taken against the restaurant from the Goodright family.