University of Minnesota-Twin Cities
Botulism has become a rare foodborne disease in the US and a leading concern for bioterrorism. From 1993-2005, 346 cases of foodborne botulism and 42 foodborne outbreaks of botulism were reported in the US. Only 4 outbreaks (10%) involved > 5 persons. In each of these outbreaks the event was recognized within 4 days following exposure because of the occurrence of multiple cases with identifiable linkages presenting at a common health care center. However, multiple other cases occurred for which the diagnosis was delayed because the individual cases were not epidemiologically linked to other suspected cases. For a widely distributed food item, recognition of the outbreak and its source would depend in part on the likelihood of cases clustering in households or among friends. The characteristics of product distribution and use should be factored into assessments of the potential impact of intentional contamination events and public health response.