Botulism and tetanus: selected epidemiologic and microbiologic aspects

Botulism is rare in both developing and developed countries. During 1980 only 89 cases (18 food borne, 68 infant, 2 wound, 1 unspecified) were reported in the United States. Coproexamination is essential for laboratory confirmation of infant botulism. Botulinal antitoxins of equine origin are used for treating food-borne and wound botulism but are usually not recommended for infant cases. Tetanus is much more common in some developing countries than in developed countries. During 1980 only 95 cases of tetanus were reported in the United States; in 68 (72%) of these cases, the patient was 50 years or older, and in only two (2.1%) cases was the patient younger than one year. Tetanus neonatorum is a major problem in some developing countries. Diagnosis of tetanus is based primarily on clinical findings, but laboratory studies can be helpful, especially in epidemiologic investigations. Human hyperimmune immunoglobulin is now used in the treatment of tetanus.