## 4 Results and Discussion
### The Biomolecular Toxicity and Activity of Botulinum Neurooxins (BoNTs)
Initial symptoms include fatigue, weakness, and dizziness followed by obvious cranial nerve dysfunction IX, X, XI, and XII with blurred vision due to dilation of the pupil, diplopia, and photophobia, drooping eyelids with symptoms of difficulty in articulation and speech. Symptoms may include vomiting, diarrhea or constipation, and bloating [30]. This is followed by paralysis of skeletal muscles such as those of the arms and legs with symmetrical progressive weakness. The completion of the symptomatology is sudden respiratory failure (Figure 2) [30; 31]. Food botulism case control measures provide treatments that prevent germination and toxin genesis or, secondly, the inactivation of the already produced toxins (heat treatment at a core temperature of at least 85 \({}^{\circ}\)C for 10 min). The treatments consist of (a) acidification by acid fermentation or the addition of acidifiers in order to obtain a final pH < 4.5; (b) addition of solutes such as salt or sugar until reaching a value of free water (Aw) <0.935 (10% NaCl brine), (c) additives and preservatives (nitrites, polyphosphates, sorbic acid, nisin, etc. ), and (d) industrial sterilization (121 \({}^{\circ}\)C \(\times\) 15 min) for all those foods that cannot be subjected to the indicated treatments. To obtain the same effect as industrial sterilization, the product must be boiled for 7-10 h [32; 33]. The second clinical form concerns botulism from a wound. This case is particularly rare and occurs when endospores of _C. botulinum_ enter from an open wound that causes discontinuity of the skin. The active strains are converted and under anaerobic conditions secrete botulinum toxins. Here, the symptoms appears slowly and can start even after two weeks. Wound botulism arises with the same symptoms of neurological involvement  
Figure 2: The development of clinical symptoms in an intoxication from BoNTs. present in food, with progressive paralysis starting from the injection site, but there are no symptoms affecting the gastrointestinal system. Such cases have occurred in drug addicts and especially in people who injected acetylated heroin (black tar) [34; 35]. Infant botulism is a syndrome caused by neurotoxic Clostridia such as _C. botulinum_ and more rarely _C. butyticum_ or _C. bartii_. They receive _C. botulinum_ endospores with food, which germinate and then turn into active strains, which form colonies in the gastrointestinal tract and thus release the toxin [36]. Thanks to the immaturity of the intestinal microbiota and therefore of competition that leads to bacterial dysbiosis, the spores can germinate, multiply, temporarily colonize the intestinal lumen in the colon, and produce the neurotoxin in situ. This cannot occur in adults and children under six months of age as the body's natural defenses prevent the endospores from turning into active bacteria. Since spores of neurotoxic Clostridia are normally present in all types of environments, both terrestrial and aquatic, soil and dust play have a critical role as a source of Clostridia for newborns [36; 37]. Such incidents have occurred also in cases of honey contaminated with endospores _C. botulinum_, which is why there is a clear warning to parents and caregivers not to feed honey to infants under one year. The study of cases of infant botulism has made it possible to correlate the onset of the infection with the inhalation of spores present in the environment surrounding the newborn. Clinical presentation is the same as for adults and the intestinal mucosa is not affected by the infection. The clinical diagnosis for infant botulism depends on a careful examination of symptoms such as neurological ones (lethargy and muscular flaccidity, mydriasis) and on characteristic elements such as the absence of fever and integrity of the sensory functions. During the illness, the child's state of consciousness remains intact, and the central nervous system is not affected, while the possible appearance of fever is a consequence of concomitant infections.