Botulism in the United States, 1899–1969

Gangarosa, EL J. (CDC, Atlanta, Ga. 30333), J. A. Donadio, R.W. Armstrong, K. F. Meyer, P. S. Brachman and V. R. Dowell. Botulism in the United States, 1899–1969. Amer J Epidem 93: 93–101, 1971.—Although a rare disease, botulism remains a threat in the United States. In 1899–1969, 659 outbreaks comprising 1, 696 cases with 959 fatalities were recorded. Three toxin types, A, B, and E, were important in these outbreaks. Most of the type A outbreaks occurred west of the Mississippi River, while most of the type B outbreaks occurred in the east. Most of the type E were distributed around the Great Lakes and in Alaska. In 89% of the outbreaks in which the vehicle of transmission was identified, home-preserved foods were responsible. Nearly 60% of the outbreaks were related to ingestion of contaminated vegetables, 25% to preserved fruit and fish products, and the rest to various causes. Since 1940, the overall incidence and case fatality ratio have decreased.