The global epidemiology of botulism outbreaks from open-source intelligence, 2017-2024

Area of Science:

• Epidemiology
• Public Health Surveillance
• Infectious Disease Outbreak Analysis

Background:

• Botulism is a rare, fatal illness caused by botulinum neurotoxin, with global outbreaks in humans and animals.
• Traditional global surveillance systems for botulism are lacking.
• Open-source intelligence (OSINT) provides real-time insights into botulism activity.

Purpose of the Study:

• To evaluate the utility of OSINT for identifying and analyzing global botulism outbreaks.
• To characterize the patterns of human and animal botulism outbreaks using OSINT data.

Main Methods:

• An Artificial-Intelligence-driven OSINT early warning system (EPIWATCH®) was used to extract botulism outbreak data.
• Data spanned from December 31, 2016, to January 1, 2025, including outbreak details like location, symptoms, and transmission routes.
• Statistical analyses were performed using STATA/BE 17.0.

Main Results:

• OSINT identified 296 botulism outbreaks: 259 in humans (1097 cases, 47 deaths) and 37 in animals (27,537 cases, 27,287 deaths).
• The highest incidence of human outbreaks occurred in Ukraine, the Russian Federation, and the USA.
• Foodborne transmission was primary (79.5%), with dried fish being a common source; common symptoms included dysphagia and nausea.

Conclusions:

• OSINT-based surveillance offers a novel mechanism for understanding global botulism patterns.
• This approach provides valuable insights, particularly in regions with limited traditional reporting infrastructure.
• OSINT enhances real-time monitoring and response capabilities for botulism outbreaks.