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National Botulism Surveillance

Since 1973, CDC, in partnership with the Council of State and Territorial Epidemiologists (CSTE), has maintained the National Botulism Surveillance System for intensive surveillance for cases of botulism in the United States. The National Botulism Surveillance System collects reports of all confirmed botulism cases in the United States and is continuously monitored for early detection of outbreaks.

Demographic (e.g., age, sex, race and ethnicity), clinical (e.g., transmission category, case-patient outcome), laboratory (e.g., laboratory testing method, toxin type), and epidemiologic (e.g., vehicle) data are reported by all 50 states and the District of Columbia. To be confirmed, cases must meet the CSTE case definition of botulism.

Transmission Categories

For surveillance purposes, CDC categorizes human botulism cases into four transmission categories: foodborne, wound, infant, and “other”.

  • Foodborne botulism is caused by the consumption of foods containing pre-formed botulinum toxin.
  • Wound botulism is caused by toxin produced in a wound infected with Clostridium botulinum.
  • Infant botulism by definition occurs in persons less than one year of age and is caused by consumption of spores of C. botulinum, which then grow and release toxins in the intestines.
  • “Other” botulism: consistent with the Council of State and Territorial Epidemiologists (CSTE) position statements, the “other” category includes botulism in which the route of transmission is unknown. Cases are classified as “other” if the patient is not an infant, has no history of ingesting a suspect food, and has no wounds. The “other” category also includes iatrogenic botulism, which is caused by an accidental overdose of botulinum toxin (i.e., therapeutic injection), and adult intestinal colonization botulism, which is very rare but is believed to occur through a mechanism similar to infant botulism.

All data regarding antitoxin releases and laboratory confirmation of cases are recorded annually by CDC and published on this website. Because CDC, the Alaska Division of Public Health, and the California Department of Health Services (CDHS), are the only sources of botulism antitoxin administered in the United States, nearly all recognized cases of botulism are reported. More about Botulism.

Surveillance Overview

National Botulism Surveillance Overview [PDF - 3 pages]

Annual Summaries of Botulism Surveillance Reported to CSTE

Suspected Botulism Case Consultation

Botulism: Frequently Asked Questions

To identify possible cases and outbreaks of botulism as rapidly as possible, CDC provides clinical and epidemiologic consultation, distributes antitoxin, and provides laboratory diagnostic services to state and local health departments in suspected non-infant botulism cases. Infant botulism consultation and surveillance are handled by the Infant Botulism Treatment and Prevention Program (IBTPP), Division of Communicable Disease Control (DCDC), California Department of Public Health (CDPH). Physicians are urged to contact their departments of health as soon as they suspect that a patient may have botulism. State health departments maintain emergency contact numbers and, in concert with CDC, can provide guidelines on diagnosis, management, and prevention of botulism.

Consultation at EDEB is available 24 hours a day for emergency response  for potential cases of botulism at (770) 488-7100. Consultation for infant botulism is also available 24 hours a day by IBTPP of the CDPH at (510) 231-7600. In concert with the state epidemiology offices, CDC epidemiologists and microbiologists recommend appropriate laboratory testing (performed either at CDC or in state laboratories) and ancillary studies  for all suspected cases of botulism.

 
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