Botulism: the present status of the disease.

The main form of human botulism throughout the world is the classic foodborne intoxication. Would botulism is very rare, and most of the documented cases have been found in the United States. While infant botulism remains rare throughout the world, it has become the most frequent form of the disease in the United States in recent years. On very rare occasions botulism results from growth and toxin production in humans other than infants. Botulism occurs in animals with much higher frequency. The causative organisms constitute a diverse group of clostridia, resulting in nomenclature problems. Human botulism is largely limited to toxin types A, B, and E, while type C botulism predominates in avian and nonhuman mammalian species. The diagnosis of botulism is made on the basis of the neurologic signs and symptoms that it causes in humans and animals. The diagnosis is confirmed by tests that identify the toxin and toxigenic organisms in patient and food specimens. Treatment includes supportive intensive care and use of therapeutic antitoxin.