Technical Information
Technical information is taken directly from the December 2001 CDC Division of Bacterial and Mycotic Diseases: Botulism

Clinical Features
A nerve paralyzing illness characterized by symmetric, descending weak paralysis of motor and autonomic nerves, always beginning with the cranial nerves. Symptoms include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. If untreated, illness might progress to cause descending paralysis of respiratory muscles, arms and legs. Botulinum antitoxin (supplied by CDC) can prevent progression of illness and shorten symptoms in severe botulism cases if administered early.

Etiologic Agent
A potent neurotoxin produced from Clostridium botulinum, an anaerobic, spore-forming bacterium.

A photomicrograph of Clostridium botulinum type A viewed using a Gram stain technique with (1978)

Incidence
In 1999, 174 cases of botulism were reported to the CDC. Of these, 26 were foodborne, 107 were infant botulism, and 41 were cases of wound botulism.

Transmission
Foodborne botulism follows ingestion of toxin produced in food by C. botulinum. The most frequent source is home-canned foods, prepared in an unsafe manner. Wound botulism occurs when C. botulinum spores germinate within wounds. Intestinal botulism occurs when C. botulinum spores germinate and produce toxin in the gastrointestinal tract.

Risk Groups
All persons. Intestinal colonization botulism usually occurs in infants, and is often called infant botulism. Injection drug users are at increased risk for wound botulism.

Surveillance
In collaboration with state health departments, CDC maintains intensive surveillance for botulism in the United States. Every case of foodborne botulism is treated as a public health emergency because the responsible food, whether homemade or commercial, might still be available for consumption and could make unsuspecting persons ill.

A photomicrograph of Clostridium botulinum bacteria (1979)

Trends
Other vehicles of transmission include homemade salsa, baked potatoes cooked in aluminum foil, cheese sauce, garlic in oil, and traditionally prepared salted or fermented fish in Alaska.

Challenges
Prompt recognition of clinical syndrome by physicians.

Opportunities
Clinician education. Consumer education about home canning.

Additional Resources

Facts about Botulism

Frequently Asked Questions about Botulism

Center for Disease Control and Prevention Botulism Information

NOTE: All images taken from the CDC Public Health Image Library website.