Fact Sheet - Botulism_BAT

Botulism Emergency: Botulism Antitoxin Heptavalent (BAT) to Treat Botulism
Emergency Use Instructions for Recipients
During a botulism emergency, you will be given a medicine called Botulism Antitoxin Heptavalent (BAT®) because
you have been exposed to botulism toxin and need treatment for your illness. Botulism causes paralysis and can be
deadly. Taking this medicine may reduce the progression of the illness. It is important to be treated as soon as you
have symptoms. If you have questions, talk to a doctor or healthcare provider about taking BAT.
What is Boutlism?
Botulism is a muscle-paralyzing disease caused by a toxin made by a germ called Clostridium botulinum. You can be
exposed to botulism toxin through food, a wound, or air (inhaled). Botulism can cause the following symptoms:
• Double vison
• Difficulty swallowing
• Blurred vision
• Dry mouth
• Drooping eyelids
• Difficulty breathing
• Slurred speech
• Muscle weakness that spreads through the body
Botulism can also cause paralysis and death. After a person is exposed to the toxin, problems can happen within as
little as 3 hours or as much as a few days. It can take weeks or months to get better. During this time, many people
need special care in the hospital.
What is BAT?
BAT is a botulism antitoxin made from the plasma of horses. It contains antibodies that can help to neutralize
botulism toxin(s). BAT is an FDA-approved medicine to treat symptoms of botulism after confirmed or suspected
exposure to Clostridium botulinum in adults and children. BAT contains antitoxins against all seven toxin serotypes A,
B, C, D, E, F, or G. Receiving BAT as quickly as possible from the start of illness may help to stop or lessen the
progression of the illness. BAT will not reverse paralysis, but it may help to slow down or prevent the spread of
paralysis, which can result in shorter hospital stays, less severe disease, and an increased chance of survival.
Who should NOT receive BAT?
You should not receive BAT if you have a known history of allergies to horses or horse blood products, asthma
or hay fever (seasonal allergies). A severe allergic reaction may include trouble breathing, swelling of your tongue or
lips, or a very fast heart rate. Talk to your doctor or public health official about other medicines available.
How is BAT given?
BAT is given as an infusion (injection through your vein). Your doctor will determine your correct dose of BAT. It may
take several hours to administer BAT. Your doctor will decide if you need more than one infusion.
What are common side effects of BAT?
The most common side effects of BAT are headache, fever, rash, hives, chills, nausea and swelling. During or
immediately after the infusion you may have brief pain, bleeding, bruising of the skin at the site where the needle
enters, soreness and swelling at that site, and possible infection at that site. Some people feel anxious or agitated after
getting BAT. Tell your doctor if you feel anxious or agitated, especially if these feelings do not go away. Also, some
people have a chilly feeling, difficulty breathing, and have a quick rise in body temperature within the first 20 to 60
minutes after getting BAT. This is called a thermal reaction. If these symptoms become severe, talk to your doctor.
What are possible serious side effects of BAT?
Since BAT is made from horse plasma, there is potential for severe allergic reactions. A small number of people
are allergic to horse-based products, usually without knowing it. Possible mild side effects from horse products
are allergic reactions such as fever, chills and discomfort. Some people may get a really bad allergic reaction,
called anaphylaxis. It causes a sudden drop in blood pressure and trouble breathing.
Seek medical care right away (go to the emergency room or call 911) if you experience:
• A weak and rapid pulse
• Closing of the throat, trouble breathing or wheezing
• Dizziness, fainting or unconsciousness
• Swelling of the lips, tongue or face
• Severe itching or rash, especially hives and wheals
(red, swollen bumps on the skin)
• Sudden drop in blood pressure
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Also, a small number of people (less than 5 in 100) who get horse serum may get pains in their joints and back, fever,
and a rash 10−21 days after treatment. This is delayed allergic reaction called serum sickness. These problems can last a
couple of weeks. You should report these problems to your doctor. Doctors can treat serum sickness with standard
medicines.
What if I am taking other medicines?
BAT may interfere with some types of blood glucose testing systems and strips. This can result in false high glucose
test reading. Tell your doctor if you are using these systems so you can be monitored appropriately. Tell your doctor or
healthcare provider about any medications you are taking as well.
What else do I need to know about BAT?
It is not known if there are any risks from receiving BAT while pregnant or nursing. However, being pregnant is not a
reason to not receive BAT. Tell your doctor if you are pregnant, plan to become pregnant or are breastfeeding.
What are my other choices for treatment?
The only other FDA-approved antitoxin is BabyBIG®, but it is for treatment of infant botulism caused by toxin type A or
B. It is your choice whether or not to be treated with BAT. It will not change your regular medical care if you decide not
to receive it. It is possible that paralysis may still progress especially if BAT treatment is not given as soon as signs or
symptoms of botulism start. However, getting BAT may help to slow or stop the progression of illness and/or paralysis.
Risk-Benefit Statement
Although BAT has some potential and serious side effects, the expected benefit of BAT in helping to reduce the
progression of illness associated with botulism outweighs these risks.
How do I report side effects or medication errors?
Tell your doctor or healthcare provider right away and report side effects or medication errors to MedWatch at
www.fda.gov/medwatch or 1-800-FDA-1088.
A federal program called the Countermeasures Injury Compensation Program (CICP) may help pay for costs of medical
care and other specific expenses of certain people who have been seriously injured by some medicines or vaccines. To
learn more about this program: visit www.hrsa.gov/cicp or call 1-855-266-2427 (toll-free).
Space Reserved for State/Local Public Health Information

Botulism Antitoxin Heptavalent (BAT®) EUI for Recipients (10/04/2018)

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