Botulism 
Annual Summary of Reportable Diseases

Botulinum toxin, a neurotoxin, is produced by the spore-forming bacteria Clostridium botulinum and other related Clostridium species. There are 8 distinct toxin types: A, B, C, D, E, F, G, and H. Toxin types A, B, E, F, and H can cause human intoxication. Botulism is characterized by a bilateral, descending paralysis that can be fatal without treatment. Botulism spores are ubiquitous in the environment and cause three main forms of intoxication: foodborne, wound, and intestinal toxemia, which includes infant botulism and intestinal toxemia. Infant botulism, which is the most common form in the United States, results from the ingestion of C. botulinum spores that germinate into vegetative bacteria that colonize the intestinal tract, producing toxin that is absorbed into the circulation. In 2022, one infant botulism case was reported. The infant botulism case occurred in an 11-week-old female from Dakota County. She received botulism immune globulin (BabyBIG) and recovered. The disease was caused by toxin type A. From 2001 to 2022, 17 cases of infant botulism, two cases of foodborne botulism, two cases of intestinal toxemia botulism, and one case of possible iatrogenic botulism due to a complication of Onabotulinumtoxin A (BOTOX) administration, were identified among Minnesota residents. The median age of affected infants was 21 weeks (range, 5 to 41 weeks). Twelve (71%) infant botulism cases were caused by botulinum toxin type B and five (29%) by toxin type A. Fourteen infants were known to be hospitalized, for a median of 16 days (range, 8 to 30 days); one infant did not require hospitalization. The two foodborne cases, caused by toxin type A occurred in 2009 in two men who consumed home-canned asparagus. Both cases were hospitalized, for 6 and 16 days. No deaths occurred among the infant or foodborne botulism cases.

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Botulinum toxin, a neurotoxin, is produced by the spore-forming bacteria Clostridium botulinum and other related Clostridium species. There are 8 distinct toxin types: A, B, C, D, E, F, G, and H. Toxin types A, B, E, F, and H can cause human intoxication. Botulism is characterized by a descending, bilateral paralysis that can be fatal without treatment. Botulism spores are ubiquitous in the environment and cause three main forms of intoxication: foodborne, wound, and intestinal toxemia, which includes infant botulism and intestinal toxemia. Infant botulism, which is the most common form in the United States, results from the ingestion of C. botulinum spores that germinate into vegetative bacteria that colonize the intestinal tract, producing toxin that is absorbed into the circulation. In 2021, one infant botulism and one intestinal toxemia botulism case were reported. The infant botulism case occurred in a 21-week-old male. He received botulism immune globulin (BabyBIG) and recovered. The disease was caused by toxin type B. The intestinal colonization case occurred in a 10-year-old female with a medical history including short bowel syndrome, G-tube dependence, and D-lactic acidosis. Despite receiving heptavalent botulism antitoxin, she succumbed to the disease. Her illness was caused by toxin type A. From 2001 to2021, 16 cases of infant botulism, 2 cases of foodborne botulism, 2 cases of intestinal toxemia botulism, and 1 case of possible iatrogenic botulism were identified among Minnesota residents. The median age of affected infants was 21 weeks (range, 5 to 41 weeks). Twelve (75%) infant botulism cases were caused by botulinum toxin type B and 4 (25%) by toxin type A. Thirteen infants were known to be hospitalized, for a median of 15 days (range, 8 to 30 days); one infant did not require hospitalization. The 2 foodborne cases, caused by toxin type A occurred in 2009 in two men who consumed home-canned asparagus. Both cases were hospitalized, for 6 and 16 days. No deaths occurred among the infant or foodborne botulism cases.

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Botulinum toxin, a neurotoxin, is produced by the spore-forming bacteria Clostridium botulinum and other related species. There are 8 Figure 1. Comparison of Average Annual Incidence of Endemic Fungal Diseases in Minnesota DCN 48;1 2022 5 continued... 0 5 10 15 20 25 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Rate per 100,000 Population Year of Report Campylobacter Shigella Cryptosporidium Salmonella E. coli O157 X X STEC* *STEC (Shiga toxin producing E. coli) includes O157 and non-O157 STEC case counts. distinct toxin types: A, B, C, D, E, F, G, and H. Toxin types A, B, E, F, and H can cause human intoxication. Botulism is characterized by a descending, bilateral paralysis that can be fatal without treatment. Botulism spores are ubiquitous in the environment and cause three main forms of intoxication: foodborne, wound, and intestinal-toxemia, which includes infant botulism and adult intestinal toxemia. Infant botulism, which is the most common form in the United States, results from the ingestion of C. botulinum spores that germinate into vegetative bacteria that colonize the intestinal tract, producing toxin that is absorbed into the circulation. In 2020, one infant, one adult intestinal colonization, and one iatrogenic botulism case were reported. The adult intestinal colonization case occurred in a 40 year-old female with multiple underlying conditions, including Crohn’s disease. The disease was caused by toxin types B and F. The iatrogenic botulism case occurred in a 78 year-old male who received Botox injections for a vocal cord disfunction. Because of the localized nature of his presentation, his case was not confirmed through mouse bioassay From 2001-2020, 15 cases of infant botulism and 2 cases of foodborne botulism were reported. The median age of infants was 18 weeks (range, 5 to 41 weeks). Eleven (73%) cases were caused by botulinum toxin type B, and 4 (27%) by toxin type A. Twelve infants were known to be hospitalized, for a median of 15 days (range, 8 to 30 days); one infant did not require hospitalization. The 2 foodborne cases were of toxin type A, occurred in 2009, in two men consuming home-canned asparagus. Both were hospitalized for 6 and 16 days. No deaths occurred among the infant or foodborne botulism cases.

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Botulinum toxin, a neurotoxin, is produced by the spore-forming bacteria Clostridium botulinum and other related species. There are 8 distinct toxin types: A, B, C, D, E, F, G, and H. Toxin types A, B, E, F, and H can cause human intoxication. Botulism is characterized by a descending, bilateral paralysis that can be fatal without treatment. Botulism spores are ubiquitous in the environment and cause three main forms of intoxication: foodborne, wound, and intestinaltoxemia which includes infant botulism and adult intestinal toxemia. Infant botulism, which is the most common form in the United States, results from the ingestion of C. botulinum spores that germinate into vegetative bacteria that colonize the intestinal tract, producing toxin that is absorbed into the circulation.

In 2019, no infant, foodborne, or wound botulism cases were reported. From 2001-2019, 14 cases of infant botulism and 2 cases of foodborne botulism were reported. The median age of infants was 19 weeks (range, 5 to 41 weeks), and 8 (57%) were male. Eleven (79%) cases were caused by botulinum toxin type B and 3 (21%) by toxin type A; since 2006 all infant cases in Minnesota have been caused by toxin type B. Eleven infants were known to be hospitalized, for a median of 15 days (range 8 to 30 days); one infant did not require hospitalization. The 2 foodborne cases were of toxin type A, and occurred in 2009 in two men consuming home-canned asparagus. Both were hospitalized for 6 and 16 days. No deaths occurred among the infant or foodborne botulism cases.

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Botulinum toxin, a neurotoxin, is produced by the spore-forming bacteria Clostridium botulinum and other related species. There are 8 distinct toxin types: A, B, C, D, E, F, G, and H. Toxin types A, B, E, F, and H can cause human intoxication. Botulism is characterized by a descending, bilateral paralysis that can be fatal without treatment. Botulism spores are ubiquitous in the environment and cause three main forms of intoxication: foodborne, wound, and intestinal-toxemia, which includes infant botulism and adult intestinal toxemia. Infant botulism, which is the most common form in the United States, results from the ingestion of C. botulinum spores that germinate into vegetative bacteria that colonize the intestinal tract, producing toxin that is absorbed into the circulation.

In 2018, 1 infant botulism case was reported. No foodborne or wound cases were reported. The infant was a 26 week-old who presented to the hospital with symptoms including weakened cry, inability to feed, progressive weakness, and ptosis. She was hospitalized for 11 days, received human botulism immune globulin and made a full recovery. The infant tested positive for C. botulinum toxin type B.

From 2001-2018, 14 cases of infant botulism and 2 cases of foodborne botulism were reported. The median age of infants was 19 weeks (range 5 to 41 weeks), and 8 (57%) were male. Eleven (79%) cases were caused by botulinum toxin type B and 3 (21%) by toxin type A; since 2006 all infant cases in Minnesota have been caused by toxin type B. Eleven infants were known to be hospitalized, for a median of 15 days (range 8 to 30 days); one infant did not require hospitalization. The 2 foodborne cases were of toxin type A, and occurred in 2009 in two men consuming home-canned asparagus. Both were hospitalized for 6 and 16 days. No deaths occurred among the infant or foodborne botulism cases.

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• Archive of Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health
  Archive of past summaries (years prior to 2023 are available as PDFs).