Botulism (Clostridium botulinum)

Clinical criteria
Any person with at least one of the following clinical forms:

Food-borne and wound botulism
At least one of the following two:
- Bilateral cranial nerve impairment (e.g. diplopia, blurred vision, dysphagia, bulbar weakness)
- Peripheral symmetric paralysis

Infant botulism
Any infant with at least one of the following six:
- Constipation
- Lethargy
- Poor feeding
- Ptosis
- Dysphagia
- General muscle weakness
The type of botulism usually encountered in infants (<12 months of age) can affect children also over 12 months of age and occasionally adults, with altered gastrointestinal anatomy and microflora.

Laboratory criteria
At least one of the following three:

• Isolation of BoNT-producing clostridia (for example, Clostridium botulinum, C. baratii, C. butyricum) for infant botulism (stool) or wound botulism (wound);
• Detection of botulinum toxin in a clinical specimen
• Detection of genes encoding for botulinum neurotoxins in a clinical specimen

Epidemiological criteria
An epidemiological link by exposure to a common source

Case classification
A. Possible case
NA
B. Probable case
Any person meeting the clinical criteria and with an epidemiological link
C. Confirmed case
Any person meeting the clinical and the laboratory criteria

Current as of: 22 January 2019

Historic Case Definitions