The Threat

We do not know if an attack using the toxin that causes botulism will ever happen. CDC and other federal agencies make plans for responding to many types of possible biological attacks. If an attack occurs, these plans will help CDC, other federal agencies, and state and local health departments treat and protect as many people as possible.

Why is botulism a concern?

Botulism is a serious, sometimes deadly, disease. Most people who get botulism require hospitalization. They may have to stay in the hospital for days, weeks, and sometimes months, before they are well enough to go home.

Symptoms of botulism typically start with paralysis of muscles in the face. If untreated, the paralysis can move down the body, involving the muscles required for breathing and for moving arms and legs. Many people with botulism need a machine called a ventilator to help them breathe. People with botulism may also need treatment with a drug called an antitoxin that prevents the toxin from causing more harm.

About 200 cases of botulism are diagnosed in the United States each year. No reported cases of botulism in the United States have been linked to bioterrorism. With proper diagnosis and treatment, fewer than 5 of every 100 people with botulism die.

How dangerous is the toxin that causes botulism?

The toxin that causes botulism is one of the most deadly toxins known. Even a small amount of it can make many people sick. Without prompt medical treatment, people with botulism can die.

If individuals or groups wanted to use a biological weapon, they might use the toxin because botulism is a severe illness.

What might an attack look like?

A biological attack that releases the toxin that causes botulism into the food supply or air might make many people sick. We might not know right away about an attack because we cannot see, smell, or taste the toxin. An attack might be recognized when doctors begin to see many people with symptoms of botulism, including difficulty breathing and moving muscles. Once doctors suspected that patients have botulism, public health officials would work with patients, their families, doctors, and others to find out how people came into contact with the toxin. Investigators would work to identify the source and warn the public how to avoid it, as well as to find other people who may have been exposed and ensure they receive proper treatment.