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Botulism is a serious illness that is caused by a bacterial toxin. It is a rare condition but can prove to be lethal within a short period of time. It can be transmitted from contaminated soil, food, or open wound. Botulism can cause paralysis of your respiratory and skeletal muscles. If left untreated, it can be fatal. Botulism should be treated as a medical emergency if you develop its symptoms. Recovery period can last from a few weeks to months. 

Causes And Types

Botulism is caused by a toxin produced by the bacteria Clostridium botulinum. These bacteria survive in habitats where there is no oxygen. This is the reason why botulism is a rare disease even though the bacteria are large in number. Based on its modes of transmission, botulism can be of three types:

·         Food borne botulism: It is caused by eating contaminated food. Even though it is rare to have food storage in oxygen-less containers, some forms of home-canned foods may provide a sufficient habitat for these bacteria to thrive in. Some examples of such foods include canned tuna fish, meat products, preserved vegetables e.g. beets, spinach, etc.

·         Wound botulism: It is one of the rarest forms. If you have an open wound, the bacteria might get into the wound through contaminated soil. It can cause a serious infection that can spread to the rest of your body. Use of drugs such as heroin or cocaine has also been linked to increase in wound botulism.

·         Infant botulism: It occurs if infants ingest spores of bacteria. It is the most common form of botulism. The bacterial spores can transfer from contaminated soil or food such as honey and corn syrup. These spores grow in the intestinal tract of an infant. It usually occurs in newborn babies between the ages of 2 to 8 months. 

Risk Factors And Epidemiology

Risk factors of botulism are based on its different types. Infants are at the highest risk of contracting this disease. Ingestion of honey and corn syrup are considered as risk factors for newborn babies. Apart from this, living in a rural area with active cases or getting exposed to contaminated soil can also put babies at risk. In adults, botulism is more common through food or soil contamination. Excessive use of canned foods can put you at risk because they provide a suitable pH and anaerobic environment for bacteria to thrive. Penetrating injury or intravenous drug abuse can be risk factors for wound botulism.

According to Centers for Disease Control and Prevention (CDC), around 145 people in the United States get infected with botulism every year. 3 to 5% of these people die because of the severity of this disease. Men and women are equally affected by this condition. 

Signs And Symptoms

The signs and symptoms of botulism can vary slightly depending on its type. The symptoms of infant botulism can take 18 to 36 hours to appear after ingestion of bacterial spores. These symptoms include constipation, floppy muscle movements, irritability, weak cry, drooping eyelids, loss of head control, tiredness, drooling, difficulty in sucking and paralysis. Food botulism can take 12 to 36 hours to develop, but the symptoms may appear earlier if you have ingested a large quantity of contaminated food. The symptoms include difficulty in speaking or swallowing, facial weakness, dry mouth, blurred vision, drooping eyelids, nausea/vomiting, abdominal cramps, difficulty in breathing and paralysis. The symptoms of wound botulism are almost similar, but they may appear in about 10 days after getting infected by the toxin. 


History and physical examination are the key factors in diagnosing botulism as early as possible. Your doctor will ask you or your attendant about recent foods you have eaten, or if you got a wound injury. Physical examination is done to assess signs of botulism such as weak muscle movements, facial paralysis, drooping eyelids etc. Constipation is an early sign of botulism in babies along with muscle weakness. Diagnostic tests are also done, including checking your blood, stool, or vomit for the presence of botulism toxin. But because these tests may take longer, the diagnosis is made early to start treatment. 

Differential Diagnosis

Botulism should be differentiated from other neuromuscular disorders, neurotoxins, and other brain and spinal cord infections that can present with similar symptoms. Differentiation can be made on the basis of certain diagnostic tests such as CT scans, spinal fluid test, and electromyography (EMG). 


In cases of foodborne or wound botulism, an antitoxin is administered as early as possible. The antitoxin attaches with the toxin and prevents it from further harming your nerves and tissues. However, the antitoxin cannot revert the damage that has already been done. If you had a late diagnosis, it may take much longer to recover from the damage of this disease. It is possible that your doctor may induce vomiting or give medications to facilitate bowl movement in case of food botulism. Severe cases of botulism with breathing difficulties require oxygen support in form of a ventilator. Infant botulism is treated by giving a different type of antitoxin known as botulism immune globulin. Recovery can take a few weeks to few months.


Medications are not given unless required for any symptomatic treatment. Antibiotics are given in case of wound botulism to decrease the risk of other infections. 


Early diagnosis and treatment can improve the overall prognosis of a person. The type of botulism and the amount of toxin that enters the body also play a role. Infant botulism has a low mortality rate. Wound botulism is considered more lethal than food botulism. The recovery period depends on the severity of your disease. 


If you use home canning techniques, ensure proper precautions before storing food. Boil these food substances for 10 minutes, or pressure cook them for 20 mins to an hour to kill botulism bacteria. Do not eat canned foods that appear bulging or smell weird. Infused oils should be refrigerated. Avoid giving honey or corn products to an infant below the age of 1. 


Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on April 30th, 2023.