Botulism

Spores from Clostridium botulinum are found worldwide in soil, agricultural products, and animal intestinal tracts. Illness is caused by the toxin produced by the bacterium after germination. Foodborne botulism results from consuming food that has been improperly handled or preserved. Infant or intestinal botulism occurs almost exclusively in children under one year of age when ingested spores germinate and colonize the intestines. Wound botulism occurs when C. botulinum infects a break in the skin. Outbreaks of wound botulism have occurred among persons who inject illicit drugs.

• Foodborne botulism factsheet
  
  
• Wound botulism: Public health warning for injection drug users – September 2011
  
  
• Facts about botulism from the Centers for Disease Control and Prevention (CDC)

• Botulism: Information and guidance for clinicians (CDC)
  
  
• Botulinum toxin as a biological weapon -- Consensus statement on medical and public health management (Journal of the American Medical Association)

Purpose of surveillance:

• To facilitate diagnosis of suspected cases and treatment with botulinum antitoxin when indicated
• To identify other exposed persons requiring medical evaluation, monitoring and/or treatment
• To identify and investigate common source outbreaks
• To identify and remove contaminated food products that could cause further cases of foodborne botulism
• To identify and investigate cases resulting from a bioterrorism attack

Local epidemiology:

In 2012 one case of foodborne botulism and one case of infant botulism were reported. The source of the cases was not established. Both cases required hospitalization and rehabilitation and one required mechanical ventilation. Both cases were caused by toxin type A.                                         

From 1991-2012, King County received 4 reports of foodborne botulism, 11 reports of infant botulism, and 4 reports of wound botulism. For the 15 cases with toxin information available, 14 illnesses were caused by toxin type A and the other was toxin type B.

Each year in Washington state there are 0 to 2 reports of foodborne botulism, 0 to 6 reports of infant botulism and 0 to 7 reports of wound botulism. Most cases are type A botulism.