Botulism is a rare and potentially fatal disease caused by botulinum toxin produced by the bacterium Clostridium botulinum, a Gram-positive, spore-forming organism whose spores are ubiquitous in soil and water and germinate under anaerobic conditions to release BoNT. [1][2][3] Seven BoNT serotypes (A–G) exist, of which types A, B, E, and rarely F cause human disease; the toxin acts at neuromuscular junctions and can be ingested preformed in food or produced in vivo in infants or wounds. [1][2][3]
Disease overview
BacterialBotulism
肉毒杆菌中毒
Evidence-backed informationEN 5/7 applicable sections · ZH 5/7 applicable sectionsUpdated Sep 3, 2026
Botulism is a rare but potentially fatal neuroparalytic illness caused by botulinum neurotoxin (BoNT) produced by Clostridium botulinum, classically presenting as descending flaccid paralysis that can progress to respiratory failure if untreated. [1][2][3] Disease occurs in three principal forms—foodborne, infant, and wound—distinguished by the route of toxin exposure or in-situ toxin production. [1][2][3] Although incidence is low, outbreaks tied to improperly processed foods and the vulnerability of infants and people who inject drugs make sustained surveillance and prevention important. [1][2][3]
Read the full clinical and epidemiological profile6
The clinical picture is dominated by symmetrical descending flaccid paralysis reflecting blockade of acetylcholine release from motor neurons by BoNT. [1][2][3] Early symptoms typically include marked fatigue, weakness, vertigo, blurred vision, dry mouth, and difficulty swallowing or speaking, sometimes accompanied by vomiting, abdominal swelling, constipation, or diarrhea, with no fever and preserved consciousness. [1][2][3] Paralysis may progress from the neck and arms to the respiratory muscles and lower limbs, and untreated cases can lead to respiratory failure and death. [1][2] In infants under about 6 months, the presentation differs and includes constipation, poor feeding, weakness, an altered cry, and a striking loss of head control. [2]
Botulism has a low overall incidence worldwide but carries a notable case-fatality risk; in the United States, 273 confirmed and probable cases were reported in 2021, of which 66% were infant botulism, 24% wound botulism, and 8% foodborne botulism. [1] Infant botulism is predominantly sporadic with marked geographic concentration, with California accounting for 25% and Pennsylvania for 12% of U.S. infant cases in 2021. [1] Among U.S. foodborne cases reported between 1990 and 2000, the case-fatality rate was approximately 4%. [1] A documented United Kingdom outbreak in June 1989 produced 27 foodborne cases and one death linked to a single brand of hazelnut yogurt, illustrating the outbreak potential of contaminated processed foods. [1]
Botulism is not transmitted person-to-person; exposure occurs when BoNT or toxin-producing C. botulinum spores reach a permissive environment. [1][2] Foodborne botulism follows ingestion of preformed toxin in improperly processed foods in which spores survived and germinated anaerobically. [1][2] Infant botulism results from ingestion of C. botulinum spores that then germinate and produce toxin within the infant gut, a vulnerability limited largely to infants under about 6 months of age because older children and adults possess intestinal defenses that prevent colonization. [1][2] Wound botulism arises when spores contaminate a wound, especially among those who inject street drugs, and germinate in the anaerobic wound milieu to release toxin locally. [1][2] Transmission can also occur by inhalation in the context of deliberate or accidental aerosol exposure to preformed BoNT. [2]
Prevention centers on food-safety practices that destroy spores or inactivate preformed toxin, including proper canning, sterilization, and adequate cooking; BoNT is heat-labile and is destroyed by heating food above 85 °C for more than 5 minutes, while C. botulinum spores are highly resistant and require moist heat autoclaving (121 °C for at least 15 minutes), dry heat (160 °C for 2 hours), or irradiation for reliable inactivation. [1] For infant botulism, avoiding honey in children under 1 year is a cornerstone recommendation, since spore-contaminated honey is a recognized exposure source. [2] For wound botulism, prevention depends on reducing risks associated with injection drug use and appropriate wound care. [1] No FDA-approved vaccine is currently available; an investigational formalin-inactivated penta-serotype BoNT/A–E toxoid vaccine used for people at high occupational risk was discontinued due to loss of potency, and DNA-, viral-vector-, and recombinant-protein-based candidate vaccines are under development. [4][5]
- 1Wikipedia contributors. Botulism - Wikipedia [Internet]. Wikipedia. cited 12 Aug 2026.Available from: https://en.wikipedia.org/wiki/Botulism
- 2World Health Organization. Botulism [Internet]. cited 3 Sept 2026.Available from: https://www.who.int/news-room/fact-sheets/detail/botulism
- 3Rawson AM et al. Pathogenicity and virulence of Clostridium botulinum. Virulence. 2023 Dec. PMID: 37157163. doi: 10.1080/21505594.2023.2205251.PubMed: https://pubmed.ncbi.nlm.nih.gov/37157163/
- 4Sundeen G et al. Vaccines against Botulism. Toxins (Basel). 2017 Sep 2. PMID: 28869493. doi: 10.3390/toxins9090268.PubMed: https://pubmed.ncbi.nlm.nih.gov/28869493/
- 5Dong M et al. Botulinum and Tetanus Neurotoxins. Annu Rev Biochem. 2019 Jun 20. PMID: 30388027. doi: 10.1146/annurev-biochem-013118-111654.PubMed: https://pubmed.ncbi.nlm.nih.gov/30388027/
Coverage
Reporting countries and regions
AustraliaAU
AustriaAT
BelgiumBE
BrazilBR
BulgariaBG
CanadaCA
CroatiaHR
CyprusCY
CzechiaCZ
DenmarkDK
EstoniaEE
FinlandFI
FranceFR
GermanyDE
GreeceGR
Hong Kong, ChinaHK
HungaryHU
IcelandIS
IrelandIE
ItalyIT
JapanJP
LatviaLV
LiechtensteinLI
LithuaniaLT
LuxembourgLU
MaltaMT
NetherlandsNL
NorwayNO
PolandPL
PortugalPT
RomaniaRO
SingaporeSG
SlovakiaSK
SloveniaSI
South KoreaKR
SpainES
SwedenSE
SwitzerlandCH
Taiwan, ChinaTW
United KingdomGB
Trends by reporting country
Monthly patterns over time
Research Radar
Recent related research
Foodborne Botulism in Canada, 1985–2005
Emerging Infectious Diseases
Literature links are provided for discovery and do not alter or validate the surveillance series above.
Data access
Page dataset index with source links and update metadata.
Official sourcesAuthority, cadence, notes53
Austria AGES Radar for Infectious Diseases
Austria
AGES Radar monthly national source. Internal ingestion retains native categories; public release is disabled pending licence review.
Australia NINDSS
Australia
Australian national notifiable diseases surveillance dashboard.
Australia NINDSS — Australian Capital Territory
Australian Capital Territory, Australia
Australian NINDSS monthly state/territory notifications for Australian Capital Territory, kept separate from the Australia national aggregate.
Australia NINDSS — New South Wales
New South Wales, Australia
Australian NINDSS monthly state/territory notifications for New South Wales, kept separate from the Australia national aggregate.
Australia NINDSS — Northern Territory
Northern Territory, Australia
Australian NINDSS monthly state/territory notifications for Northern Territory, kept separate from the Australia national aggregate.
Australia NINDSS — Queensland
Queensland, Australia
Australian NINDSS monthly state/territory notifications for Queensland, kept separate from the Australia national aggregate.
Australia NINDSS — South Australia
South Australia, Australia
Australian NINDSS monthly state/territory notifications for South Australia, kept separate from the Australia national aggregate.
Australia NINDSS — Tasmania
Tasmania, Australia
Australian NINDSS monthly state/territory notifications for Tasmania, kept separate from the Australia national aggregate.
Australia NINDSS — Victoria
Victoria, Australia
Australian NINDSS monthly state/territory notifications for Victoria, kept separate from the Australia national aggregate.
Australia NINDSS — Western Australia
Western Australia, Australia
Australian NINDSS monthly state/territory notifications for Western Australia, kept separate from the Australia national aggregate.
ECDC Surveillance Atlas — Belgium Annual Baseline
Belgium
Belgium annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Bulgaria Annual Baseline
Bulgaria
Bulgaria annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Brazil DATASUS SINAN
Brazil
Brazil Ministry of Health DATASUS/SINAN public DBC microdata aggregated to national monthly notification counts.
Canada PHAC CNDSS Annual
Canada
Canada is the national jurisdiction; subdivision feeds are registered separately.
Public Health Ontario IDTO Monthly
Ontario, Canada
Ontario-level current-year preliminary monthly case counts from Public Health Ontario's IDTO report.
Switzerland FOPH IDD
Switzerland
Switzerland FOPH/BAG IDD mandatory reporting API normalized to national case rows. Monthly series may use the dashboard CHFL aggregate where CH-only monthly series are not exposed.
ECDC Surveillance Atlas — Cyprus Annual Baseline
Cyprus
Cyprus annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Czechia Annual Baseline
Czechia
Czechia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Germany RKI SurvStat 2.0
Germany
RKI SurvStat national weekly notification export; raw ZIP exports are retained and recent weeks are overwritten for revisions.
ECDC Surveillance Atlas — Denmark Annual Baseline
Denmark
Denmark annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Estonia Annual Baseline
Estonia
Estonia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Spain Annual Baseline
Spain
Spain annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Finland THL Infectious Diseases Register
Finland
Finland THL Infectious Diseases Register national monthly case counts. The current month is ingested as provisional and the latest three months are refreshed for source revisions.
ECDC Surveillance Atlas — France Annual Baseline
France
France annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — United Kingdom Annual Baseline
United Kingdom
United Kingdom annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Greece Annual Baseline
Greece
Greece annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Hong Kong, China CHP Notifiable Diseases
Hong Kong, China
Hong Kong, China CHP annual notifiable infectious disease CSVs normalized to national monthly totals
ECDC Surveillance Atlas — Croatia Annual Baseline
Croatia
Croatia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Hungary Annual Baseline
Hungary
Hungary annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Ireland HPSC Notifiable Diseases Hub
Ireland
Ireland HPSC national weekly notifiable-disease totals from the official ArcGIS FeatureServer. Internal ingestion is enabled; public release remains disabled pending written redistribution permission.
Iceland Directorate of Health Annual Dashboard
Iceland
National annual case notifications by disease. Published values can be revised retrospectively and remain annual period totals.
Iceland Directorate of Health STI Dashboard
Iceland
Monthly STI diagnosis facts from laboratory and registry surveillance; the official dashboard is published on a quarterly schedule.
Iceland Directorate of Health Respiratory Dashboard
Iceland
ISO-week respiratory diagnosis counts. Hospitalizations, samples, and vaccination indicators are separate measures and are not counted as diagnoses.
Iceland Directorate of Health Historical Registry
Iceland
Historical official registry tables for 1997–2021, with annual totals and disease-specific monthly notification facts retained at source grain.
Iceland Directorate of Health Legacy ICD Monthly
Iceland
Historical Saga EHR ICD encounter counts for 1997–2020. This clinical measure is non-comparable with registry notifications and is kept separate.
ECDC Surveillance Atlas — Italy Annual Baseline
Italy
Italy annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
JP NIID Weekly
Japan
Japan weekly infectious disease surveillance via NIID/JIHS.
Korea KDCA EID
South Korea
Korea KDCA notifiable infectious disease OpenAPI or portal/KOSIS downloads aggregated to national monthly notification counts.
ECDC Surveillance Atlas — Liechtenstein Annual Baseline
Liechtenstein
Liechtenstein annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Lithuania Annual Baseline
Lithuania
Lithuania annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Luxembourg Annual Baseline
Luxembourg
Luxembourg annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Latvia Annual Baseline
Latvia
Latvia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Malta Annual Baseline
Malta
Malta annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Netherlands Annual Baseline
Netherlands
Netherlands annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Norway FHI MSIS Statistics Bank
Norway
Norway FHI MSIS national monthly notifications from the official Allvis frontend API; adapter contract checks guard the unversioned endpoint.
ECDC Surveillance Atlas — Poland Annual Baseline
Poland
Poland annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Portugal Annual Baseline
Portugal
Portugal annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Romania Annual Baseline
Romania
Romania annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Sweden Public Health Agency SmiNet
Sweden
Sweden SmiNet national monthly reported cases from the official Public Health Agency statistics pages; public release is enabled with closed-month publication and revisable recent-month refreshes.
Singapore CDA Weekly Infectious Diseases Bulletin
Singapore
Singapore national weekly case notifications, combining the official data.gov.sg 2012–2022 CSV history with CDA annual workbooks from 2023 onward; 2023 weekly PDFs are retained as a source fallback.
ECDC Surveillance Atlas — Slovenia Annual Baseline
Slovenia
Slovenia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
ECDC Surveillance Atlas — Slovakia Annual Baseline
Slovakia
Slovakia annual Member-State reported case counts from the ECDC Surveillance Atlas. Missing topic/year cells remain unknown and published zeroes are preserved. Data provided by ECDC based on data reported by EU/EEA Member States.
Taiwan, China CDC NIDSS
Taiwan, China
Taiwan, China monthly notifiable infectious disease open-data CSV feed.