What Is Botulism?

Table of ContentsView AllTable of ContentsSymptomsTypes and CausesDiagnosisTreatmentPreventionFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

Symptoms

Types and Causes

Diagnosis

Treatment

Prevention

Frequently Asked Questions

The toxin leads to muscle paralysis, with early botulism symptoms usually beginning in the face (e.g., droopy eyelids and/or slurred speech). The paralysis may then spread downward, affecting the muscles in your neck, chest, arms, and legs. Immediate medical attention is needed.

Verywell / Gary Ferster

This article discusses the types, causes, and symptoms of botulism, as well as how it is diagnosed and treated. It also provides information about botulism prevention.

Botulism Symptoms

The bacterium that causes botulism produces botulinum toxin, a neurotoxin that binds to the tiny space between a nerve and a muscle. This prevents the nerve from sending a message to the corresponding muscle. When a nerve cannot send a message to direct a muscle to move, the muscle becomes paralyzed.

Botulism classically causes paralysis of the facial muscles first. This may cause one or more of the following:

As the bacteria can produce large amounts of botulinum toxin, it can end up spreading throughout the body, paralyzing many muscles at a time. These may be in the neck, arms, chest/trunk, or legs.

In Babies and Kids

Anyone can develop botulism, including babies and young children. Instead of the above symptoms, though, infants with botulism may:

Go the ERIf you experience or observe the signs and symptoms of botulism, seek immediate medical attention. The toxin released from the bacterium that causes botulism can rapidly cause dangerous paralysis, after which the condition is much more problematic and recovery is difficult. Botulism can also be life-threatening.

Go the ER

If you experience or observe the signs and symptoms of botulism, seek immediate medical attention. The toxin released from the bacterium that causes botulism can rapidly cause dangerous paralysis, after which the condition is much more problematic and recovery is difficult. Botulism can also be life-threatening.

Types and Causes of Botulism

There are five types of syndromes related to botulism. They all cause similar symptoms related to muscle paralysis, though their origins differ.

Foodborne Botulism

This is the most common type of botulism. Botulinum toxin can enter a canned food item through a dent, slit, or a small hole in the can and grow prior to the food’s consumption. Consuming even a small amount of a food that is contaminated can have serious effects.

Certain foods are at greater risk than others, asC. botulinumwill not grow in very acidic conditions. There is also less risk of the bacteria growing in foods stored at low temperatures or that have a high salt content. Of course, which foods pose the most risk of botulism may differ from country to country, depending on their food preparation and storage practices.

In general, canned foods that are prepared at home without the use of safe processing methods are at the highest risk. But there are also outbreaks of botulism related to professionally and industrially canned foods, though these outbreaks are few and far between.

According to the Centers for Disease Control and Prevention, the most common foods related to botulism from home-canned goods are:

If you think you may have consumed a food contaminated with the bacterium that causes botulism, store the food in a container with a lid and bring it to your healthcare team for lab evaluation.

Infant Botulism

Adult Intestinal Toxemia Botulism

Adult intestinal toxemia botulism is very rare and occurs when, as with infants, the spores ofClostridium botulinumget into a person’s intestines and then grow and make the toxin.

Iatrogenic Botulism

Sometimes botulinum toxin (Botox) is deliberately used for cosmetic injections to temporarily prevent the appearance ofwrinkles,prevent migraine headaches, orrelieve muscle stiffness.

While it is not common, injections of botulinum toxin for medical or cosmetic reasons can cause unwanted paralysis of eye movement or facial muscles, which is usually temporary.

Wound Botulism

Wound botulism is a very rare botulism syndrome. Wounds that become infected withClostridium botulinumaregenerally associated with injection drug use, especially the injection of black-tar heroin (a sticky, dark-colored type of heroin) into the skin or muscle.

Surgical incisions, abrasions, lacerations, and open fractures can also increase the risk of this type of infection.

Botulism is not a common medical condition, but if you experience face, eye, or mouth weakness, your medical team will do a thorough medical history and physical examination to determine the cause.

Botulism may be considered alongside other, more likely diagnoses.

Medical History and Physical Examination

During a person’s evaluation for potential botulism, a doctor will look for the presence of three criteria, based on data from the United States National Botulism Surveillance Database:

In infants, a doctor will look for a sudden onset of weak suck, drooping eyelid, lack of activity, and constipation.

In order to assess for potential botulism exposures, various questions may be asked, such as:

Specialized Tests

Special tests may be required to make a diagnosis because botulism symptoms can mimic several other neurological conditions. These conditions include:

Some of the tests that may be ordered to sort out the correct diagnosis include:

Laboratory Tests

Various laboratory tests are used to confirm a diagnosis of botulism. These tests evaluate blood, stool, wounds, or food sources to either look for the presence of the toxin or the bacteria.

The results of botulism tests may take days to come back. This is why, if botulism is suspected, treatment is started before the diagnosis is confirmed.

Botulism Treatment

The treatment of botulism starts with immediate hospitalization and delivery of an antitoxin medication.

Hospitalization

Hospitalization and close monitoring, usually in anintensive care unit (ICU), is the mainstay of treatment of people with botulism.

Some patients require intubation withmechanical ventilation(a breathing machine) for symptoms or signs of respiratory failure from paralysis of the breathing muscles.

Medication

In addition to hospitalization with close monitoring, patients with botulism will be given an antitoxin drug.

Surgery

Surgical wound debridement, in which a wound is vigorously cleaned out to remove the infected tissue, is reserved for the treatment of wound botulism. It is used in addition to antibiotics and antitoxin.

How to Prevent Botulism

Infant botulism is the most common type to occur in the U.S., with foodborne illness accounting for about 25% of cases.Proper food handling and preparation are among your best bets for preventing botulism.

Proper Food Handling and Preparation

Always examine cans before purchasing or using them. Throw away cans with any damage.

In addition, if you have a can of food that shows signs of liquid bubbling or a bad smell, it’s safest to discard it.

Does botulism have a taste?No. You cannot taste the bacteria that causes botulism, nor can you see or smell it.

Does botulism have a taste?

No. You cannot taste the bacteria that causes botulism, nor can you see or smell it.

How to Prevent Salmonella

Avoiding Honey in Infants

Avoid giving honey to babies less than 1 year old to help prevent infant botulism. Their digestive systems are not developed enough to fight botulism bacteria before it can cause harmful effects.

Practice Proper Wound Care

Be sure to obtain prompt treatment of all wounds. Likewise, avoid injection drug use to protect yourself from related skin damage.

A Word From Verywell

With the discovery of a botulinum antitoxin and the advances in medical education and monitoring about this condition, less than five out of every 100 people with botulism die.

That said, botulism still remains a very serious illness that requires immediate treatment.

Refrigeration will prevent the growth ofC. botulinum, and safe food storage is key to avoiding the bacteria in food.That said, strains ofC. botulinumcan grow at 37.4 degrees F or higher. If in doubt, boiling food at 185 degrees F for five minutes will kill the botulin neurotoxins.Learn MoreKitchen and Food Safety

Refrigeration will prevent the growth ofC. botulinum, and safe food storage is key to avoiding the bacteria in food.That said, strains ofC. botulinumcan grow at 37.4 degrees F or higher. If in doubt, boiling food at 185 degrees F for five minutes will kill the botulin neurotoxins.

Learn MoreKitchen and Food Safety

Learn MoreHow Vaccines Work

12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kim MJ, Neta M, Davis FC, et al.Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings from an A-B-A design.Biol Mood Anxiety Disord.2014;4:11. doi:10.1186/2045-5380-4-11Centers for Disease Control and Prevention.About Botulism.Centers for Disease Control and Prevention.Home-Canned Foods. Protect Yourself from Botulism.World Health Organization.Botulism.Centers for Disease Control and Prevention.Botulism: Prevention.Pirazzini M, Montecucco C, Rossetto O.Toxicology and pharmacology of botulinum and tetanus neurotoxins: an update.Arch Toxicol. 2022 Jun;96(6):1521-1539. doi:10.1007/s00204-022-03271-9Centers for Disease Control and Prevention.Botulism: Symptoms.Centers for Disease Control and Prevention.Testing for Botulism.Centers for Disease Control and Prevention.Botulism: Epidemiological Overview for Clinicians.Centers for Disease Control and Prevention.Botulism: The Threat.Pernu N, Keto-Timonen R, Lindström M, Korkeala H.High prevalence of Clostridium botulinum in vegetarian sausages.Food Microbiol. 2020 Oct;91:103512. doi:10.1016/j.fm.2020.103512.Sundeen G, Barbieri JT.Vaccines against Botulism.Toxins (Basel). 2017 Sep 2;9(9):268. doi:10.3390/toxins9090268.Additional ReadingClostridium, Peptostreptococcus, Bacteroides, and Other Anaerobes. In: Ryan KJ, Ray C. eds.Sherris Medical Microbiology, 6eNew York, NY: McGraw-Hill; 2014.Mezencev R, Klement C.[Foodborne botulism - a re-emerging public health challenge].Epidemiol Mikrobiol Imunol. Winter 2017;66(1):39-48.Pegram PS, Stone SM.Botulism. In D.S. Bartlett JG (Ed.),UpToDate.Tsai HJ.Botulism with unusual rapid progression to complete paralysis in a child.Pediatr Neonatol.2015 Dec;56(6):425-8. doi:10.1016/j.pedneo.2013.03.020

12 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kim MJ, Neta M, Davis FC, et al.Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings from an A-B-A design.Biol Mood Anxiety Disord.2014;4:11. doi:10.1186/2045-5380-4-11Centers for Disease Control and Prevention.About Botulism.Centers for Disease Control and Prevention.Home-Canned Foods. Protect Yourself from Botulism.World Health Organization.Botulism.Centers for Disease Control and Prevention.Botulism: Prevention.Pirazzini M, Montecucco C, Rossetto O.Toxicology and pharmacology of botulinum and tetanus neurotoxins: an update.Arch Toxicol. 2022 Jun;96(6):1521-1539. doi:10.1007/s00204-022-03271-9Centers for Disease Control and Prevention.Botulism: Symptoms.Centers for Disease Control and Prevention.Testing for Botulism.Centers for Disease Control and Prevention.Botulism: Epidemiological Overview for Clinicians.Centers for Disease Control and Prevention.Botulism: The Threat.Pernu N, Keto-Timonen R, Lindström M, Korkeala H.High prevalence of Clostridium botulinum in vegetarian sausages.Food Microbiol. 2020 Oct;91:103512. doi:10.1016/j.fm.2020.103512.Sundeen G, Barbieri JT.Vaccines against Botulism.Toxins (Basel). 2017 Sep 2;9(9):268. doi:10.3390/toxins9090268.Additional ReadingClostridium, Peptostreptococcus, Bacteroides, and Other Anaerobes. In: Ryan KJ, Ray C. eds.Sherris Medical Microbiology, 6eNew York, NY: McGraw-Hill; 2014.Mezencev R, Klement C.[Foodborne botulism - a re-emerging public health challenge].Epidemiol Mikrobiol Imunol. Winter 2017;66(1):39-48.Pegram PS, Stone SM.Botulism. In D.S. Bartlett JG (Ed.),UpToDate.Tsai HJ.Botulism with unusual rapid progression to complete paralysis in a child.Pediatr Neonatol.2015 Dec;56(6):425-8. doi:10.1016/j.pedneo.2013.03.020

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Kim MJ, Neta M, Davis FC, et al.Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings from an A-B-A design.Biol Mood Anxiety Disord.2014;4:11. doi:10.1186/2045-5380-4-11Centers for Disease Control and Prevention.About Botulism.Centers for Disease Control and Prevention.Home-Canned Foods. Protect Yourself from Botulism.World Health Organization.Botulism.Centers for Disease Control and Prevention.Botulism: Prevention.Pirazzini M, Montecucco C, Rossetto O.Toxicology and pharmacology of botulinum and tetanus neurotoxins: an update.Arch Toxicol. 2022 Jun;96(6):1521-1539. doi:10.1007/s00204-022-03271-9Centers for Disease Control and Prevention.Botulism: Symptoms.Centers for Disease Control and Prevention.Testing for Botulism.Centers for Disease Control and Prevention.Botulism: Epidemiological Overview for Clinicians.Centers for Disease Control and Prevention.Botulism: The Threat.Pernu N, Keto-Timonen R, Lindström M, Korkeala H.High prevalence of Clostridium botulinum in vegetarian sausages.Food Microbiol. 2020 Oct;91:103512. doi:10.1016/j.fm.2020.103512.Sundeen G, Barbieri JT.Vaccines against Botulism.Toxins (Basel). 2017 Sep 2;9(9):268. doi:10.3390/toxins9090268.

Kim MJ, Neta M, Davis FC, et al.Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings from an A-B-A design.Biol Mood Anxiety Disord.2014;4:11. doi:10.1186/2045-5380-4-11

Centers for Disease Control and Prevention.About Botulism.

Centers for Disease Control and Prevention.Home-Canned Foods. Protect Yourself from Botulism.

World Health Organization.Botulism.

Centers for Disease Control and Prevention.Botulism: Prevention.

Pirazzini M, Montecucco C, Rossetto O.Toxicology and pharmacology of botulinum and tetanus neurotoxins: an update.Arch Toxicol. 2022 Jun;96(6):1521-1539. doi:10.1007/s00204-022-03271-9

Centers for Disease Control and Prevention.Botulism: Symptoms.

Centers for Disease Control and Prevention.Testing for Botulism.

Centers for Disease Control and Prevention.Botulism: Epidemiological Overview for Clinicians.

Centers for Disease Control and Prevention.Botulism: The Threat.

Pernu N, Keto-Timonen R, Lindström M, Korkeala H.High prevalence of Clostridium botulinum in vegetarian sausages.Food Microbiol. 2020 Oct;91:103512. doi:10.1016/j.fm.2020.103512.

Sundeen G, Barbieri JT.Vaccines against Botulism.Toxins (Basel). 2017 Sep 2;9(9):268. doi:10.3390/toxins9090268.

Clostridium, Peptostreptococcus, Bacteroides, and Other Anaerobes. In: Ryan KJ, Ray C. eds.Sherris Medical Microbiology, 6eNew York, NY: McGraw-Hill; 2014.Mezencev R, Klement C.[Foodborne botulism - a re-emerging public health challenge].Epidemiol Mikrobiol Imunol. Winter 2017;66(1):39-48.Pegram PS, Stone SM.Botulism. In D.S. Bartlett JG (Ed.),UpToDate.Tsai HJ.Botulism with unusual rapid progression to complete paralysis in a child.Pediatr Neonatol.2015 Dec;56(6):425-8. doi:10.1016/j.pedneo.2013.03.020

Clostridium, Peptostreptococcus, Bacteroides, and Other Anaerobes. In: Ryan KJ, Ray C. eds.Sherris Medical Microbiology, 6eNew York, NY: McGraw-Hill; 2014.

Mezencev R, Klement C.[Foodborne botulism - a re-emerging public health challenge].Epidemiol Mikrobiol Imunol. Winter 2017;66(1):39-48.

Pegram PS, Stone SM.Botulism. In D.S. Bartlett JG (Ed.),UpToDate.

Tsai HJ.Botulism with unusual rapid progression to complete paralysis in a child.Pediatr Neonatol.2015 Dec;56(6):425-8. doi:10.1016/j.pedneo.2013.03.020

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