ABSTRACT
Botulism is a rare paralytic disease caused by a neurotoxin produced from the spore-forming
bacterium Clostridium botulinum and in rare cases, Clostridium butyricum and Clostridium baratii.
Botulism in humans is usually caused by toxin types A, B, and E. Since 1973, a median of 24
cases of foodborne botulism, 3 cases of wound botulism, and 71 cases of infant botulism have
been reported annually to the Centers for Disease Control and Prevention (CDC) (1,2). Botulism
has four naturally occurring syndromes: foodborne, wound, infant botulism, and adult
intestinal toxemia. Inhalational botulism could result from aerosolization of botulinum toxin,
and iatrogenic botulism can result from injection of toxin. All of these produce the same clinical
syndrome of symmetrical cranial nerve palsies followed by descending, symmetric flaccid
paralysis of voluntary muscles, which may progress to respiratory compromise and death. The
weaponization of botulinum toxin is of great concern.
