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Botulism (Clostridium botulinum)
2011 Case Definition

NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

CSTE Position Statement(s)

  • 10-ID-03

Subtype(s)

  • Botulism, foodborne
  • Botulism, infant
  • Botulism, wound
  • Botulism, other

Subtype(s) Case Definition  

Botulism, foodborne

Clinical Description

Ingestion of botulinum toxin results in an illness of variable severity. Common symptoms are diplopia, blurred vision, and bulbar weakness. Symmetric paralysis may progress rapidly.

Laboratory Criteria for Diagnosis

  • Detection of botulinum toxin in serum, stool, or patient's food, OR
  • Isolation of Clostridium botulinum from stool

Case Classification

Probable

A clinically compatible case with an epidemiologic link (e.g., ingestion of a home-canned food within the previous 48 hours)

Confirmed

A clinically compatible case that is laboratory confirmed or that occurs among persons who ate the same food as persons who have laboratory-confirmed botulism

Botulism, infant

Clinical Description

An illness of infants, characterized by constipation, poor feeding, and "failure to thrive"that may be followed by progressive weakness, impaired respiration, and death

Laboratory Criteria for Diagnosis

  • Detection of botulinum toxin in stool or serum, OR
  • Isolation of Clostridium botulinum from stool

Case Classification

Confirmed

A clinically compatible case that is laboratory-confirmed, occurring in a child aged less than 1 year

Botulism, wound

Clinical Description

An illness resulting from toxin produced by Clostridium botulinum that has infected a wound. Common symptoms are diplopia, blurred vision, and bulbar weakness. Symmetric paralysis may progress rapidly.

Laboratory Criteria for Diagnosis

  • Detection of botulinum toxin in serum, OR
  • Isolation of Clostridium botulinum from wound

Case Classification

Probable

A clinically compatible case in a patient who has no suspected exposure to contaminated food and who has either a history of a fresh, contaminated wound during the 2 weeks before onset of symptoms, or a history of injection drug use within the 2 weeks before onset of symptoms

Confirmed

A clinically compatible case that is laboratory confirmed in a patient who has no suspected exposure to contaminated food and who has a history of a fresh, contaminated wound during the 2 weeks before onset of symptoms, or a history of injection drug use within the 2 weeks before onset of symptoms

Botulism, other

Clinical Description

See Botulism, foodborne.

Laboratory Criteria for Diagnosis

  • Detection of botulinum toxin in clinical specimen, OR
  • Isolation of Clostridium botulinum from clinical specimen

Case Classification

Confirmed

A clinically compatible case that is laboratory-confirmed in a patient aged greater than or equal to 1 year who has no history of ingestion of suspect food and has no wounds



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