Human and animal botulism surveillance in France from 2008 to 2019

Abstract

Botulism is a human and animal neurological disease caused by the action of bacterial neurotoxins (botulinum toxins) produced by bacteria from the genus Clostridium. This disease induces flaccid paralysis that can result in respiratory paralysis and heart failure. Due to its serious potential impact on public health, botulism is a closely monitored notifiable disease in France through a case-based passive surveillance system. In humans, this disease is rare, with an average of 10 outbreaks reported each year, mainly due to the consumption of contaminated foods. Type B and to a lesser extend type A are responsible for the majority of cases of foodborne botulism. Each year, an average of 30 outbreaks are recorded on poultry farms, about 20 cases in wild birds and about 10 outbreaks in cattle, involving a large number of animals. Mosaic forms C/D and D/C in birds and cattle, respectively, are the predominant types in animals in France. Types C and D have also been observed to a lesser extent in animals. With the exception of botulinum toxin E, which was exceptionally detected throughout the period in wild birds, the types of botulism found in animal outbreaks are different from those identified in human outbreaks over the last ten years in France and no human botulism outbreaks investigated have been linked to animal botulism. In line with the One Health concept, we present the first integrative approach to the routine surveillance of botulism in humans and animals in France.

Keywords: One Health; botulism; bovine; poultry; surveillance; wild bird.

Figure 1

Number of foodborne human botulism outbreaks and cases based on NRC data. The curves represent a trend analysis over the period 1987–2018 (A,C) and over the period 2008–2018 [panel (B,D)]. r represents the growth rate of the log-linear model used for assessing the growth or decline of the number of cases or oubreaks.

Figure 2

Distribution of animal botulism outbreaks from 2009 to 2019 by species (n = 592).

Figure 3

Evolution of the number of botulism cases in wild birds (2005–2019), outbreaks in poultry (2005–2019) and cattle (2009–2019) (n = 592).

Figure 4

Distribution of human outbreaks (n = 82) and infant botulism outbreaks (n = 14) according to botulinum toxin type and case origin identification over the period 2008–2018 in France.

Figure 5

Distribution of foodborne botulism outbreaks with identification of the food source (n = 41) in France between 2008 and 2018 according to the type of preparation, nature of the food, origin of the food and type of botulinum toxin.

Figure 6

Distribution of botulism toxins from 2010 to 2019 for wild birds (n = 193), poultry (n = 231) and cattle (n = 118).