Title: Botulism mortality in the USA, 1975-2009

Authors: Kelly A. Jackson; Barbara E. Mahon; John Copeland; Ryan P. Fagan

Addresses: Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS D63, Atlanta, GA 30333, USA ' Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS D63, Atlanta, GA 30333, USA ' Biostatistics and Information Management Office, Centers for Disease Control and Prevention, 2500 Century Boulevard, MS E33, Atlanta, GA 30345, USA ' Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS D63, Atlanta, GA 30333, USA

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: botulism mortality; infants; age groups; USA; United States; food; wounds; botulism-related deaths; Clostridium botulinum.

DOI: 10.1504/TBJ.2015.078132

The Botulinum Journal, 2015 Vol.3 No.1, pp.6 - 17

Available online: 29 Jun 2016

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