Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)
I. IDENTIFICATION
A. CLINICAL DESCRIPTION: Ingestion of botulinum toxin resulting in an illness of variable severity. Common symptoms are double vision, blurred vision, difficulty swallowing and dry mouth. Descending symmetric flaccid paralysis may progress rapidly.
B. REPORTING CRITERIA: Laboratory confirmation of botulism or a diagnosis without laboratory confirmation if the clinical and epidemiologic evidence is overwhelming.
C. LABORATORY CRITERIA FOR CONFIRMATION:
- Detection of botulinum toxin in serum, stool or suspect food, OR
- Isolation of Clostridium botulinum from stool.
D. CASE DEFINITION: A clinically compatible illness that is laboratory confirmed or that occurs among persons who ate the same food as persons with laboratory confirmed botulism.
II. ACTIONS REQUIRED / PREVENTION MEASURES
A. WISCONSIN DISEASE SURVEILLANCE CATEGORY I: Report IMMEDIATELY BY TELEPHONE to the patient's local health officer upon identification of a case or suspected case. Complete and mail an Acute and Communicable Disease Case Report (DPH 4151) to the local health officer within 24 hours.
B. EPIDEMIOLOGY REPORTS REQUESTED: Acute and Communicable Diseases Case Report (DPH 4151).
C. PUBLIC HEALTH INTERVENTIONS:
- Immediate treatment required for case patient. Contact DPH Emergency Hotline at (608) 258-0099 for protocol on receiving botulism antitoxin.
- Determine if others consumed suspect food items.
- Source investigation by LHD.
III. CONTACTS FOR CONSULTATION
A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-9009.
B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.
C. WSLH / BACTERIOLOGY: (608) 263-3421.
IV. RELATED REFERENCES
1. “Botulism, Foodborne” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets
2. Heymann DL, ed. BOTULISM. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004: 69-75.
3. Pickering LK, ed. Botulism and Infant Botulism. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:243-246.
V. DISEASE TRENDS
Foodborne botulism is a rare disease in Wisconsin . Between 1999 and 2003 only one case of foodborne botulism has been reported to the BCDP.