The epidemiology and clinical aspects of foodborne botulism in Texas, 1992-2001




Wolf, Peter William

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Foodborne botulism, caused by the organism Clostridium botulinum is a public health emergency requiring rapid diagnosis and response. Outbreaks of botulism occur sporadically, and there may be no cases reported in Texas for several years at a time. As the most potent organic toxin known, C. botulinum toxin has the potential to be used as a biological weapon. Methods used to treat botulism include administration of antitoxin, cathartics, gastric lavage and high enemas. An affected person may spend months on a ventilator while recovering from foodborne botulism. This study looks at the effect diarrhea may have on the symptoms and outcomes of botulism. Diarrhea may occur in about one half of the cases, and may be caused by other organisms found in the implicated food. Study subjects were identified from two foodborne outbreaks of botulism. With age and sex as covariates, the relationship between diarrhea (independent variable) and various symptoms and outcomes (dependent variables), was examined with the use of odds ratios, logistic regression and other multivariate techniques. Study results indicated an association between diarrhea and fatigue (odds ratio (OR) = 6.29, 95% confidence interval (Cl) 1.19 - 33.35). Frequency of neurologic symptoms and interventions were lower in those with diarrhea. Patients with diarrhea were less likely to be hospitalized (OR = 0.76, 95% Cl = 0.16 - 3.58), but this association was not significant at the 0.05 level. Diarrhea was not significantly associated with any other symptoms or outcomes.



botulism, foodborne diseases, diarrhea


Wolf, P. W. (2003). The epidemiology and clinical aspects of foodborne botulism in Texas, 1992-2001 (Unpublished thesis). Southwest Texas State University, San Marcos, Texas.


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