Resources & Publications

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For more information on Clostridium botulinum outbreaks reported to CDC:

  1. Go to NORS Dashboard.
  2. Set your search parameters, being sure to select “Clostridium” as the etiology.
  3. At the bottom of the page, select “Download current search data.”
  4. Sort by “Genus Species” or select the arrow next to that heading to select only “Clostridium botulinum.

Case Definition

Surveillance

Botulism Manual

Podcast

Dr. Agam Rao discusses how to recognize and treat botulism.

Botulism: Countering Common Clinical Misperceptionsexternal icon
April 1, 2013 Dr. Agam Rao discusses how to recognize and treat botulism and addresses common clinical misperceptions about the illness.
Read the transcript

 

Publications

“Botulism,” a CDC-sponsored supplement to Clinical Infectious Diseases
Cover of Clinical Infectious Diseases

Topics include:

  • Clinical characteristics
  • Systematic reviews of literature on botulism among pregnant women and children
  • Safety, effectiveness, and allergic profile of antitoxin
  • Outbreak investigations
  • Case reports describing uncommon clinical features

Citation: Sobel J, Rao A. Making the best of the evidence: towards national clinical guidelines for botulism. Clin Infect Dis. 2017 Dec 27;66(Suppl_1):1–3. DOIexternal icon

 

  • 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
  • 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 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. 19th 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.
  • 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.
  • 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 pagespdf iconexternal 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—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 3rd, 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.