Botulism is a paralytic disease caused by potent protein neurotoxins elaborated by Clostridium botulinum. Illness begins with cranial nerve involvement and proceeds caudally to involve the extremities. Cases may be classified as (1) food-borne botulism, from ingestion of preformed toxin in food contaminated with C. botulinum; (2) wound botulism, from toxin produced in wounds contaminated with the organism; and (3) intestinal botulism, from ingestion of spores and production of toxin in the intestine of infants (infant botulism) or adults. Botulinum toxin, because of its extraordinary potency, has long been considered a threat as an agent of bioterrorism or biologic.
