[Clinical and epidemiological characteristics of botulism in France]

Botulism is still found in France. Botulism is life-threatening and may have epidemic occurrences, which justifies an epidemiological watch with systematic notification of cases. In order to complete these recent epidemiological data, older cases since 1940 have been reviewed through a survey sent to the French Ministry of Health and the Pasteur Institute (National Reference Center). A Medline search has also been completed. In France, foodborne botulism is the main source of contamination. Type B is nearly always involved but type E botulism has been regularly reported. Fatal outcome due to botulism-induced respiratory muscle weakness can now be avoided by mechanical ventilation, leading to better prognosis. Microbiological diagnosis has been confirmed in two-thirds of the cases by isolation of toxin in the patient's serum. It is important to identify the foodstuff incriminated to prevent the development of a botulism outbreak. Foodstuffs responsible for foodborne botulism are the same since 1940. However, the increased consumption of vacuum-packed foodstuffs might facilitate the persistence of botulism. In conclusion, this review points out the significance of epidemiological screening of foodstuffs in the alimentary chain as well as the systematic notification of botulism. The regular educational information for young physicians regarding botulism should be continued.