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Public Health Risk Associated with Botulism as Foodborne Zoonoses
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Adult Intestinal Toxemia Botulism

1
Botulism Reference Service for Canada, Microbiology Research Division, Bureau of Microbial Hazards, Food Directorate, Health Products and Food Branch, Ottawa, ON K1A 0K9, Canada
2
National Reference Centre for Botulism, Microbiological Foodborne Hazard Unit, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, viale Regina Elena, 29900161 Rome, Italy
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(2), 81; https://doi.org/10.3390/toxins12020081
Received: 23 December 2019 / Revised: 20 January 2020 / Accepted: 22 January 2020 / Published: 24 January 2020
(This article belongs to the Special Issue New Challenges in Foodborne Botulism Outbreaks)
Intoxication with botulinum neurotoxin can occur through various routes. Foodborne botulism results after consumption of food in which botulinum neurotoxin-producing clostridia (i.e., Clostridium botulinum or strains of Clostridium butyricum type E or Clostridium baratii type F) have replicated and produced botulinum neurotoxin. Infection of a wound with C. botulinum and in situ production of botulinum neurotoxin leads to wound botulism. Colonization of the intestine by neurotoxigenic clostridia, with consequent production of botulinum toxin in the intestine, leads to intestinal toxemia botulism. When this occurs in an infant, it is referred to as infant botulism, whereas in adults or children over 1 year of age, it is intestinal colonization botulism. Predisposing factors for intestinal colonization in children or adults include previous bowel or gastric surgery, anatomical bowel abnormalities, Crohn’s disease, inflammatory bowel disease, antimicrobial therapy, or foodborne botulism. Intestinal colonization botulism is confirmed by detection of botulinum toxin in serum and/or stool, or isolation of neurotoxigenic clostridia from the stool, without finding a toxic food. Shedding of neurotoxigenic clostridia in the stool may occur for a period of several weeks. Adult intestinal botulism occurs as isolated cases, and may go undiagnosed, contributing to the low reported incidence of this rare disease.
Keywords: Clostridium botulinum; Clostridium butyricum; Clostridium baratii; botulism; botulinum toxin; intestinal toxemia Clostridium botulinum; Clostridium butyricum; Clostridium baratii; botulism; botulinum toxin; intestinal toxemia
MDPI and ACS Style

Harris, R.A.; Anniballi, F.; Austin, J.W. Adult Intestinal Toxemia Botulism. Toxins 2020, 12, 81.

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