A Descriptive Analysis of Wound Botulism - United States 1999-2014 Open Access

Brennan, Julia (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/0c483j95n?locale=en
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Abstract

Abstract

Purpose The primary objective of this paper is to describe the clinical features and geographic distribution of laboratory-confirmed wound botulism cases in the United States from 1999-2014. The secondary objective is to evaluate predictors of mechanical ventilation in confirmed cases of wound botulism.

Methods Using all laboratory-confirmed wound botulism cases from 1999-2014 from CDC's National Botulism Surveillance database I characterized clinical features and geographic distribution of wound botulism cases. Using a Firth logistic regression model, I evaluated predictors of mechanical ventilation.

Results From 1999-2014, 366 cases of laboratory-confirmed wound botulism occurred in the United States. Of those, 350 reported injecting illicit drugs. All cases occurred within 12 states, the majority of which were on the West Coast; California had 309 (84.4%) cases. The covariates associated with mechanical ventilation were facial paralysis and shortness of breath.

Conclusions Wound botulism cases in the United States are increasing alongside heroin use. The majority of patients have symmetric and normal strength and symmetric deep tendon reflexes. Facial paralysis and shortness of breath are predictors for mechanical ventilation and can help identify patients who need intensive respiratory monitoring and rapid treatment with botulinum antitoxin.

CDC disclaimer: The findings and conclusions in this report are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Table of Contents

Table of Contents

Table of Contents

List of Tables

List of Figures

Intro/Background and Significance……………………………………………………………1

Research methods ……………………………………………………………………………........3

Results…………………………………………………………………………………….…..............5

Discussion…………………………………………………………………………………….............10

Conclusion……………………………………………………………………………………............13

References…………………………………………………………………………………............…15

Tables and Figures……………………………………………………………………….............17

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