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Updated: Feb 28, 2026

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Botulism mortality in the USA, 1975-2009.

Kelly A Jackson1, Barbara E Mahon1, John Copeland2

  • 1Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS D63, Atlanta, GA 30333, USA.

The Botulinum Journal
|June 13, 2017
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Summary

Botulism mortality has significantly decreased since the 1950s. However, non-infant botulism cases and older adults face higher risks, requiring targeted prevention efforts.

Keywords:
USAage groupsbotulismfoodinfantmortality

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Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Botulism historically presented a high mortality rate exceeding 60% before the 1950s.
  • Understanding current trends in botulism mortality is crucial for public health interventions.

Purpose of the Study:

  • To analyze mortality trends and risk factors associated with botulism in the USA.
  • To identify specific populations and transmission categories at higher risk for botulism-related death.

Main Methods:

  • Retrospective review of confirmed botulism cases in the USA from 1975 to 2009.
  • Categorization of cases by acquisition type: infant, foodborne, wound, and other/unknown.
  • Multivariate logistic regression analysis for non-infant cases to identify mortality predictors.

Main Results:

  • Overall botulism mortality was 3.0% (109 deaths out of 3,618 cases).
  • Mortality varied significantly by age, increasing with age (0.8% in infants to 34.4% in those ≥80 years).
  • Toxin type F demonstrated higher mortality (13.8%) compared to types A, B, and E.

Conclusions:

  • Botulism mortality has dramatically decreased but remains a concern, particularly in non-infant cases and the elderly.
  • Targeting non-infant transmission routes and focusing on older adult populations are essential for reducing botulism deaths.
  • Further research into Toxin type F specific outcomes may inform treatment strategies.