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. 2015;3(1):6-17.
doi: 10.1504/TBJ.2015.078132. Epub 2016 Aug 4.

Botulism mortality in the USA, 1975-2009

Kelly A Jackson  1 , Barbara E Mahon  1 , John Copeland  2 , Ryan P Fagan  1
Affiliations

Botulism mortality in the USA, 1975-2009

Kelly A Jackson et al. Botulinum J. 2015.

Abstract

Botulism had mortality rates >60% before the 1950s. We reviewed confirmed botulism cases in the USA during 1975-2009 including infant, foodborne, wound, and other/unknown acquisition categories, and calculated mortality ratios. We created a multivariate logistic regression model for non-infant cases (foodborne, wound, and other/unknown). Overall mortality was 3.0% with 109 botulism-related deaths among 3,618 botulism cases [18 (<1%) deaths among 2,352 infant botulism cases, 61 (7.1%) deaths among 854 foodborne botulism cases, 18 (5.0%) deaths among 359 wound botulism cases, and 12 (22.6%) deaths among 53 other/unknown botulism cases]. Mortality among all cases increased with age; it was lowest among infants (0.8%) and highest among persons ≥80 years old (34.4%). Toxin type F had higher mortality (13.8%) than types A, B, or E (range, 1.4% to 4.1%). Efforts to reduce botulism mortality should target non-infant transmission categories and older adults.

Keywords: USA; age groups; botulism; food; infant; mortality.

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Figures

Figure 1
Figure 1. Botulism mortality (deaths per 100 cases) by time period and acquisition category, USA, 1975–2009 (n = 3,618)*, **
Notes: *Excludes cases with unknown outcome (n = 435) and cases with unknown or mixed toxin type (n = 66), **Due to the very small number of cases categorised as other/unknown (n = 53), the other/unknown acquisition category was not analysed by time period ***The non-infant category includes all botulism cases classifed as foodborne, wound and other/unknown.
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