Resources & Publications

• Clinical Characteristics and Ancillary Test Results Among Patients With Botulism—United States, 2002–2015. DOIexternal icon PubMedexternal icon
  Rao AK, Lin NH, Jackson KA, Mody RK, Griffin PM. Clin Infect Dis. 2017 Dec 27; 66(Suppl 1): p. S4–S10.
• Clinical Features of Foodborne and Wound Botulism: A Systematic Review of the Literature, 1932–2015. DOIexternal icon PubMedexternal icon
  Chatham-Stephens K, Fleck-Derderian S, Johnson SD, Sobel J, Rao AK, Meaney-Delman D. Clin Infect Dis. 2017 Dec 27; 66 (Suppl 1): p. S11–S16.
• Pediatric Botulism and Use of Equine Botulinum Antitoxin in Children: A Systematic Review. DOIexternal icon PubMedexternal icon
  Griese SE, Kisselburgh HM, Bartenfeld MT, Thomas E, Rao AK, Sobel J, Dziuban EJ. Clin Infect Dis. 2017 Dec 27; 66(Suppl 1): p. S17–S29.
• Botulism During Pregnancy and the Postpartum Period: A Systematic Review. DOIexternal icon PubMedexternal icon
  Badell ML, Rimawi BH, Rao AK, Jamieson DJ, Rasmussen S, Meaney-Delman D. Clin Infect Dis. 2017 Dec 27; 66(Suppl 1): p. S30–S37.
• Botulism mortality in the United States, 1975–2009. DOIexternal icon PubMedexternal icon PMCexternal icon
  Jackson KA, Mahon BE, Copeland J, Fagan R. The Botulinum J. 2016; 3(1): p. 6–17.
• Botulism. In: Bacterial Infections of Humans. Springerexternal icon
  Yu PA, Maslanka SE, St Louis ME, Swerdlow DL. Editors: Evans AS, Brachman PS. New York: Springer; 2009. p. 159–176.
• Long-term outcomes of 217 botulism cases in the Republic of Georgia. DOIexternal icon PubMedexternal icon
  Gottlieb SL, Kretsinger K, Tarkhashvili N, Chakvetadze N, Chokheli M, Chubinidze M, et al. Clin Infect Dis. 2007 Jul 15; 45(2): p. 174–80.
• Adult botulism type F in the United States, 1981–2002. DOIexternal icon PubMedexternal icon
  Gupta A, Sumner CJ, Castor M, Maslanka S, Sobel J. Neurology. 2005 Dec 13; 65(11): p. 1694–700.
• Botulism. DOIexternal icon PubMedexternal icon
  Sobel J. Clin Infect Dis. 2005 Oct 15; 41(8): p. 1167–73.
• Identification of the major steps in botulinum toxin action. DOIexternal icon PubMedexternal icon
  Simpson LL. Annu Rev Pharmacol Toxicol. 2004 Feb 10; 44: p. 167–93.
• Botulism in the United States: a clinical and epidemiologic review. DOIexternal icon PubMedexternal icon
  Shapiro RL, Hatheway C, Swerdlow DL. Ann Intern Med. 1998 Aug 1; 129(3): p. 221–8.
• Botulism. In: Bacterial Infections of Humans. Springerexternal icon
  Angulo FJ, St. Louis ME. Editors: Evans AS, Brachman PS. New York: Plenum; 1998. p. 131­­­­­­­–3.

• The Epidemiology of Foodborne Botulism Outbreaks: A Systematic Review. DOIexternal icon PubMedexternal icon
  Fleck-Derderian S, Shankar M, Rao AK, Chatham-Stephens K, Adjei S, Sobel J, et al. Clin Infect Dis. 2017 Dec 27; 66 (Suppl 1): p. S73–S81.

Botulism linked to improperly home-canned, fermented, or preserved foods, including traditional Alaska Native foods

• Notes from the Field: botulism Type E after consumption of salt-cured fish — New Jersey, 2018. MMWR PubMedexternal icon
  Ganapathiraju PV, Gharpure R, Thomas D, Millet N, Gurrieri D, Chatham-Stephens K, et al. MMWR Morb Mortal Wkly Rep. 2019 Nov; 68(44): p. 1008–09.
• Botulism outbreak associated with home-canned peas—New York City, 2018. MMWR PubMedexternal icon
  Bergeron G, Latash J, Dacosta-Carter CA, Egan C, Stavinsky F, Kileci JA, et al. MMWR Morb Mortal Wkly Rep. 2019 Mar; 68(10): p. 251–52.
• Large outbreak of botulism associated with a church potluck meal—Ohio, 2015. MMWR PubMedexternal icon PMCexternal icon
  McCarty CL, Angelo K, Beer KD, Cibulskas-White K, Quinn K, de Fijter S, et al. MMWR Morb Mortal Wkly Rep. 2015 Jul 31; 64(29): p. 802–3.
• Regional variations in home canning practices and the risk of foodborne botulism in the Republic of Georgia, 2003. DOIexternal icon PubMedexternal icon PMCexternal icon
  Tarkhashvili N, Chokheli M, Chubinidze M, Abazashvili N, Chakvetadze N, Imnadze P, et al. J Food Prot. 2015 Apr; 78(4): p. 746–50.
• Botulism associated with home-fermented tofu in two Chinese immigrants—New York City, March–April 2012. MMWR PubMedexternal icon PMCexternal icon
  Chai E, Choi E, Guitierrez C, Hochman M, Johnkutty S, Kamel W, et al. MMWR Morb Mortal Wkly Rep. 2013 July 5; 62(26): p. 529–32.
• Three outbreaks of foodborne botulism caused by unsafe home canning of vegetables—Ohio and Washington, 2008 and 2009. DOIexternal icon PubMedexternal icon
  Date K, Fagan R, Crossland S, MacEachern D, Pyper B, Bokanyi R, et al. J Food Prot. 2011; 74(12): p. 2090–6.
• Outbreak of clinically mild botulism type E illness from home-salted fish in patients presenting with predominantly gastrointestinal symptoms. DOIexternal icon PubMedexternal icon
  Sobel J, Malavet M, John S. Clin Infect Dis. 2007 Jul 15; 45(2): p. 14–6.
• The need for global planned mobilization of essential medicine: lessons from a massive Thai botulism outbreak. PDF [3 - pages]external icon PubMedexternal icon PMCexternal icon
  Ungchusak K, Chunsuttiwat S, Braden CR, Aldis W, Ueno K, Olsen SJ, Wiboolpolprasert S. Bull World Health Organ. 2007 Mar; 85(3): p. 238–240.
• Brief Report: Foodborne botulism from home-prepared fermented tofu—California. MMWR PubMedexternal icon
  Meyers H, Inami G, Rosenberg J, Mohle-Boetani J, Vugia D, Yuan J. MMWR Morb Mortal Wkly Rep. 2007 Feb 9; 56(5): p. 96–7.
• Botulism type E outbreak associated with eating a beached whale, Alaska. DOIexternal icon PubMedexternal icon PMCexternal icon
  McLaughlin JB, Sobel J, Lynn T, Funk E, Middaugh JP. Emerg Infect Dis. 2004 Sep; 10(9): p. 1685–7.
• Botulism among Alaska natives in the Bristol Bay area of southwest Alaska: a survey of knowledge, attitudes, and practices related to fermented foods known to cause botulism. DOIexternal icon PubMedexternal icon
  Chiou LA, Hennessy TW, Horn A, Carter G, Butler JC. Int J Circumpolar Health. 2002 Feb; 61(1): p. 50–60.
• Foodborne botulism from eating home-pickled eggs—Illinois, 1997. MMWR PubMedexternal icon
  Rifkin G, Sibounheuang K, Peterson L, Kelly K, Langkop C, Kauerauf D, et al. MMWR Morb Mortal Wkly Rep. 2000 Sep 1; 49(34): p. 778–80.

Botulism linked to pruno, a type of homemade alcohol

• Notes from the field: botulism outbreak from drinking prison-made illicit alcohol in a federal correctional facility—Mississippi, June 2016. MMWR PubMedexternal icon
  McCrickard L, Marlow M, Self JL, Watkins LF, Chatham-Stephens K, Anderson J, et al. MMWR Morb Mortal Wkly Rep. 2017 Jan 6; 65(52): p. 1491–2.
• A qualitative inquiry about pruno, an illicit alcoholic beverage linked to botulism outbreaks in United States prisons. DOIexternal icon PubMedexternal icon PMCexternal icon
  Walters MS, Sreenivasan N, Person B, Shew M, Wheeler D, Hall J, et al. Am J Public Health. 2015 Nov; 105(11): p. 2256–61.
• Alcohol production, prevention strategies, and inmate knowledge about the risk for botulism from pruno consumption in a correctional facility—Arizona, 2013. DOIexternal icon PubMedexternal icon PMCexternal icon
  Adams LE, Yasmin S, Briggs G, Redden K, Silvas S, Anderson S, et al. J Correct Health Care. 2015 Oct; 21(4): p. 335–42.
• Notes from the field: botulism from drinking prison-made illicit alcohol—Arizona, 2012. MMWR PubMedexternal icon PMCexternal icon
  Briggs G, Anderson S, Komatsu K, Weiss J, Henke E, Tsang CA, et al. MMWR Morb Mortal Wkly Rep. 2013 Feb 8; 62(5): p. 88.
• Botulism from drinking prison-made illicit alcohol—Utah, 2011. MMWR PubMedexternal icon
  Thurston D, Risk I, Hill MB, Vitek D, Bogdanow L, Robertson J, et al. MMWR Morb Mortal Wkly Rep. 2012 Oct 5; 61(39): p. 782–4.
• Botulism from drinking pruno. DOIexternal icon PubMedexternal icon PMCexternal icon
  Vugia DJ, Mase SR, Cole B, Stiles J, Rosenberg J, Velasquez L, et al. Emerg Infect Dis. 2009 Jan; 15(1): p. 69–71.

Botulism linked to other foods

• Notes from the field: botulism caused by consumption of commercially produced potato soups stored improperly—Ohio and Georgia, 2011. MMWR PubMedexternal icon
  Seaman MP, Sulka AC, Tobin-D’Angelo M, Blass MA, Mills RL, Carmean J, et al. MMWR Morb Mortal Wkly Rep. 2011 Jul 8; 60(26): p. 890.
• International outbreak of severe botulism with prolonged toxemia caused by commercial carrot juice. DOIexternal icon PubMedexternal icon
  Sheth AN, Wiersma P, Atrubin D, Dubey V, Zink D, Skinner G, et al. Clin Infect Dis. 2008 Nov 15; 47(10): p. 1245–51.
• Botulism associated with commercially canned chili sauce—Texas and Indiana. MMWR PubMedexternal icon
  Ginsberg MM, Granzow L, Teclaw RF, Gaul LK, Bagdure S, Cole A, et al. MMWR Morb Mortal Wkly Rep. 2007 Aug 3; 56(30): p. 767–9.
• Botulism associated with commercial carrot juice—Georgia and Florida, September 2006. MMWR PubMedexternal icon
  Shuler C, Drenzek C, Lance S, Gonzalez G, Miller J, Tobin-D’Angelo M, et al. MMWR Morb Mortal Wkly Rep. 2006 Oct 13; 55(40): p. 1098–9.
• An outbreak of foodborne botulism associated with food sold at a salvage store in Texas. DOIexternal icon PubMedexternal icon
  Kalluri P, Crowe C, Reller M, Gaul L, Hayslett J, Barth S, et al. Clin Infect Dis. 2003 Dec 1; 37(11): p. 1490–5.
• A large outbreak of botulism: the hazardous baked potato. DOIexternal icon PubMedexternal icon
  Angulo FJ, Getz J, Taylor JP, Hendricks KA, Hatheway CL, Barth SS, et al. J Infect Dis. 1998 Jul; 178(1): p. 172–7.
• Foodborne botulism—Oklahoma, 1994. MMWR PubMedexternal icon
  Knubley W, McChesney TC, Mallonee J, Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep. 1995 Mar 24; 44(11): p. 200–2.
• Epidemiologic notes and reports fish botulism—Hawaii, 1990. MMWR DOIexternal icon PubMedexternal icon
  Kershaw P, Dioso M, Wong B, Ibara C, Robertson D, Tamao W, et al. MMWR Morb Mortal Wkly Rep. 1991 Jun 21; 40(24): p. 412–4.
• Botulism from chopped garlic: delayed recognition of a major outbreak. DOIexternal icon PubMedexternal icon
  St. Louis ME, Peck SHS, Bowering D, Morgan GB, Blatherwick J, Banerjee S, et al. Ann Intern Med. 1988 Mar; 108(3): p. 363–8.

Other foodborne botulism

• Foodborne botulism in the United States, 1999–2000. DOIexternal icon PubMedexternal icon PMCexternal icon
  Sobel J, Tucker N, McLaughlin J, Maslanka S. Emerg Infect Dis. 2004 Sep; 10(9): p. 1606–11.
• Foodborne botulism in the Republic of Georgia. DOIexternal icon PubMedexternal icon PMCexternal icon
  Varma JK, Katsitadze G, Moiscrafishvili M, Zardiashvili T, Chikheli M, Tarkashvili N, et al. Emerg Infect Dis. 2004 Sept; 10(9): p. 1601–5.
• Signs and symptoms predictive of death in patients with foodborne botulism—Republic of Georgia, 1980–2002. DOIexternal icon PubMedexternal icon
  Varma JK, Katsitadze G, Moiscrafishvili M, Zardiashvili T, Chokheli M, Tarkhashvili N, et al. Clin Infect Dis. 2004 Aug 1; 39(3): p. 357–62.

• Botulism in Alaska: A Guide for Physicians and Health Care Providers. CDC Stacks PDF pdf icon[32 pages]external icon
  Castrodale LJ (ed.). State of Alaska Department of Health and Social Services. 2011.
• Endemic foodborne botulism among Alaska Native persons—Alaska, 1947–2007. DOIexternal icon PubMedexternal icon
  Fagan RP, McLaughlin JB, Castrodale LJ, Gessner BD, Jenkerson SA, Funk EA, et al. Clin Infect Dis. 2011 Mar 1; 52(5): p. 585–92.
• Botulism type E outbreak associated with eating a beached whale, Alaska. DOIexternal icon PubMedexternal icon PMCexternal icon
  McLaughlin JB, Sobel J, Lynn T, Funk E, Middaugh JP. Emerg Infect Dis. 2004 Sep; 10(9): p. 1685–7.
• Botulism among Alaska Natives in the Bristol Bay area of southwest Alaska: a survey of knowledge, attitudes, and practices related to fermented foods known to cause botulism. DOIexternal icon PubMedexternal icon
  Chiou LA, Hennessy TW, Horn A, Carter G, Butler JC. Int J Circumpolar Health. 2002 Feb; 61(1): p. 50–60.
• Botulism among Alaska Natives. The role of changing food preparation and consumption practices. PubMedexternal icon PMCexternal icon
  Shaffer N, Wainwright RB, Middaugh JP, Tauxe RV. West J Med. 1990 Oct; 153(4): p. 390–3.

• Equine botulinum antitoxin for the treatment of infant botulism. DOIexternal icon PubMed↗external icon PMCexternal icon
  Vanella de Cuetos EE, Fernandez RA, Bianco MI, Sartori OJ, Piovano ML, Lúquez C, de Jong LI. Clin Vaccine Immunol. 2011 Nov; 18(11): p. 1845–9.
• Clostridial infections: botulism and infant botulism. In: The Red Book: 2009 Report of the Committee on Infectious Diseases. PDF pdf icon[32 pages]external icon
  Arnon SS, Barzilay EJ. Editors: Pickering LK, Baker CJ, Kimberlin DW, Long SS. Elk Grove Village (IL): American Academy of Pediatrics; 2009. p. 259–62.
• Intestinal botulism formerly infant botulism. In: Control of Communicable Disease Manual. 19^th ed. APHAexternal icon
  Barzilay E, Schlundt J, Toyofuku H. Editor: Heymann DL. Washington, D.C.: American Public Health Association. 2008. p. 79–87.
• Global occurrence of infant botulism, 1976–2006. DOIexternal icon PubMedexternal icon
  Koepke R, Sobel J, Arnon S. Pediatrics. 2008 Jul; 122(1): p. 72–82.
• Human botulism immune globulin for the treatment of infant botulism. DOIexternal icon PubMedexternal icon
  Arnon SS, Schechter R, Maslanka SE, Jewell NP, Hatheway CL. N Engl J Med. 2006 Feb 2; 354(5): p. 462–71.
• Foodborne botulism in a six-month-old infant caused by home-canned baby food. DOIexternal icon PubMed↗external icon
  Armada M, Love S, Barrett E, Monroe J, Peery D, Sobel J. Ann Emerg Med. 2003 Aug; 42(2): p. 226–9.
• Infant botulism—New York City, 2001–2002. MMWR PubMedexternal icon
  Reddy V, Balter S, Weiss D, Layton M, Kornstein L, Friberg I, et al. MMWR Morb Mortal Wkly Rep. 2003 Jan 17; 52(2): p. 21–4.
• Risk of infant botulism from corn syrup. Ovidexternal icon PubMedexternal icon
  Olsen SJ, Swerdlow DL. Pediatr Infect Dis J. 2000 Jun; 19(6): p. 584–5.

• Notes from the field: Botulism Type B after intravenous methamphetamine use – New Jersey, 2020. MMWR PubMedexternal icon
  Waltenburg MA, Larson VA, Naor EH, Webster TG, Dykes J, Foltz V, et al. MMWR Morb Mortal Wkly Rep. 2020 Oct; 69(39): p. 1425–26.
• Recurrent wound botulism among injection drug users in California. DOIexternal icon PubMedexternal icon
  Yuan J, Inami G, Mohle-Boetani J, Vugia DJ. Clin Infect Dis. 2011 Apr 1; 52(7): p. 862–6.
• Wound botulism acquired in the Amazonian rain forest of Ecuador. PDF - 4 pagesexternal icon PubMedexternal icon
  Reller ME, Douce RW, Maslanka SE, Torres DS, Manock SR, Sobel J. Am J Trop Med Hyg. 2006 Apr; 74(4): p. 628–31.
• Wound botulism among black tar heroin users—Washington, 2003. MMWR DOIexternal icon PubMedexternal icon
  Spitters C, Moran J, Kruse D, Barg N, Leslie M, Hoffman J, et al. MMWR Morb Mortal Wkly Rep. 2003 Sep 19; 52(37): p. 885–6.
• Wound Botulism in California, 1951–1998: Recent Epidemic in Heroin Injectors. DOIexternal icon PubMedexternal icon
  Benson Werner S, Passaro D, McGee J, Schechter R, Vugia DJ. Clin Infect Dis. 2000 Oct 1; 31(4): p. 1018–24.
• Wound botulism—California, 1995. MMWR PubMedexternal icon
  Gollober M, Beyer RA, Kwan S, Bates RO, Billimek M, Matson SE, et al. MMWR Morb Mortal Wkly Rep. 1995 Dec 8; 44(48): p. 889–92.

• Efficacy of Antitoxin Therapy in Treating Patients With Foodborne Botulism: A Systematic Review and Meta-analysis of Cases, 1923–2016. DOIexternal icon PubMedexternal icon PMCexternal icon
  O'Horo JC, Harper EP, El Rafei A, Ali R, DeSimone DC, Sakusic A, et al. Clin Infect Dis. 2017 Dec 27; 66 (Suppl 1): p. S43–S56.
• Safety and Improved Clinical Outcomes in Patients Treated With New Equine-Derived Heptavalent Botulinum Antitoxin. DOIexternal icon PubMedexternal icon PMCexternal icon
  Yu PA, Lin NH, Mahon BE, Sobel J, Yu Y, Mody RK, et al. Clin Infect Dis. 2017 Dec 27; 66 (Suppl 1): p. S57–S64.
• Allergic Reactions to Botulinum Antitoxin: A Systematic Review. DOIexternal icon PubMedexternal icon PMCexternal icon
  Schussler E, Sobel J, Hsu J, Yu P, Meaney-Delman D, Grammer LC 3^rd, Nowak-Wegrzyn A. Clin Infect Dis. 2017 Dec 27; 66 (Suppl 1): p. S65–S72.
• The eyes have it. DOIexternal icon PubMedexternal icon
  Rao AK, Jackson KA, Mahon BE. N Engl J Med. 2013 Jan 24; 368(4): p. 392.
• Initial recovery and rebound of type F intestinal colonization botulism after administration of investigational heptavalent botulinum antitoxin. DOIexternal icon PubMedexternal icon
  Fagan RP, Neil KP, Sasich R, Luquez C, Asaad H, Maslanka S, Khalil W. Clin Infect Dis. 2011 Nov; 53(9): p. 125–8.
• Utility of botulinum toxin ELISA A, B, E, F kits for clinical laboratory investigations of human botulism. DOIexternal icon
  Maslanka SE, Luquez C, Raphael BH, Dykes JK, Joseph, LA. Botulinum J. 2011; 2(1): p. 72–92.
• Investigational heptavalent botulinum antitoxin (HBAT) to replace licensed antitoxin AB and investigational botulinum antitoxin E. MMWR PubMedexternal icon
  Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep. 2010 Mar 19; 59(10): p. 299.

• Botulism. In: Beyond Anthrax: The Weaponization of Infectious Diseases. Springerexternal icon
  Sobel J. Editors: Lutwick LI, Lutwick SM. Towata (NJ): Humana Press. 2009. p. 85–105.
• Botulinum toxin as a biological weapon: medical and public health management. DOIexternal icon PubMedexternal icon
  Arnon SS, Schechter R, Inglesby TV, Henderson DA, Bartlett JG, Ascher MS, et al. JAMA. 2001 Feb 28; 285(8): p. 1059–70.
• Botulism surveillance and emergency response: a public health strategy for a global challenge. DOIexternal icon PubMedexternal icon
  Shapiro RL, Hatheway C, Becher J, Swerdlow DL. JAMA. 1997 Aug 6; 278(5): p. 433–5.

• Notes from the Field: Intestinal colonization and possible iatrogenic botulism identified by mass spectrometry in mouse-bioassay-negative serum specimens—Los Angeles County, California, November 2017. MMWRexternal icon PubMedexternal icon
  Halai U, Terashita D, Kim M, Green N, Kalb SR, Chatham-Stephens K, Balter S. MMWR Morb Mortal Wkly Rep. 2018 Nov; 67(43): p. 1221-22.