Botulism - Knowledge (XXG)

1212:. Thirty people were affected; 4 required mechanical ventilation. All ate food from a Greek restaurant. The attack rate among people who ate a potato-based dip was 86% (19/22) compared with 6% (11/176) among people who did not eat the dip (relative risk = 13.8; 95% confidence interval , 7.6–25.1). The attack rate among people who ate an eggplant-based dip was 67% (6/9) compared with 13% (24/189) among people who did not (RR = 5.2; 95% CI, 2.9–9.5). Botulism toxin type A was detected in patients and in both dips. Toxin formation resulted from holding aluminum foil-wrapped baked potatoes at room temperature, apparently for several days, before they were used in the dips. Food handlers should be informed of the potential hazards caused by holding foil-wrapped potatoes at ambient temperatures after cooking. 674:, botulinum toxin was detected in whole blood and serum but not in milk samples, suggesting that botulinum type C toxin does not enter milk in detectable concentrations. Cooking and pasteurization denatures botulinum toxin but does not necessarily eliminate spores. Botulinum spores or toxins can find their way into the dairy production chain from the environment. Despite the low risk of milk and meat contamination, the protocol for fatal bovine botulism cases appears to be incineration of carcasses and withholding any potentially contaminated milk from human consumption. It is also advised that raw milk from affected cows should not be consumed by humans or fed to calves. 4880: 1401:, and sternal recumbency. Laterally recumbent animals are usually very close to death. In sheep, the symptoms may include drooling, a serous nasal discharge, stiffness, and incoordination. Abdominal respiration may be observed and the tail may switch on the side. As the disease progresses, the limbs may become paralyzed and death may occur. Phosphorus-deficient cattle, especially in southern Africa, are inclined to ingest bones and carrion containing clostridial toxins and consequently develop 7428: 431: 529: 7439: 1165:

implicated in 70 events (~69%) with canned asparagus being the most frequent cause. Two restaurant-associated outbreaks affected 25 people. The median number of cases per year was 23 (range 17–43), the median number of events per year was 14 (range 9–24). The highest incidence rates occurred in Alaska, Idaho, Washington, and Oregon. All other states had an incidence rate of 1 case per ten million people or less.

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vaccines require annual boosters to maintain immunity. Many of these vaccines can be used on multiple species including cattle, sheep, and goats with some labeled for use in horses and mules as well as separate vaccines for mink. Additionally, vaccination during an outbreak is as beneficial as therapeutic treatment in cattle, and this method is also used in horses and pheasants.

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heat (160°C for 2 hours) or by irradiation. The spores of group I strains are inactivated by heating at 121°C (250°F) for 3 minutes during commercial canning. Spores of group II strains are less heat-resistant, and they are often damaged by 90°C (194°F) for 10 minutes, 85°C for 52 minutes, or 80°C for 270 minutes; however, these treatments may not be sufficient in some foods.

718:. This may include loss of strength, blurred vision, change of voice, or trouble breathing which can result in death. Onset can be hours to weeks after an injection. This generally only occurs with inappropriate strengths of botulinum toxin for cosmetic use or due to the larger doses used to treat movement disorders. Following a 2008 review the FDA added these concerns as a 7469: 34: 7418: 7449: 7495: 793:

produce toxin that may affect feeding birds and other animals. Spores are not killed by boiling, but botulism is uncommon because special, rarely obtained conditions are necessary for botulinum toxin production from C. botulinum spores, including an anaerobic, low-salt, low-acid, low-sugar environment at ambient temperatures.

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The use of region specific toxoids to immunize animals has been shown to be effective. Toxoid types C and D used to immunize cattle is a useful vaccination method in South Africa and Australia. Toxoid has also been shown to be an appropriate method of immunizing minks and pheasants. In endemic areas,

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The largest recorded outbreak of foodborne botulism in the United Kingdom occurred in June 1989. A total of 27 patients were affected; one patient died. Twenty-five of the patients had eaten one brand of hazelnut yogurt in the week before the onset of symptoms. Control measures included the cessation

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reported 263 individual foodborne cases from 160 botulism events in the United States with a case-fatality rate of 4%. Thirty-nine percent (103 cases and 58 events) occurred in Alaska, all of which were attributable to traditional Alaskan aboriginal foods. In the lower 49 states, home-canned food was

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When the bacteria are under stress, they develop spores, which are inert. Their natural habitats are in the soil, in the silt that comprises the bottom sediment of streams, lakes, and coastal waters and ocean, while some types are natural inhabitants of the intestinal tracts of mammals (e.g., horses,

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plant. It was later identified that the Castleberry's plant had serious production problems on a specific line of retorts that had under-processed the cans of food. These issues included broken cooking alarms, leaking water valves and inaccurate temperature devices, all the result of poor management

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In 1958, a team of experts were sent to the area by the Ministry of Health to investigate the cases. The epidemic survey conducted proved that the disease was primarily type A botulism, with several cases of type B. The team also discovered that the source of the botulinum was local fermented grain

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In the United States an average of 145 cases are reported each year. Of these, roughly 65% are infant botulism, 20% are wound botulism, and 15% are foodborne. Infant botulism is predominantly sporadic and not associated with epidemics, but great geographic variability exists. From 1974 to 1996, for

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The paralysis caused by botulism can persist for two to eight weeks, during which supportive care and ventilation may be necessary to keep the patient alive. Botulism can be fatal in five to ten percent of people who are affected. However, if left untreated, botulism is fatal in 40 to 50 percent of

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Oils infused with fresh garlic or herbs should be acidified and refrigerated. Potatoes which have been baked while wrapped in aluminum foil should be kept hot until served or refrigerated. Because the botulism toxin is destroyed by high temperatures, home-canned foods are best boiled for 10 minutes

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There are eight serological varieties of the bacterium denoted by the letters A to H. The toxin from all of these acts in the same way and produces similar symptoms: the motor nerve endings are prevented from releasing acetylcholine, causing flaccid paralysis and symptoms of blurred vision, ptosis,

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Prevention is primarily by proper food preparation. The toxin, though not the spores, is destroyed by heating it to more than 85 °C (185 °F) for longer than five minutes. The clostridial spores can be destroyed in the autoclave with moist heat (120°C/ 250°F for at least 15 minutes) or dry

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A variety of vaccines have been developed for the prevention of botulism in livestock. Most initial vaccinations require multiple doses at intervals from 2–6 weeks, however, some newer vaccines require only one shot. This mainly depends on the type of vaccine and manufacturers recommendations. All

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The clinical signs in horses are similar to cattle. The muscle paralysis is progressive; it usually begins at the hindquarters and gradually moves to the front limbs, neck, and head. Death generally occurs 24 to 72 hours after initial symptoms and results from respiratory paralysis. Some foals are

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When canning or preserving food at home, attention should be paid to hygiene, pressure, temperature, refrigeration and storage. When making home preserves, only acidic fruit such as apples, pears, stone fruits and berries should be used. Tropical fruit and tomatoes are low in acidity and must have

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Although tomatoes usually are considered an acid food, some are now known to have pH values slightly above 4.6. Figs also have pH values slightly above 4.6. Therefore, if they are to be canned as acid foods, these products must be acidified to a pH of 4.6 or lower with lemon juice or citric acid.

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Low-acid foods have pH values higher than 4.6. They include red meats, seafood, poultry, milk, and all fresh vegetables except for most tomatoes. Most mixtures of low-acid and acid foods also have pH values above 4.6 unless their recipes include enough lemon juice, citric acid, or vinegar to make

882:(ECL) tests and mouse inoculation or feeding trials. The toxins can be typed with neutralization tests in mice. In toxicoinfectious botulism, the organism can be cultured from tissues. On egg yolk medium, toxin-producing colonies usually display surface iridescence that extends beyond the colony. 1104:

to horse-derived proteins. To avoid this, a human-derived antitoxin has been developed and approved by the U.S. FDA in 2003 for the treatment of infant botulism. This human-derived antitoxin has been shown to be both safe and effective for the treatment of infant botulism. However, the danger of

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The spores require warm temperatures, a protein source, an anaerobic environment, and moisture in order to become active and produce toxin. In the wild, decomposing vegetation and invertebrates combined with warm temperatures can provide ideal conditions for the botulism bacteria to activate and

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spores have been allowed to germinate in low-oxygen conditions. This typically occurs in improperly prepared home-canned food substances and fermented dishes without adequate salt or acidity. Given that multiple people often consume food from the same source, it is common for more than a single

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growth. Additionally, water sources should be checked for dead or dying animals, and fields should be checked for animal remains prior to mowing for hay or silage. Correcting any dietary deficiencies can also prevent animals from consuming contaminated materials such as bones or carcasses. Raw

442:) was first recognized in 1976, and is the most common form of botulism in the United States. Infants are susceptible to infant botulism in the first year of life, with more than 90% of cases occurring in infants younger than six months. Infant botulism results from the ingestion of the 1562:

in May 1986. 1991 CIA reports also show Iraqis filled shells, warheads, and bombs with biological agents like botulinum (though none have been deployed). The Iraqi air force used the code name "tea" to refer to botulinum, and it was also referred to as bioweapon "A."

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Vaccines have been developed for use in animals to prevent botulism. The availability and approval of these vaccines varies depending on the location, with places experiencing more cases generally having more vaccines available and routine vaccination is more common.

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While commercially canned goods are required to undergo a "botulinum cook" in a pressure cooker at 121 °C (250 °F) for 3 minutes, and thus rarely cause botulism, there have been notable exceptions. Two were the 1978 Alaskan salmon outbreak and the 2007

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Death from botulism is common in waterfowl; an estimated 10,000 to 100,000 birds die of botulism annually. The disease is commonly called "limberneck". In some large outbreaks, a million or more birds may die. Ducks appear to be affected most often. An

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Any container of food which has been heat-treated and then assumed to be airtight which shows signs of not being so, e.g., metal cans with pinprick holes from rust or mechanical damage, should be discarded. Contamination of a canned food solely with

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Although the vegetative form of the bacteria is destroyed by boiling, the spore itself is not killed by the temperatures reached with normal sea-level-pressure boiling, leaving it free to grow and again produce the toxin when conditions are right.

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spores and has been linked to infant botulism. For this reason, honey is not recommended for infants less than one year of age. Most cases of infant botulism, however, are thought to be caused by acquiring the spores from the natural environment.

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materials used for silage or feed mixed on site should be checked for any sign of mold or rotten appearance. Acidification of animal feed can reduce, but will not eliminate, the risk of toxin formation, especially in carcasses that remain whole.

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A recommended prevention measure for infant botulism is to avoid giving honey to infants less than 12 months of age, as botulinum spores are often present. In older children and adults the normal intestinal bacteria suppress development of

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Botulism in the United States, 1889–1996. Handbook for Epidemiologists, Clinicians and Laboratory Technicians. Centers for Disease Control and Prevention. National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases

1583:. From 1990 to 1995, the cult staged numerous unsuccessful bioterrorism attacks on civilians. They sprayed botulinum toxin from a truck in downtown Tokyo and in the Narita airport, but there are no reported cases of botulism as a result. 994:

before eating. Metal cans containing food in which bacteria are growing may bulge outwards due to gas production from bacterial growth or the food inside may be foamy or have a bad odor; cans with any of these signs should be discarded.

1473:. Food-borne botulism can be prevented in domestic animals through careful inspection of the feed, purchasing high quality feed from reliable sources, and ensuring proper storage. Poultry litter and animal carcasses are places in which 1002:

may not cause any visual defects to the container, such as bulging. Only assurance of sufficient thermal processing during production, and absence of a route for subsequent contamination, should be used as indicators of food safety.

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of the company. All of the victims were hospitalized and placed on mechanical ventilation. The Castleberry's Food Company outbreak was the first instance of botulism in commercial canned foods in the United States in over 30 years.

2355: 2330: 291:. In this situation, spores enter a wound, and in the absence of oxygen, release the toxin. The disease is not passed directly between people. Its diagnosis is confirmed by finding the toxin or bacteria in the person in question. 1261:

of all yogurt production by the implicated producer, the withdrawal of the firm's yogurts from sale, the recall of cans of the hazelnut conserve, and advice to the general public to avoid the consumption of all hazelnut yogurts.

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In October 2013, scientists released news of the discovery of type H, the first new botulism neurotoxin found in forty years. However, further studies showed type H to be a chimeric toxin composed of parts of types F and A (FA).

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Toxin that is produced by the bacterium in containers of food that have been improperly preserved is the most common cause of food-borne botulism. Fish that has been pickled without the salinity or acidity of brine that contains

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and releases the toxin. This typically only occurs in children less than one year old, as protective mechanisms against development of the bacterium develop after that age. Wound botulism is found most often among those who

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form of duck botulism in the Western US and Canada is known as "western duck sickness". Botulism also affects commercially raised poultry. In chickens, the mortality rate varies from a few birds to 40% of the flock.

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Botulism seems to be relatively uncommon in domestic mammals; however, in some parts of the world, epidemics with up to 65% mortality are seen in cattle. The prognosis is poor in large animals that are recumbent.

1535: 2486:"A Novel Botulinum Neurotoxin, Previously Reported as Serotype H, Has a Hybrid-Like Structure With Regions of Similarity to the Structures of Serotypes A and F and Is Neutralized With Serotype A Antitoxin" 3060: 263:, and trouble speaking. This may then be followed by weakness of the arms, chest muscles, and legs. Vomiting, swelling of the abdomen, and diarrhea may also occur. The disease does not usually affect 785:

Toxin is produced by the bacteria when environmental conditions are favourable for the spores to replicate and grow, but the gene that encodes for the toxin protein is actually carried by a virus or

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that had been prepared with the hot sauce. The full clinical spectrum (mild symptomatology with neurologic findings through life-threatening ventilatory paralysis) of type B botulism was documented.

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All data regarding botulism antitoxin releases and laboratory confirmation of cases in the US are recorded annually by the Centers for Disease Control and Prevention and published on their website.

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failure. However, in the past 50 years, the proportion of patients with botulism who die has fallen from about 50% to 7% due to improved supportive care. A patient with severe botulism may require

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when exposed to low oxygen levels and certain temperatures. Foodborne botulism happens when food containing the toxin is eaten. Infant botulism instead happens when the bacterium develops in the

1293:. It was endemic with distinctive epidemic patterns, yet the underlying cause remained unknown for a long period of time. It caused a number of deaths and forced some people to leave the place. 1251:

A botulism outbreak occurred in Northern California in May 2017 after 10 people consumed nacho cheese dip served at a gas station in Sacramento County. One man died as a result of the outbreak.

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antibodies which have had the Fc portion cleaved off leaving the F(ab')2 portions. This less immunogenic antitoxin is effective against all known strains of botulism where not contraindicated.

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spores are able to germinate so it is advised to avoid spreading poultry litter or any carcass containing materials on fields producing feed materials due to their potential for supporting

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equine-derived antitoxin to infants has not been clearly established, and one study showed the equine-derived antitoxin to be both safe and effective for the treatment of infant botulism.

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Arnon SS, Schechter R, Inglesby TV, Henderson DA, Bartlett JG, Ascher MS, et al. (February 2001). "Botulinum toxin as a biological weapon: medical and public health management".

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are under development, but they have disadvantages. As of 2017 work to develop a better vaccine was being carried out, but the US FDA had not approved any vaccine against botulism.

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No withdrawal periods have been established for cows affected by Botulism. Lactating cows injected with various doses of Botulinum toxin C have not resulted in detectable Botulinum

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with the bacterium in the small intestine during the early stages of their lives. The bacterium then produces the toxin, which is absorbed into the bloodstream. The consumption of

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produces in anaerobic conditions and not by the bacterium itself. The pattern of damage occurs because the toxin affects nerves that fire (depolarize) at a higher frequency first.

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In 2017, there were 70 cases of botulism with 8 deaths in Ukraine. The previous year there were 115 cases with 12 deaths. Most cases were the result of dried fish, a common local

4755: 870:. A definite diagnosis can be made if botulinum toxin is identified in the food, stomach or intestinal contents, vomit or feces. The toxin is occasionally found in the blood in 7176: 2814: 2796: 628:

during the first year of life has been identified as a risk factor for infant botulism; it is a factor in a fifth of all cases. The adult form of infant botulism is termed

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and botulism were widely regarded as the two most effective options. During the 1950s, a highly lethal strain was discovered during the biological warfare program. The

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that typically starts with the muscles of the face and then spreads towards the limbs. In severe forms, botulism leads to paralysis of the breathing muscles and causes

5092: 4384: 475:. Typical symptoms of infant botulism include constipation, lethargy, weakness, difficulty feeding, and an altered cry, often progressing to a complete descending 6343: 7098: 3070: 498:

is a ubiquitous soil-dwelling bacterium. Many infant botulism patients have been demonstrated to live near a construction site or an area of soil disturbance.

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Wound botulism results from the contamination of a wound with the bacteria, which then secrete the toxin into the bloodstream. This has become more common in

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Centers for Disease Control and Prevention (CDC) (3 August 2007). "Botulism associated with commercially canned chili sauce--Texas and Indiana, July 2007".

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distinct but structurally similar. Human botulism is caused mainly by types A, B, E, and (rarely) F. Types C and D cause toxicity only in other animals.

1187:(FDA) released a public warning after learning that a New York man had died and his wife had become seriously ill due to botulism after eating a can of 501:

Infant botulism has been reported in 49 of 50 US states (all save for Rhode Island), and cases have been recognized in 26 countries on five continents.

4358: 7127: 3783: 3518: 392:. The weakness then spreads to the arms (starting in the shoulders and proceeding to the forearms) and legs (again from the thighs down to the feet). 1450:

Pigs are relatively resistant to botulism. Reported symptoms include anorexia, refusal to drink, vomiting, pupillary dilation, and muscle paralysis.

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Passaro DJ, Werner SB, McGee J, Mac Kenzie WR, Vugia DJ (March 1998). "Wound botulism associated with black tar heroin among injecting drug users".

3151:"Effect of nitrite and nitrate on toxin production by Clostridium botulinum and on nitrosamine formation in perishable canned comminuted cured meat" 4066: 1754:"Clostridium botulinum and the clinical laboratorian: a detailed review of botulism, including biological warfare ramifications of botulinum toxin" 7141: 5376: 7472: 3126:. Clemson Cooperative Extension - College of Agriculture, Forestry and Life Sciences - Home & Garden Information Center (HGIC). 13 May 2020. 3034: 1915: 1168:

The number of cases of food borne and infant botulism has changed little in recent years, but wound botulism has increased because of the use of

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In people whose history and physical examination suggest botulism, these clues are often not enough to allow a diagnosis. Other diseases such as

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Arnon SS, Midura TF, Damus K, Thompson B, Wood RM, Chin J (February 1979). "Honey and other environmental risk factors for infant botulism".

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them acidic. Acid foods have a pH of 4.6 or lower. They include fruits, pickles, sauerkraut, jams, jellies, marmalades, and fruit butters.

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Between 31 March and 6 April 1977, 59 individuals developed type B botulism. All who fell ill had eaten at the same Mexican restaurant in

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In adults, a trivalent antitoxin containing antibodies raised against botulinum toxin types A, B, and E is used most commonly; however, a

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is usually seen in the legs, wings, neck and eyelids. Broiler chickens with the toxicoinfectious form may also have diarrhea with excess

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when a botulism outbreak occurred after a church potluck in April 2015. The suspected source was a salad made from home-canned potatoes.

778:; type E and some types of B, C, D and F are nonproteolytic and can go undetected because there is no strong odor associated with them. 683: 4861: 3463:"Efficacy of Antitoxin Therapy in Treating Patients With Foodborne Botulism: A Systematic Review and Meta-analysis of Cases, 1923-2016" 3270: 789:

that infects the bacteria. Little is known about the natural factors that control phage infection and replication within the bacteria.

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person to be affected simultaneously. Symptoms usually appear 12–36 hours after eating, but can also appear within 6 hours to 10 days.

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outbreak. Foodborne botulism is the rarest form, accounting for only around 15% of cases (US) and has more frequently resulted from

875: 599: 2810: 2792: 2137:"Short communication: Attempts to identify Clostridium botulinum toxin in milk from three experimentally intoxicated Holstein cows" 1085:. This prevents additional toxin from binding to the neuromuscular junction, but does not reverse any already inflicted paralysis. 1059:

In some abdominal cases, physicians may try to remove contaminated food still in the digestive tract by inducing vomiting or using

1201:, and had consumed a hot sauce made with improperly home-canned jalapeño peppers, either by adding it to their food, or by eating 812:, and public health officials are usually involved to identify the source and take steps to prevent further cases from occurring. 7345: 7181: 7112: 7107: 6228: 4638: 2721: 1443:

type C exotoxin or spores within bird carcasses or other infected meat but are generally resistant to the more severe effects of

4670:"Management of Animal Botulism Outbreaks: From Clinical Suspicion to Practical Countermeasures to Prevent or Minimize Outbreaks" 2044: 7284: 7191: 7055: 6970: 6733: 6112: 5351: 5331: 5299: 5280: 1732: 311:

may be used for wound botulism. Death occurs in 5 to 10% of people. Botulism also affects many other animals. The word is from

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For botulism in babies, diagnosis should be made on signs and symptoms. Confirmation of the diagnosis is made by testing of a

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Humeau Y, Doussau F, Grant NJ, Poulain B (May 2000). "How botulinum and tetanus neurotoxins block neurotransmitter release".

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can appear similar to botulism, and special tests may be needed to exclude these other conditions. These tests may include a

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Terranova W, Breman JG, Locey RP, Speck S (August 1978). "Botulism type B: epidemiologic aspects of an extensive outbreak".

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Infant botulism typically has no long-term side effects but can be complicated by treatment-associated adverse events. The

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Some types produce a characteristic putrefactive smell and digest meat (types A and some of B and F); these are said to be

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W.B. Gross (1984), Botulism, in "Diseases of poultry", ed. by M.S. Hofstad, Iowa State University Press, Ames, Iowa, USA;

3127: 1290: 1233: 904: 800:, a neurotransmitter, responsible for communication between motor neurons and muscle cells. All forms of botulism lead to 467:, which is then absorbed into the bloodstream and taken throughout the body, causing paralysis by blocking the release of 198: 7485: 4380: 2296: 1225:(whale blubber) from a beached whale, resulting in eight of them developing botulism, with two of the affected requiring 299:

can contain the organism, and for this reason, honey should not be fed to children under 12 months. Treatment is with an

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spores, and subsequent colonization of the small intestine. The infant gut may be colonized when the composition of the

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An infant with botulism. Despite not being asleep or sedated, he cannot open his eyes or move; he also has a weak cry.

5077: 7367: 5549: 3698:"Safety and Improved Clinical Outcomes in Patients Treated With New Equine-Derived Heptavalent Botulinum Antitoxin" 2770: 2743: 1301:. They promoted the improvement of fermentation techniques among local residents, and thus eliminated the disease. 1447:

type C. Symptoms include flaccid muscle paralysis, which can lead to death due to cardiac and respiratory arrest.

1112:(Fab and Fc portions). In the United States, this antitoxin is available from the local health department via the 649:

levels, as well as smoked fish stored at too high a temperature, presents a risk, as does improperly canned food.

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and its resultant depressant effect on the brain. This may lead to respiratory compromise and death if untreated.

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for 2 to 8 weeks, plus intensive medical and nursing care. After this time, paralysis generally improves as new

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Domingo RM, Haller JS, Gruenthal M (November 2008). "Infant botulism: two recent cases and literature review".

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Beginning in late June 2007, 8 people contracted botulism poisoning by eating canned food products produced by

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Vanella de Cuetos EE, Fernandez RA, Bianco MI, Sartori OJ, Piovano ML, Lúquez C, et al. (November 2011).

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cattle, humans), and are present in their excreta. The spores can survive in their inert form for many years.

372:(decreased blood pressure on standing, with resultant lightheadedness and risk of blackouts), and eventually 7239: 7151: 6592: 6467: 6305: 6300: 6009: 5735: 5446: 5241: 4350: 3101: 1322: 1188: 879: 671: 135: 7452: 3775: 3510: 990:

Properly acidified tomatoes and figs are acid foods and can be safely processed in a boiling-water canner.

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From 1958 to 1983 there were 986 outbreaks of botulism in China involving 4,377 people with 548 deaths.

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Botulinum toxin is broken into eight neurotoxins (labeled as types A, B, C , D, E, F, and G), which are

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nerve synapses is blocked. This can lead to a variety of autonomic signs and symptoms described above.

3810: 3027: 1063:. Wounds should be treated, usually surgically, to remove the source of the toxin-producing bacteria. 356:, loss of facial expression and swallowing problems may therefore occur. In addition to affecting the 7442: 6756: 6585: 6440: 6213: 5868: 5847: 5515: 5454: 5234: 5227: 4886: 4879: 4236: 3061:"Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Handbook Clostridium botulinum" 2583: 1469:

One of the main routes of exposure for botulism is through the consumption of food contaminated with

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Supportive care for botulism includes monitoring of respiratory function. Respiratory failure due to

439: 369: 3405: 3002: 667: 479:. Although constipation is usually the first symptom of infant botulism, it is commonly overlooked. 7458: 7402: 7161: 6859: 6001: 5410: 5370: 5220: 5123: 4984: 4668:

Anniballi F, Fiore A, Löfström C, Skarin H, Auricchio B, Woudstra C, et al. (September 2013).

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O'Mahony M, Mitchell E, Gilbert RJ, Hutchinson DN, Begg NT, Rodhouse JC, et al. (June 1990).

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in 2013. In infants, horse-derived antitoxin is sometimes avoided for fear of infants developing

1078: 931:. However, outbreaks of botulism have resulted from more unusual sources. In July 2002, fourteen 808:. In light of this life-threatening complication, all suspected cases of botulism are treated as 595: 548: 422:

and descending paralysis, lack of fever, and clear senses and mental status ("clear sensorium").

121: 110: 6265: 4927: 4905: 4301:

Leclair D, Fung J, Isaac-Renton JL, Proulx JF, May-Hadford J, Ellis A, et al. (June 2013).

3998:"Outbreak of botulism type E associated with eating a beached whale--Western Alaska, July 2002" 2908:"Outbreak of botulism type E associated with eating a beached whale--Western Alaska, July 2002" 2177: 7515: 7387: 7196: 6882: 6516: 6501: 6483: 6397: 6275: 5986: 5880: 5611: 5435: 5405: 5043: 5014: 4915: 4853: 4789: 4760: 4697: 4689: 4617: 4599: 4489: 4467: 4449: 4332: 4252: 4184: 4149: 4048: 4009: 3978: 3937: 3902: 3867: 3745: 3727: 3678: 3660: 3618: 3574: 3492: 3440: 3384: 3313: 3237: 3219: 3180: 2976: 2919: 2853: 2676: 2638: 2594: 2564: 2515: 2441: 2270: 2252: 2205: 2197: 2158: 2109: 2101: 2078:

Moeller RB, Puschner B, Walker RL, Rocke T, Galey FD, Cullor JS, et al. (November 2003).

1988: 1944: 1881: 1838: 1773: 1677: 1454: 1198: 867: 847: 809: 476: 260: 190: 175: 127: 105: 4818: 3811:"National Case Surveillance: National Botulism Surveillance | CDC National Surveillance" 2949: 2630: 1938: 1618: 1397:

In cattle, the symptoms may include drooling, restlessness, incoordination, urine retention,

1373:. Botulism has been reported in such species as rats, mice, chicken, frogs, toads, goldfish, 620:

The most common form in Western countries is infant botulism. This occurs in infants who are

7038: 6950: 6930: 6778: 6748: 6364: 6120: 6062: 5920: 5832: 4959: 4894: 4843: 4833: 4681: 4607: 4589: 4441: 4322: 4314: 4244: 4176: 4139: 4131: 3968: 3955:

Angulo FJ, Getz J, Taylor JP, Hendricks KA, Hatheway CL, Barth SS, et al. (July 1998).

3929: 3894: 3857: 3849: 3717: 3709: 3668: 3652: 3608: 3564: 3556: 3482: 3474: 3374: 3364: 3305: 3262: 3227: 3211: 3170: 3162: 2845: 2554: 2546: 2505: 2497: 2413: 2260: 2244: 2189: 2148: 2091: 1980: 1873: 1864:

Koepke R, Sobel J, Arnon SS (July 2008). "Global occurrence of infant botulism, 1976-2006".

1830: 1765: 1667: 1326: 1237: 1208:

In April 1994, the largest outbreak of botulism in the United States since 1978 occurred in

1169: 1121: 1101: 1082: 859: 687: 572: 275: 114: 62: 2484:

Maslanka SE, Lúquez C, Dykes JK, Tepp WH, Pier CL, Pellett S, et al. (February 2016).

1309:

From 1985 to 2005 there were outbreaks causing 91 confirmed cases of foodborne botulism in

1014:

to processed meats such as ham, bacon, and sausages reduces growth and toxin production of

7499: 7254: 6960: 6922: 6892: 6738: 6671: 6536: 6521: 6445: 6412: 6260: 6173: 6155: 6057: 6052: 6042: 6024: 5959: 5605: 5319: 5146: 4922: 2080:"Determination of the Median Toxic Dose of Type C Botulinum Toxin in Lactating Dairy Cows" 1597: 1426: 1245: 731: 715: 556: 464: 430: 353: 279: 278:

which cause it are common in both soil and water and are very resistant. They produce the

250: 45:

shown in the left image, and dilated and non-moving pupils shown in the right image. This

42: 5054: 3997: 2964: 2907: 2793:"Guidance for Industry: Refrigerated Carrot Juice and Other Refrigerated Low-Acid Juices" 2664: 2467: 328:

The muscle weakness of botulism characteristically starts in the muscles supplied by the

4240: 7377: 6541: 6506: 6402: 6072: 5763: 4997: 4993: 4848: 4612: 4577: 4327: 4302: 4144: 4119: 3933: 3862: 3837: 3722: 3697: 3673: 3640: 3569: 3544: 3487: 3462: 3379: 3352: 3232: 3199: 2717: 2510: 2485: 2265: 2232: 1555: 1422: 1209: 1157:

example, 47% of all infant botulism cases reported in the U.S. occurred in California.

1097: 975: 337: 329: 288: 4989: 4669: 4445: 4248: 3175: 3150: 2849: 2559: 2534: 2135:

Moeller R, Puschner B, Walker R, Rocke T, Smith S, Cullor J, et al. (June 2009).

2056: 528: 41:

A 14-year-old boy with botulism, characterised by weakness of the eye muscles and the

7509: 7382: 6902: 6710: 6571: 6551: 6462: 6427: 6310: 6183: 6163: 6087: 5400: 5309: 5162: 4750: 4746: 3461:

O'Horo JC, Harper EP, El Rafei A, Ali R, DeSimone DC, Sakusic A, et al. (2018).

1893: 1617:

Center for Food Security and Public Health Iowa State University (19 February 2024).

1572: 1148:

Globally, botulism is fairly rare, with approximately 1,000 identified cases yearly.

1137: 1108:

Trivalent (A,B,E) botulinum antitoxin is derived from equine sources utilizing whole

944: 797: 786: 719: 575: 468: 418:

Clinicians frequently think of the symptoms of botulism in terms of a classic triad:

264: 3325: 2121: 1850: 1721: 7432: 7392: 6907: 6728: 6720: 6690: 6561: 6546: 6392: 6130: 6082: 6032: 5741: 5426: 4709: 4271: 3656: 2884: 2233:"Outbreak of botulism type A in dairy cows detected by MALDI-TOF mass spectrometry" 2217: 1513: 1436: 1370: 1329:, following consumption of traditionally prepared marine mammal and fish products. 912: 908: 691: 419: 400: 373: 361: 3166: 2550: 5008: 4205:

Wu CR, Lian EH, Chen WJ, Liu YZ (1958). "Botulism: A report for Qapqal disease".

4120:"An outbreak of foodborne botulism associated with contaminated hazelnut yoghurt" 3776:"Botulism - Diseases and Conditions - Publications - Public Information - MOHLTC" 1791: 815:

Botulinum toxin A, C, and E cleave the SNAP-25, ultimately leading to paralysis.

612:

Mechanisms of entry into the human body for botulinum toxin are described below.

7462: 7422: 7008: 6965: 6897: 6877: 6854: 6829: 6633: 6628: 6606: 6599: 6556: 6526: 6496: 6352: 6285: 6218: 6208: 6198: 5895: 5670: 5640: 5038: 4509: 2883:. Centers for Disease Control and Prevention (CDC). 1 April 2011. Archived from 1769: 1286: 1191: 959: 863: 775: 764: 756:

nausea, vomiting, diarrhea or constipation, cramps, and respiratory difficulty.

734:

produced under anaerobic conditions (where there is no oxygen) by the bacterium

642: 579: 412: 377: 4781: 3123: 2096: 2079: 1575:

created laboratories that produced biological weapons, specifically botulinum,

7223: 6975: 6940: 6869: 6656: 6531: 6491: 6360: 6290: 6280: 6270: 6223: 6125: 6037: 5823: 5808: 5797: 5660: 5541: 5469: 5314: 5288: 5114: 5060: 5019: 4974: 4180: 4135: 2288: 2193: 1499:

for example Kentucky, vaccination with type B toxoid appears to be effective.

1378: 1366: 1173: 954:

Other, much rarer sources of infection (about every decade in the US) include

940: 851: 824: 749: 703: 663: 457: 389: 365: 345: 308: 46: 4693: 4603: 4188: 3664: 3223: 3092:

Schneider KR, Silverberg R, Chang A, Goodrich Schneider RM (9 January 2015).

2629:

International Commission on Microbiological Specifications for Foods (1996).

2256: 2248: 2231:

Frye EA, Egan C, Perry MJ, Crouch EE, Burbank KE, Kelly KM (September 2020).

2201: 2105: 1834: 1703: 1554:

Iraq has historically possessed many types of germs, including botulism. The

1354: 874:

cases. Botulinum toxin can be detected by a variety of techniques, including

7269: 6980: 6912: 6887: 6849: 6814: 6806: 6788: 6773: 6761: 6705: 6682: 6650: 6645: 6435: 6295: 6145: 6140: 6067: 5768: 5675: 5532: 5495: 5340: 5118: 5110: 5049: 3898: 3595:

Arnon SS, Schechter R, Maslanka SE, Jewell NP, Hatheway CL (February 2006).

3149:

Christiansen LN, Johnston RW, Kautter DA, Howard JW, Aunan WJ (March 1973).

2501: 2472: 2387: 2018: 1984: 1398: 1045: 1038: 801: 560: 449: 283: 231: 220: 4857: 4838: 4793: 4701: 4621: 4594: 4488:(5th ed.). London: Baillière Tindall. pp. 1060 (Grass sickness). 4453: 4336: 4318: 4256: 4052: 4013: 3871: 3853: 3731: 3682: 3622: 3578: 3496: 3444: 3388: 3317: 3241: 2923: 2680: 2519: 2274: 2209: 2162: 2113: 1992: 1885: 1877: 1842: 1777: 1681: 1353:. All of them were related to a product containing contaminated vegetarian 605:

In all cases, illness is caused by the botulinum toxin which the bacterium

33: 4685: 4153: 3982: 3906: 3369: 3184: 2980: 2568: 2153: 2136: 947:, and eight of them developed symptoms of botulism, two of them requiring 7244: 6834: 6783: 6639: 6407: 6377: 6245: 6203: 6135: 6092: 6077: 5981: 5624: 5581: 5474: 5181: 5151: 4227:

Fu SW, Wang CH (August 2008). "An overview of type E botulism in China".

3941: 3713: 3613: 3596: 3560: 3478: 3215: 2857: 2535:"Survey of the U.S. Gulf Coast for the presence of Clostridium botulinum" 1539: 1386: 1338: 1109: 1074: 1011: 971: 967: 871: 832: 385: 349: 4916:

University of California, Santa Cruz Environmental toxicology – Botulism

4674:

Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science

2747: 1244:

One person died, 21 cases were confirmed, and 10 more were suspected in

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Sobel J, Tucker N, Sulka A, McLaughlin J, Maslanka S (September 2004).

2948:. Colorado State University Cooperative Extension. 1998. Archived from 1580: 1430: 1374: 1350: 1318: 1026: 1007: 963: 598:. Furthermore, acetylcholine release from the presynaptic membranes of 404: 341: 246: 7417: 4942: 4884:

Knowledge (XXG)'s health care articles can be viewed offline with the

4565:(8th ed.). Whitehouse Station, NJ: Merck and Co. pp. 442–44. 3431:

Brook I (2006). "Botulism: the challenge of diagnosis and treatment".

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Yu PA, Lin NH, Mahon BE, Sobel J, Yu Y, Mody RK, et al. (2018).

3597:"Human botulism immune globulin for the treatment of infant botulism" 3198:

Lee S, Lee H, Kim S, Lee J, Ha J, Choi Y, et al. (August 2018).

3028:"Complete Guide to Home Canning; Guide 1: Principles of Home Canning" 1310: 1221: 1216: 1202: 955: 932: 843: 646: 381: 3293: 2746:. Food Safety Authority of Ireland. 15 November 2011. Archived from 4819:"Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021" 4578:"Public Health Risk Associated with Botulism as Foodborne Zoonoses" 4093:"Man dies in Sacramento county botulism outbreak from nacho cheese" 3973: 3956: 1672: 1655: 748:

is a large anaerobic Gram-positive bacillus that forms subterminal

6798: 6450: 5976: 1458: 1314: 1060: 928: 828: 625: 564: 527: 482: 429: 312: 296: 268: 4407:"Lethal bacteria in vegan pate puts seven people on life support" 3996:

Centers for Disease Control and Prevention (CDC) (January 2003).

3545:"Equine botulinum antitoxin for the treatment of infant botulism" 3093: 2635:

Microorganisms in Foods 5: Characteristics of Microbial Pathogens

2176:

Lindström M, Myllykoski J, Sivelä S, Korkeala H (19 March 2010).

1425:, a condition in horses which occurs in rainy and hot summers in 694:

rather than the veins. Wound botulism accounts for 29% of cases.

4576:

Rasetti-Escargueil C, Lemichez E, Popoff MR (30 December 2019).

3782:. Government of Ontario, Ministry of Health and Long-Term Care. 3001:. Department of Public Health, Western Australia. Archived from 2665:"Botulism from drinking prison-made illicit alcohol - Utah 2011" 924: 920: 6325: 5916: 5081: 3408:. U.S. Centers for Disease Control and Prevention (CDC). 2006. 714:

Symptoms of botulism may occur away from the injection site of

212:

Proper food preparation, no honey for children younger than one

6695: 1093: 2906:

Centers for Disease Control Prevention (CDC) (January 2003).

2663:

Centers for Disease Control Prevention (CDC) (October 2012).

1731:(5th ed.). Philadelphia: WB Saunders. pp. 1758–66. 594:

by paralysing the muscles of the chest; this can progress to

89: 3813:. Centers for Disease Control and Prevention. 25 June 2013. 3639:

Chalk CH, Benstead TJ, Pound JD, Keezer MR (17 April 2019).

796:

Botulinum inhibits the release within the nervous system of

652:

Food-borne botulism results from contaminated food in which

4067:"1 dead in botulism outbreak linked to Ohio church potluck" 303:. In those who lose their ability to breathe on their own, 74: 5912: 4817:

Rao AK, Sobel J, Chatham-Stephens K, Luquez C (May 2021).

3957:"A large outbreak of botulism: the hazardous baked potato" 77: 71: 4167:

Ying S, Shuyan C (1 November 1986). "Botulism in China".

1727:. In Feigin RD, Cherry JD, Demmler GJ, Kaplan SL (eds.). 83: 3456: 3454: 1546:, raising much concern from Pentagon health officials. 1140:

rate is less than two percent for hospitalized babies.

4911:

CDC Botulism: Control Measures Overview for Clinicians

4381:"Độc tố trong pate Minh Chay được phát hiện cách nào?" 3022: 3020: 2533:

Ward BQ, Carroll BJ, Garrett ES, Reese GB (May 1967).

563:

is lethal to humans when inhaled. It acts by blocking

7483: 3094:"Preventing Foodborne Illness: Clostridium botulinum" 1092:

has also been developed and was approved by the U.S.

702:

Isolated cases of botulism have been described after

590:. This causes paralysis. Advanced botulism can cause 86: 4932: 3838:"Foodborne botulism in the United States, 1990-2000" 2178:"Clostridium botulinum in Cattle and Dairy Products" 1349:

In 2020, several cases of botulism were reported in

559:

is one of the most powerful known toxins: about one

407:(difficulty breathing), but when severe can lead to 259:. The disease begins with weakness, blurred vision, 80: 68: 7360: 7298: 7222: 7177:

2024 United Kingdom Shigatoxigenic E. coli outbreak

6999: 6921: 6868: 6797: 6747: 6719: 6681: 6570: 6478: 6426: 6359: 6154: 6111: 6023: 6000: 5950: 5879: 5831: 5822: 5795: 5761: 5725: 5684: 5668: 5659: 5622: 5579: 5531: 5494: 5483: 5468: 5424: 5391: 5362: 5330: 5279: 5270: 5208: 5180: 5171: 5160: 5145: 5136: 5029: 4936: 2698:Weber JT (1994). "Botulism". In Hpeprich PD (ed.). 1914:. U.S. Centers for Disease Control and Prevention. 1421:type C toxin has been incriminated as the cause of 230: 216: 208: 184: 174: 162: 154: 146: 134: 120: 104: 65: 53: 26: 4756:Germs: Biological Weapons and America's Secret War 2963:Centers for Disease Control (CDC) (October 1985). 4200: 4198: 456:and levels of bile acids (which normally inhibit 395:Severe botulism leads to reduced movement of the 380:). Some of the toxins (B and E) also precipitate 3400: 3398: 4788:, Treasure Island (FL): StatPearls Publishing, 3538: 3536: 1758:Archives of Pathology & Laboratory Medicine 1118:heptavalent (A,B,C,D,E,F,G) botulinum antitoxin 970:, improperly handled baked potatoes wrapped in 509:Infant botulism has no long-term side effects. 4639:"Botulism in Animals - Generalized Conditions" 2436: 2434: 2318: 2316: 2314: 2237:Journal of Veterinary Diagnostic Investigation 2182:Critical Reviews in Food Science and Nutrition 2084:Journal of Veterinary Diagnostic Investigation 2021:. 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Centers for Disease Control: 1606–11. 3645:The Cochrane Database of Systematic Reviews 3033:. United States Department of Agriculture. 2969:MMWR. Morbidity and Mortality Weekly Report 2912:MMWR. Morbidity and Mortality Weekly Report 2669:MMWR. Morbidity and Mortality Weekly Report 1715: 1713: 1649: 1647: 1645: 1643: 1641: 1639: 1637: 1635: 1633: 1631: 982:some acidity added before they are canned. 362:disruptions in the autonomic nervous system 315: 6344: 6330: 6322: 5935: 5921: 5913: 5828: 5681: 5665: 5491: 5480: 5276: 5177: 5168: 5157: 5142: 5100: 5086: 5078: 4933: 3805: 3803: 3801: 3257: 3255: 3253: 3251: 2875: 2873: 2871: 2869: 2867: 2053:Centers for Disease Control and Prevention 1747: 1745: 1357:. Some patients were put on life support. 1162:Centers for Disease Control and Prevention 32: 23: 7128:2008 United States salmonellosis outbreak 4847: 4837: 4611: 4593: 4326: 4303:"Foodborne botulism in Canada, 1985-2005" 4222: 4220: 4143: 3972: 3861: 3721: 3672: 3612: 3568: 3486: 3378: 3368: 3351:Sundeen G, Barbieri JT (September 2017). 3231: 3174: 2558: 2509: 2264: 2152: 2095: 1729:Textbook of Pediatric Infectious Diseases 1671: 1413:found dead without other clinical signs. 686:since the 1990s, especially people using 368:(due to decreased production of saliva), 7172:2018 Australian strawberry contamination 7034:Morinaga Milk arsenic poisoning incident 3100:. University of Florida IFAS Extension. 2942:"Oil Infusions and the Risk of Botulism" 2811:"Similarities Between Botox and Dysport" 2444:. University of California, Santa Cruz. 1966: 1964: 1752:Caya JG, Agni R, Miller JE (June 2004). 274:Botulism can occur in several ways. The 7490: 7142:2011 United States listeriosis outbreak 5377:Cutaneous Streptococcus iniae infection 2799:from the original on 24 September 2015. 1609: 1503:Use in biological warfare and terrorism 1120:, is derived from "despeciated" equine 1077:that neutralize botulinum toxin in the 571:) through inhibition of the excitatory 378:forward movement of intestinal contents 332:—a group of twelve nerves that control 7157:2015 Mozambique funeral beer poisoning 6734:Ethylenediaminetetraacetic acid (EDTA) 4741: 4739: 4270:Huang Beibei, ed. (12 November 2011). 2881:"Arctic Investigations Program – DPEI" 1285:) was noticed to be affecting several 460:growth) are lower than later in life. 4737: 4735: 4733: 4731: 4729: 4727: 4725: 4723: 4721: 4719: 4663: 4661: 4659: 4633: 4631: 4516:from the original on 21 February 2014 4387:from the original on 4 September 2020 4229:Biomedical and Environmental Sciences 3634: 3632: 3332:from the original on 21 December 2019 2724:from the original on 16 February 2014 2651:from the original on 28 November 2015 911:foods with low acid content, such as 438:Infant botulism (also referred to as 253:, which is produced by the bacterium 7: 7448: 7336:Institute for Food Safety and Health 7076:Australian meat substitution scandal 7044:Moroccan oil poisoning disaster 1959 6820:Arsenic contamination of groundwater 5511:Staphylococcal scalded skin syndrome 4867:from the original on 9 October 2022. 4542:from the original on 4 February 2014 4361:from the original on 29 October 2017 4282:from the original on 24 October 2012 3817:from the original on 30 January 2014 3786:from the original on 17 October 2017 3756:from the original on 9 February 2019 3130:from the original on 23 January 2021 3104:from the original on 8 February 2017 3040:from the original on 27 January 2018 2336:from the original on 5 December 2019 2293:The Lecturio Medical Concept Library 1957:from the original on 1 January 2017. 1558:sold 5 variants of botulinum to the 1281:in 1949, a mysterious plague (named 858:examination, nerve conduction test ( 512:Botulism can result in death due to 7468: 7324:Food Information and Control Agency 3601:The New England Journal of Medicine 3521:from the original on 1 January 2016 3059:U.S. Food and Drug Administration. 2817:from the original on 20 August 2021 2049:Emergency Preparedness and Response 1943:. Infobase Publishing. p. 38. 1802:from the original on 7 October 2016 1593:List of foodborne illness outbreaks 974:foil, tomatoes, and home-canned or 180:Finding the bacteria or their toxin 7526:Conditions diagnosed by stool test 6169:Avian infectious laryngotracheitis 3961:The Journal of Infectious Diseases 3934:10.1093/oxfordjournals.aje.a112599 3273:from the original on 23 March 2019 2987:from the original on 25 June 2017. 2930:from the original on 25 June 2017. 2781:from the original on 4 March 2016. 2610:from the original on 9 August 2016 2490:The Journal of Infectious Diseases 2364:. 15 November 2017. Archived from 2025:from the original on 27 April 2020 1738:from the original on 26 July 2011. 876:enzyme-linked immunosorbent assays 463:The growth of the spores releases 411:, due to the buildup of unexhaled 14: 7341:International Food Safety Network 7265:International Food Safety Network 6986:Variant Creutzfeldt–Jakob disease 6936:Acid-hydrolyzed vegetable protein 6663:Shigatoxigenic and verotoxigenic 6184:Histomoniasis (blackhead disease) 5747:Clostridial necrotizing enteritis 4536:"Overview of botulism in poultry" 4413:from the original on 22 July 2021 4207:National Medical Journal of China 4073:from the original on 22 July 2015 4020:from the original on 25 June 2017 3412:from the original on 4 March 2016 2771:"Couple suing over tainted juice" 2687:from the original on 6 June 2017. 2388:"About Botulism | Botulism | CDC" 2055:. 14 October 2001. Archived from 1918:from the original on 16 June 2016 1536:Nixon's ban on biological warfare 1185:U.S. Food and Drug Administration 7493: 7467: 7457: 7447: 7438: 7437: 7426: 7416: 7346:Ministry of Food and Drug Safety 7182:Kobayashi red yeast rice scandal 7113:2008 Canada listeriosis outbreak 7108:ICA meat repackaging controversy 6229:Fatty liver hemorrhagic syndrome 4878: 4538:. Merck Manuals. 31 March 2012. 4099:from the original on 23 May 2017 3922:American Journal of Epidemiology 3641:"Medical treatment for botulism" 3433:Reviews in Neurological Diseases 3124:"Botulism Factsheet (HGIC 3680)" 2591:Field Manual of Wildlife Disease 2299:from the original on 9 July 2021 1556:American Type Culture Collection 1073:Botulinum antitoxin consists of 485:is a known dietary reservoir of 245:is a rare and potentially fatal 61: 7285:Quality Assurance International 7192:Food safety incidents in Taiwan 7162:2017 Brazil Operation Weak Meat 7056:1971 Iraq poison grain disaster 6971:Polycyclic aromatic hydrocarbon 6098:Abnormal behaviour in captivity 5352:Group B streptococcal infection 5300:Group A streptococcal infection 4069:. CNNWIRE. CNN. 28 April 2015. 3549:Clinical and Vaccine Immunology 2769:Teotonio I (21 February 2008). 2448:from the original on 9 May 2013 1465:Prevention in non-human species 7314:European Food Safety Authority 7187:Food safety incidents in China 7024:1858 Bradford sweets poisoning 6991:Water fluoridation controversy 3657:10.1002/14651858.CD008123.pub4 3292:Webb RP, Smith LA (May 2013). 1090:heptavalent botulism antitoxin 692:injecting heroin into the skin 1: 4446:10.1016/S0300-9084(00)00216-9 4249:10.1016/S0895-3988(08)60054-9 3167:10.1128/AEM.25.3.357-362.1973 2850:10.1016/S0022-3476(79)80863-X 2637:. Springer. pp. 66–111. 2582:Franson JC, Friend M (1999). 2551:10.1128/aem.15.3.629-636.1967 1528:continued to hold 5 grams of 1291:Qapqal Xibe Autonomous County 866:chloride (Tensilon) test for 403:. This may be experienced as 307:may be necessary for months. 199:Amyotrophic lateral sclerosis 7319:Food and Drug Administration 7001:Food contamination incidents 6179:Avian sarcoma leukosis virus 5890:Erysipelothrix rhusiopathiae 4512:. Vet Book. 12 August 2012. 4307:Emerging Infectious Diseases 4169:Clinical Infectious Diseases 3842:Emerging Infectious Diseases 3702:Clinical Infectious Diseases 3467:Clinical Infectious Diseases 3066:Food and Drug Administration 2361:Food and Drug Administration 1660:Clinical Infectious Diseases 1279:Chinese Communist Revolution 340:and the muscles controlling 7373:Food and drink prohibitions 7147:Bihar school meal poisoning 7071:United Kingdom BSE outbreak 7029:1900 English beer poisoning 6383:Antibiotic use in livestock 4887:Medical Knowledge (XXG) app 3517:. U.S. FDA. 22 March 2013. 3353:"Vaccines against Botulism" 2006:Oxford Textbook of Medicine 1770:10.5858/2004-128-653-CBATCL 1453:In poultry and wild birds, 1365:Botulism can occur in many 1160:Between 1990 and 2000, the 958:or herbs stored covered in 632:, and is exceedingly rare. 7557: 7368:Curing (food preservation) 6441:Monosodium glutamate (MSG) 4895:WHO fact sheet on botulism 4272:"The Xibe ethnic minority" 4124:Epidemiology and Infection 2593:. U.S. Geological Survey. 2097:10.1177/104063870301500603 1823:Journal of Child Neurology 1234:Castleberry's Food Company 905:Castleberry's Food Company 399:, and hence problems with 126:Weakness, trouble seeing, 7411: 7398:Genetically modified food 7250:Food labeling regulations 7118:2008 Chinese milk scandal 6251:Infectious bursal disease 6240:Gallid alphaherpesvirus 3 5305:Streptococcal pharyngitis 4136:10.1017/s0950268800047403 3298:Expert Review of Vaccines 3267:World Health Organization 2838:The Journal of Pediatrics 2194:10.1080/10408390802544405 1512:Based on CIA research in 1361:Other susceptible species 1054:neuromuscular connections 730:The toxin is the protein 364:. This is experienced as 40: 31: 7260:Food safety in Australia 6456:High-fructose corn syrup 6015:List of poultry feathers 5785:Pseudomembranous colitis 5779:Clostridioides difficile 4780:Ni SA, Brady MF (2022), 4759:. Simon & Schuster. 3263:"Fact sheets - Botulism" 2744:"Foodborne Botulism FAQ" 2704:J. B. Lippincott Company 2249:10.1177/1040638720943127 2141:Journal of Dairy Science 1835:10.1177/0883073808318200 1654:Sobel J (October 2005). 1317:communities, especially 1116:. The second antitoxin, 831:specimen with the mouse 666:in milk produced. Using 630:adult intestinal toxemia 354:drooping of both eyelids 16:Human and animal disease 7240:Acceptable daily intake 7152:2013 horse meat scandal 6593:Clostridium perfringens 6306:Tibial dyschondroplasia 6301:Squamous cell carcinoma 6010:List of chicken colours 5736:Clostridium perfringens 5447:Urinary tract infection 4643:Merck Veterinary Manual 4563:Merck Veterinary Manual 4181:10.1093/clinids/8.6.984 3899:10.1001/jama.279.11.859 2631:"Clostridium botulinum" 2008:, 4th Ed., Section 7.55 1985:10.1001/jama.285.8.1059 1571:A Japanese cult called 1313:, 85% of which were in 880:electrochemiluminescent 840:Guillain–Barré syndrome 706:by laboratory workers. 672:immunostick ELISA tests 616:Colonization of the gut 584:neuromuscular junctions 390:difficulty with talking 195:Guillain–Barré syndrome 7308:Centre for Food Safety 7123:2008 Irish pork crisis 6825:Benzene in soft drinks 5842:Ureaplasma urealyticum 5635:Listeria monocytogenes 5339:bacitracin resistant, 5198:Pneumococcal infection 4839:10.15585/mmwr.rr7002a1 4595:10.3390/toxins12010017 4319:10.3201/eid1906.120873 3854:10.3201/eid1009.030745 2045:"Facts About Botulism" 1908:"Prevent Illness From 1878:10.1542/peds.2007-1827 1429:. The main symptom is 1227:mechanical ventilation 1050:mechanical ventilation 949:mechanical ventilation 684:intravenous drug users 588:somatic nervous system 569:neuromuscular blockade 539: 518:mechanical ventilation 473:neuromuscular junction 435: 397:muscles of respiration 366:a dry mouth and throat 316: 305:mechanical ventilation 225:mechanical ventilation 203:Lambert Eaton syndrome 186:Differential diagnosis 7330:Food Standards Agency 7280:Organic certification 7275:Nutrition facts label 7019:Esing Bakery incident 6807:environment pollution 5863:Mycoplasma pneumoniae 5856:Mycoplasma genitalium 5695:Clostridium botulinum 5441:Enterococcus faecalis 5216:Viridans streptococci 4686:10.1089/bsp.2012.0089 4095:. KCRA. 22 May 2017. 3750:Medical Life Sciences 3370:10.3390/toxins9090268 2999:"Botulism fact sheet" 2502:10.1093/infdis/jiv327 2154:10.3168/jds.2008-1919 1560:University of Baghdad 1531:Clostridium botulinum 1418:Clostridium botulinum 1041:and supportive care. 745:Clostridium botulinum 737:Clostridium botulinum 555:, spore-forming rod. 544:Clostridium botulinum 535:Clostridium botulinum 532:A photomicrograph of 531: 495:Clostridium botulinum 450:intestinal microflora 433: 320:, meaning 'sausage'. 256:Clostridium botulinum 168:Clostridium botulinum 7099:2006 North American 6757:Acesulfame potassium 6586:Campylobacter jejuni 6480:Intestinal parasites 6353:Consumer food safety 6214:Dermanyssus gallinae 5869:Mycoplasma pneumonia 5848:Ureaplasma infection 5558:novobiocin resistant 5516:Toxic shock syndrome 5455:Enterococcus faecium 4782:"Botulism Antitoxin" 3780:www.health.gov.on.ca 3746:"Botulism Prognosis" 3708:(suppl_1): S57–S64. 3614:10.1056/NEJMoa051926 3561:10.1128/CVI.05261-11 3473:(suppl_1): S43–S56. 3216:10.5713/ajas.17.0675 3155:Applied Microbiology 2584:"38: Avian Botulism" 2539:Applied Microbiology 2442:"ETOX 80E -Botulism" 1538:in 1969. During the 1183:On 2 July 1971, the 1083:passive immunization 578:'s release from the 440:floppy baby syndrome 370:postural hypotension 360:, it can also cause 49:was fully conscious. 7531:Foodborne illnesses 7403:Conspiracy theories 6956:Heterocyclic amines 6860:Shellfish poisoning 5801:(non-spore forming) 5411:Streptococcus bovis 5371:Streptococcus iniae 5119:Infectious diseases 4486:Veterinary Medicine 4241:2008BioES..21..353F 3752:. 2 December 2009. 3269:. 10 January 2018. 3073:on 29 November 2012 3005:on 30 December 2013 2706:. pp. 1185–94. 2700:Infectious Diseases 2368:on 15 November 2017 1937:Emmeluth D (2010). 1486:Vaccines in animals 1377:, squid, crayfish, 856:cerebrospinal fluid 810:medical emergencies 806:respiratory failure 592:respiratory failure 409:respiratory failure 289:inject street drugs 236:~7.5% risk of death 141:Respiratory failure 7521:Biological weapons 7061:Toxic oil syndrome 7014:Swill milk scandal 6840:Diethylstilbestrol 6512:Diphyllobothriasis 6194:Campylobacteriosis 5709:Clostridium tetani 5592:Bacillus anthracis 5209:optochin resistant 5124:Bacterial diseases 5030:External resources 4921:9 May 2013 at the 3714:10.1093/cid/cix816 3479:10.1093/cid/cix815 2887:on 16 October 2010 2795:. FDA. June 2007. 1518:biological warfare 1215:In 2002, fourteen 1079:circulatory system 862:, or EMG), and an 596:respiratory arrest 540: 436: 376:(due to decreased 324:Signs and symptoms 130:, trouble speaking 111:Infectious disease 7481: 7480: 7388:Food preservation 7197:Foodborne illness 6749:Sugar substitutes 6502:Cryptosporidiosis 6484:parasitic disease 6398:HGH controversies 6365:food contaminants 6319: 6318: 6276:Newcastle disease 6256:Infectious coryza 5910: 5909: 5906: 5905: 5881:Anaeroplasmatales 5818: 5817: 5757: 5756: 5655: 5654: 5651: 5650: 5575: 5574: 5464: 5463: 5420: 5419: 5387: 5386: 5266: 5265: 5075: 5074: 4680:(S1): S191–S199. 4510:"Dogs / Botulism" 4495:978-0-7020-0718-7 4474:, 8th ed., p. 257 3310:10.1586/erv.13.37 3098:edis.ifas.ufl.edu 2644:978-0-412-47350-0 2600:978-0-607-88096-0 1950:978-1-60413-235-9 1792:"Infant Botulism" 1722:"Infant Botulism" 1720:Arnon SS (2004). 1455:flaccid paralysis 1199:Pontiac, Michigan 868:myasthenia gravis 848:myasthenia gravis 477:flaccid paralysis 358:voluntary muscles 240: 239: 191:Myasthenia gravis 176:Diagnostic method 21:Medical condition 7548: 7541:Poultry diseases 7498: 7497: 7496: 7489: 7471: 7470: 7461: 7451: 7450: 7441: 7440: 7433:Drink portal 7431: 7430: 7429: 7421: 7420: 7332:(United Kingdom) 7081:Jack in the Box 7052: 7039:Minamata disease 6951:Food irradiation 6931:4-Hydroxynonenal 6779:Sodium cyclamate 6622:Escherichia coli 6614:Escherichia coli 6346: 6339: 6332: 6323: 6063:Broiler industry 5937: 5930: 5923: 5914: 5833:Mycoplasmataceae 5829: 5809:Finegoldia magna 5682: 5666: 5564:S. saprophyticus 5492: 5481: 5277: 5178: 5169: 5158: 5143: 5102: 5095: 5088: 5079: 4934: 4928:CDC Botulism FAQ 4882: 4868: 4866: 4851: 4841: 4823: 4804: 4803: 4802: 4800: 4777: 4771: 4770: 4743: 4714: 4713: 4665: 4654: 4653: 4651: 4649: 4635: 4626: 4625: 4615: 4597: 4573: 4567: 4566: 4558: 4552: 4551: 4549: 4547: 4532: 4526: 4525: 4523: 4521: 4506: 4500: 4499: 4481: 4475: 4464: 4458: 4457: 4429: 4423: 4422: 4420: 4418: 4403: 4397: 4396: 4394: 4392: 4377: 4371: 4370: 4368: 4366: 4347: 4341: 4340: 4330: 4298: 4292: 4291: 4289: 4287: 4267: 4261: 4260: 4224: 4215: 4214: 4202: 4193: 4192: 4164: 4158: 4157: 4147: 4115: 4109: 4108: 4106: 4104: 4089: 4083: 4082: 4080: 4078: 4063: 4057: 4056: 4036: 4030: 4029: 4027: 4025: 3993: 3987: 3986: 3976: 3952: 3946: 3945: 3917: 3911: 3910: 3882: 3876: 3875: 3865: 3833: 3827: 3826: 3824: 3822: 3807: 3796: 3795: 3793: 3791: 3772: 3766: 3765: 3763: 3761: 3742: 3736: 3735: 3725: 3693: 3687: 3686: 3676: 3636: 3627: 3626: 3616: 3592: 3583: 3582: 3572: 3540: 3531: 3530: 3528: 3526: 3515:FDA News Release 3507: 3501: 3500: 3490: 3458: 3449: 3448: 3428: 3422: 3421: 3419: 3417: 3402: 3393: 3392: 3382: 3372: 3348: 3342: 3341: 3339: 3337: 3289: 3283: 3282: 3280: 3278: 3259: 3246: 3245: 3235: 3210:(8): 1073–1077. 3195: 3189: 3188: 3178: 3146: 3140: 3139: 3137: 3135: 3120: 3114: 3113: 3111: 3109: 3089: 3083: 3082: 3080: 3078: 3069:. Archived from 3056: 3050: 3049: 3047: 3045: 3039: 3032: 3024: 3015: 3014: 3012: 3010: 2995: 2989: 2988: 2960: 2954: 2953: 2952:on 4 April 2013. 2938: 2932: 2931: 2903: 2897: 2896: 2894: 2892: 2877: 2862: 2861: 2833: 2827: 2826: 2824: 2822: 2807: 2801: 2800: 2789: 2783: 2782: 2766: 2760: 2759: 2757: 2755: 2740: 2734: 2733: 2731: 2729: 2714: 2708: 2707: 2702:(5th ed.). 2695: 2689: 2688: 2660: 2658: 2656: 2626: 2620: 2619: 2617: 2615: 2609: 2588: 2579: 2573: 2572: 2562: 2530: 2524: 2523: 2513: 2481: 2475: 2464: 2458: 2457: 2455: 2453: 2438: 2429: 2428: 2426: 2424: 2410: 2404: 2403: 2401: 2399: 2384: 2378: 2377: 2375: 2373: 2352: 2346: 2345: 2343: 2341: 2335: 2328: 2320: 2309: 2308: 2306: 2304: 2285: 2279: 2278: 2268: 2228: 2222: 2221: 2173: 2167: 2166: 2156: 2147:(6): 2529–2533. 2132: 2126: 2125: 2099: 2075: 2069: 2068: 2066: 2064: 2041: 2035: 2034: 2032: 2030: 2019:"About Botulism" 2015: 2009: 2003: 1997: 1996: 1968: 1959: 1958: 1934: 1928: 1927: 1925: 1923: 1904: 1898: 1897: 1861: 1855: 1854: 1818: 1812: 1811: 1809: 1807: 1788: 1782: 1781: 1749: 1740: 1739: 1737: 1726: 1717: 1708: 1707: 1706:on 2 April 2012. 1702:. Archived from 1692: 1686: 1685: 1675: 1651: 1626: 1625: 1623: 1614: 1327:British Columbia 1325:of the coast of 1238:Augusta, Georgia 1172:, especially in 1170:black tar heroin 1102:hypersensitivity 1006:The addition of 860:electromyography 688:black tar heroin 573:neurotransmitter 319: 276:bacterial spores 115:gastroenterology 96: 95: 92: 91: 88: 85: 82: 79: 76: 73: 70: 67: 43:drooping eyelids 36: 24: 7556: 7555: 7551: 7550: 7549: 7547: 7546: 7545: 7506: 7505: 7504: 7494: 7492: 7484: 7482: 7477: 7427: 7425: 7423:Food portal 7415: 7407: 7356: 7294: 7255:Food libel laws 7218: 7046: 6995: 6961:Modified starch 6923:Food processing 6917: 6864: 6793: 6743: 6739:Sodium benzoate 6715: 6677: 6672:Vibrio cholerae 6566: 6537:Gnathostomiasis 6522:Fasciolopsiasis 6474: 6422: 6413:Mercury in fish 6355: 6350: 6320: 6315: 6266:Marek's disease 6174:Avian influenza 6150: 6107: 6058:Poultry farming 6053:Chicken tractor 6043:Furnished cages 6019: 5996: 5946: 5941: 5911: 5902: 5875: 5814: 5791: 5753: 5721: 5647: 5618: 5606:Bacillus cereus 5571: 5527: 5472: 5460: 5416: 5383: 5358: 5326: 5320:Rheumatic fever 5262: 5204: 5149: 5147:Lactobacillales 5132: 5106: 5076: 5071: 5070: 5025: 5024: 4945: 4923:Wayback Machine 4891: 4883: 4875: 4864: 4826:MMWR Recomm Rep 4821: 4816: 4813: 4811:Further reading 4808: 4807: 4798: 4796: 4779: 4778: 4774: 4767: 4749:, Engelberg S, 4745: 4744: 4717: 4667: 4666: 4657: 4647: 4645: 4637: 4636: 4629: 4575: 4574: 4570: 4560: 4559: 4555: 4545: 4543: 4534: 4533: 4529: 4519: 4517: 4508: 4507: 4503: 4496: 4483: 4482: 4478: 4465: 4461: 4431: 4430: 4426: 4416: 4414: 4405: 4404: 4400: 4390: 4388: 4379: 4378: 4374: 4364: 4362: 4349: 4348: 4344: 4300: 4299: 4295: 4285: 4283: 4269: 4268: 4264: 4226: 4225: 4218: 4204: 4203: 4196: 4166: 4165: 4161: 4117: 4116: 4112: 4102: 4100: 4091: 4090: 4086: 4076: 4074: 4065: 4064: 4060: 4038: 4037: 4033: 4023: 4021: 3995: 3994: 3990: 3954: 3953: 3949: 3919: 3918: 3914: 3884: 3883: 3879: 3835: 3834: 3830: 3820: 3818: 3809: 3808: 3799: 3789: 3787: 3774: 3773: 3769: 3759: 3757: 3744: 3743: 3739: 3695: 3694: 3690: 3651:(4): CD008123. 3638: 3637: 3630: 3594: 3593: 3586: 3542: 3541: 3534: 3524: 3522: 3509: 3508: 3504: 3460: 3459: 3452: 3430: 3429: 3425: 3415: 3413: 3404: 3403: 3396: 3350: 3349: 3345: 3335: 3333: 3291: 3290: 3286: 3276: 3274: 3261: 3260: 3249: 3197: 3196: 3192: 3148: 3147: 3143: 3133: 3131: 3122: 3121: 3117: 3107: 3105: 3091: 3090: 3086: 3076: 3074: 3058: 3057: 3053: 3043: 3041: 3037: 3030: 3026: 3025: 3018: 3008: 3006: 2997: 2996: 2992: 2962: 2961: 2957: 2940: 2939: 2935: 2905: 2904: 2900: 2890: 2888: 2879: 2878: 2865: 2835: 2834: 2830: 2820: 2818: 2813:. August 2021. 2809: 2808: 2804: 2791: 2790: 2786: 2768: 2767: 2763: 2753: 2751: 2742: 2741: 2737: 2727: 2725: 2716: 2715: 2711: 2697: 2696: 2692: 2662: 2654: 2652: 2645: 2628: 2627: 2623: 2613: 2611: 2607: 2601: 2586: 2581: 2580: 2576: 2532: 2531: 2527: 2483: 2482: 2478: 2468:Botulinum Toxin 2465: 2461: 2451: 2449: 2440: 2439: 2432: 2422: 2420: 2412: 2411: 2407: 2397: 2395: 2386: 2385: 2381: 2371: 2369: 2354: 2353: 2349: 2339: 2337: 2333: 2326: 2322: 2321: 2312: 2302: 2300: 2287: 2286: 2282: 2230: 2229: 2225: 2175: 2174: 2170: 2134: 2133: 2129: 2077: 2076: 2072: 2062: 2060: 2043: 2042: 2038: 2028: 2026: 2017: 2016: 2012: 2004: 2000: 1970: 1969: 1962: 1951: 1936: 1935: 1931: 1921: 1919: 1906: 1905: 1901: 1863: 1862: 1858: 1829:(11): 1336–46. 1820: 1819: 1815: 1805: 1803: 1790: 1789: 1785: 1751: 1750: 1743: 1735: 1724: 1719: 1718: 1711: 1694: 1693: 1689: 1653: 1652: 1629: 1621: 1616: 1615: 1611: 1606: 1598:Botulinum toxin 1589: 1569: 1552: 1510: 1505: 1488: 1467: 1427:Northern Europe 1363: 1347: 1335: 1307: 1275: 1267: 1258: 1246:Lancaster, Ohio 1154: 1146: 1130: 1069: 1035: 1024: 888: 821: 732:botulinum toxin 728: 716:botulinum toxin 712: 700: 680: 668:mouse bioassays 638: 618: 557:Botulinum toxin 526: 507: 465:botulinum toxin 428: 426:Infant botulism 326: 280:botulinum toxin 251:botulinum toxin 223:, antibiotics, 100: 64: 60: 22: 17: 12: 11: 5: 7554: 7552: 7544: 7543: 7538: 7533: 7528: 7523: 7518: 7508: 7507: 7503: 7502: 7479: 7478: 7476: 7475: 7465: 7455: 7445: 7435: 7412: 7409: 7408: 7406: 7405: 7400: 7395: 7390: 7385: 7380: 7378:Food marketing 7375: 7370: 7364: 7362: 7361:Related topics 7358: 7357: 7355: 7354: 7349: 7343: 7338: 7333: 7327: 7321: 7316: 7311: 7304: 7302: 7296: 7295: 7293: 7292: 7287: 7282: 7277: 7272: 7267: 7262: 7257: 7252: 7247: 7242: 7236: 7234: 7220: 7219: 7217: 7216: 7215: 7214: 7209: 7204: 7194: 7189: 7184: 7179: 7174: 7169: 7164: 7159: 7154: 7149: 7144: 7139: 7130: 7125: 7120: 7115: 7110: 7105: 7096: 7087: 7078: 7073: 7068: 7063: 7058: 7053: 7041: 7036: 7031: 7026: 7021: 7016: 7011: 7005: 7003: 6997: 6996: 6994: 6993: 6988: 6983: 6978: 6973: 6968: 6963: 6958: 6953: 6948: 6946:Food additives 6943: 6938: 6933: 6927: 6925: 6919: 6918: 6916: 6915: 6910: 6905: 6900: 6895: 6890: 6885: 6880: 6874: 6872: 6866: 6865: 6863: 6862: 6857: 6852: 6847: 6842: 6837: 6832: 6827: 6822: 6817: 6811: 6809: 6795: 6794: 6792: 6791: 6786: 6781: 6776: 6771: 6770: 6769: 6759: 6753: 6751: 6745: 6744: 6742: 6741: 6736: 6731: 6725: 6723: 6717: 6716: 6714: 6713: 6708: 6703: 6698: 6693: 6687: 6685: 6679: 6678: 6676: 6675: 6668: 6660: 6653: 6648: 6643: 6636: 6631: 6626: 6618: 6610: 6603: 6596: 6589: 6582: 6576: 6574: 6572:Microorganisms 6568: 6567: 6565: 6564: 6559: 6554: 6549: 6544: 6542:Paragonimiasis 6539: 6534: 6529: 6524: 6519: 6514: 6509: 6507:Cyclosporiasis 6504: 6499: 6494: 6488: 6486: 6476: 6475: 6473: 6472: 6471: 6470: 6460: 6459: 6458: 6448: 6443: 6438: 6432: 6430: 6428:Food additives 6424: 6423: 6421: 6420: 6415: 6410: 6405: 6403:Lead poisoning 6400: 6395: 6390: 6385: 6380: 6375: 6369: 6367: 6357: 6356: 6351: 6349: 6348: 6341: 6334: 6326: 6317: 6316: 6314: 6313: 6308: 6303: 6298: 6293: 6288: 6283: 6278: 6273: 6268: 6263: 6258: 6253: 6248: 6243: 6236: 6231: 6226: 6221: 6216: 6211: 6206: 6201: 6196: 6191: 6186: 6181: 6176: 6171: 6166: 6160: 6158: 6152: 6151: 6149: 6148: 6143: 6138: 6133: 6128: 6123: 6117: 6115: 6109: 6108: 6106: 6105: 6100: 6095: 6090: 6085: 6080: 6075: 6073:Forced molting 6070: 6065: 6060: 6055: 6050: 6045: 6040: 6035: 6029: 6027: 6021: 6020: 6018: 6017: 6012: 6006: 6004: 5998: 5997: 5995: 5994: 5989: 5984: 5979: 5974: 5969: 5968: 5967: 5956: 5954: 5948: 5947: 5942: 5940: 5939: 5932: 5925: 5917: 5908: 5907: 5904: 5903: 5901: 5900: 5899: 5898: 5885: 5883: 5877: 5876: 5874: 5873: 5872: 5871: 5859: 5852: 5851: 5850: 5837: 5835: 5826: 5820: 5819: 5816: 5815: 5813: 5812: 5804: 5802: 5793: 5792: 5790: 5789: 5788: 5787: 5774: 5772: 5764:Clostridioides 5759: 5758: 5755: 5754: 5752: 5751: 5750: 5749: 5744: 5731: 5729: 5723: 5722: 5720: 5719: 5718: 5717: 5705: 5704: 5703: 5690: 5688: 5679: 5663: 5657: 5656: 5653: 5652: 5649: 5648: 5646: 5645: 5644: 5643: 5630: 5628: 5620: 5619: 5617: 5616: 5615: 5614: 5612:Food poisoning 5602: 5601: 5600: 5587: 5585: 5577: 5576: 5573: 5572: 5570: 5569: 5568: 5567: 5555: 5554: 5553: 5550:S. epidermidis 5537: 5535: 5529: 5528: 5526: 5525: 5524: 5523: 5518: 5513: 5500: 5498: 5489: 5486:Staphylococcus 5478: 5466: 5465: 5462: 5461: 5459: 5458: 5451: 5450: 5449: 5432: 5430: 5422: 5421: 5418: 5417: 5415: 5414: 5403: 5397: 5395: 5389: 5388: 5385: 5384: 5382: 5381: 5380: 5379: 5366: 5364: 5360: 5359: 5357: 5356: 5355: 5354: 5336: 5334: 5328: 5327: 5325: 5324: 5323: 5322: 5317: 5312: 5307: 5302: 5285: 5283: 5274: 5268: 5267: 5264: 5263: 5261: 5260: 5252: 5245: 5238: 5231: 5224: 5212: 5210: 5206: 5205: 5203: 5202: 5201: 5200: 5187: 5185: 5175: 5166: 5155: 5140: 5134: 5133: 5131: 5130: 5121: 5107: 5105: 5104: 5097: 5090: 5082: 5073: 5072: 5069: 5068: 5057: 5055:article/213311 5046: 5034: 5033: 5031: 5027: 5026: 5023: 5022: 5011: 5000: 4977: 4962: 4946: 4941: 4940: 4938: 4937:Classification 4931: 4930: 4925: 4913: 4908: 4903: 4897: 4877: 4876: 4874: 4873:External links 4871: 4870: 4869: 4812: 4809: 4806: 4805: 4772: 4765: 4715: 4655: 4627: 4568: 4553: 4527: 4501: 4494: 4476: 4459: 4424: 4398: 4372: 4342: 4293: 4276:People's Daily 4262: 4216: 4213:(10): 932–942. 4194: 4175:(6): 984–990. 4159: 4110: 4084: 4058: 4031: 3988: 3974:10.1086/515615 3947: 3912: 3893:(11): 859–63. 3877: 3828: 3797: 3767: 3737: 3688: 3628: 3584: 3555:(11): 1845–9. 3532: 3502: 3450: 3423: 3394: 3343: 3284: 3247: 3190: 3141: 3115: 3084: 3051: 3016: 2990: 2955: 2933: 2898: 2863: 2828: 2802: 2784: 2761: 2750:on 21 May 2014 2735: 2709: 2690: 2643: 2621: 2599: 2574: 2525: 2476: 2459: 2430: 2405: 2379: 2347: 2310: 2280: 2243:(5): 722–726. 2223: 2188:(4): 281–304. 2168: 2127: 2090:(6): 523–526. 2070: 2059:on 5 July 2011 2036: 2010: 1998: 1979:(8): 1059–70. 1960: 1949: 1929: 1910:C. perfringens 1899: 1856: 1813: 1796:kidshealth.org 1783: 1741: 1709: 1700:OutbreakID.com 1687: 1673:10.1086/444507 1666:(8): 1167–73. 1627: 1608: 1607: 1605: 1602: 1601: 1600: 1595: 1588: 1585: 1568: 1565: 1551: 1548: 1509: 1506: 1504: 1501: 1487: 1484: 1466: 1463: 1423:grass sickness 1362: 1359: 1346: 1343: 1339:drinking snack 1334: 1331: 1321:, as well as 1306: 1303: 1283:Qapqal disease 1274: 1273:Qapqal disease 1271: 1266: 1263: 1257: 1256:United Kingdom 1254: 1253: 1252: 1249: 1242: 1230: 1213: 1210:El Paso, Texas 1206: 1195: 1153: 1150: 1145: 1142: 1129: 1126: 1098:serum sickness 1068: 1065: 1034: 1031: 1023: 1020: 976:fermented fish 887: 884: 820: 817: 727: 724: 711: 708: 699: 696: 679: 676: 637: 634: 617: 614: 525: 522: 506: 503: 427: 424: 413:carbon dioxide 338:facial muscles 330:cranial nerves 325: 322: 238: 237: 234: 228: 227: 218: 214: 213: 210: 206: 205: 188: 182: 181: 178: 172: 171: 164: 160: 159: 156: 152: 151: 150:12 to 72 hours 148: 144: 143: 138: 132: 131: 124: 118: 117: 108: 102: 101: 99: 98: 57: 55: 51: 50: 38: 37: 29: 28: 20: 15: 13: 10: 9: 6: 4: 3: 2: 7553: 7542: 7539: 7537: 7534: 7532: 7529: 7527: 7524: 7522: 7519: 7517: 7514: 7513: 7511: 7501: 7491: 7487: 7474: 7466: 7464: 7460: 7456: 7454: 7446: 7444: 7436: 7434: 7424: 7419: 7414: 7413: 7410: 7404: 7401: 7399: 7396: 7394: 7391: 7389: 7386: 7384: 7383:Food politics 7381: 7379: 7376: 7374: 7371: 7369: 7366: 7365: 7363: 7359: 7353: 7350: 7348:(South Korea) 7347: 7344: 7342: 7339: 7337: 7334: 7331: 7328: 7325: 7322: 7320: 7317: 7315: 7312: 7309: 7306: 7305: 7303: 7301: 7297: 7291: 7288: 7286: 7283: 7281: 7278: 7276: 7273: 7271: 7268: 7266: 7263: 7261: 7258: 7256: 7253: 7251: 7248: 7246: 7243: 7241: 7238: 7237: 7235: 7233: 7229: 7225: 7221: 7213: 7212:United States 7210: 7208: 7205: 7203: 7200: 7199: 7198: 7195: 7193: 7190: 7188: 7185: 7183: 7180: 7178: 7175: 7173: 7170: 7168: 7165: 7163: 7160: 7158: 7155: 7153: 7150: 7148: 7145: 7143: 7140: 7138: 7136: 7133:2011 Germany 7131: 7129: 7126: 7124: 7121: 7119: 7116: 7114: 7111: 7109: 7106: 7104: 7102: 7097: 7095: 7093: 7090:1996 Odwalla 7088: 7086: 7084: 7079: 7077: 7074: 7072: 7069: 7067: 7064: 7062: 7059: 7057: 7054: 7050: 7045: 7042: 7040: 7037: 7035: 7032: 7030: 7027: 7025: 7022: 7020: 7017: 7015: 7012: 7010: 7007: 7006: 7004: 7002: 6998: 6992: 6989: 6987: 6984: 6982: 6979: 6977: 6974: 6972: 6969: 6967: 6964: 6962: 6959: 6957: 6954: 6952: 6949: 6947: 6944: 6942: 6939: 6937: 6934: 6932: 6929: 6928: 6926: 6924: 6920: 6914: 6911: 6909: 6906: 6904: 6901: 6899: 6896: 6894: 6891: 6889: 6886: 6884: 6881: 6879: 6876: 6875: 6873: 6871: 6867: 6861: 6858: 6856: 6853: 6851: 6848: 6846: 6843: 6841: 6838: 6836: 6833: 6831: 6828: 6826: 6823: 6821: 6818: 6816: 6813: 6812: 6810: 6808: 6804: 6800: 6796: 6790: 6787: 6785: 6782: 6780: 6777: 6775: 6772: 6768: 6765: 6764: 6763: 6760: 6758: 6755: 6754: 6752: 6750: 6746: 6740: 6737: 6735: 6732: 6730: 6727: 6726: 6724: 6722: 6721:Preservatives 6718: 6712: 6711:Methamidophos 6709: 6707: 6704: 6702: 6699: 6697: 6694: 6692: 6689: 6688: 6686: 6684: 6680: 6674: 6673: 6669: 6667: 6666: 6661: 6659: 6658: 6654: 6652: 6649: 6647: 6644: 6642: 6641: 6637: 6635: 6632: 6630: 6627: 6625: 6623: 6619: 6617: 6615: 6611: 6609: 6608: 6604: 6602: 6601: 6597: 6595: 6594: 6590: 6588: 6587: 6583: 6581: 6578: 6577: 6575: 6573: 6569: 6563: 6560: 6558: 6555: 6553: 6552:Toxoplasmosis 6550: 6548: 6545: 6543: 6540: 6538: 6535: 6533: 6530: 6528: 6525: 6523: 6520: 6518: 6515: 6513: 6510: 6508: 6505: 6503: 6500: 6498: 6495: 6493: 6490: 6489: 6487: 6485: 6481: 6477: 6469: 6466: 6465: 6464: 6463:Vegetable oil 6461: 6457: 6454: 6453: 6452: 6449: 6447: 6444: 6442: 6439: 6437: 6434: 6433: 6431: 6429: 6425: 6419: 6416: 6414: 6411: 6409: 6406: 6404: 6401: 6399: 6396: 6394: 6391: 6389: 6386: 6384: 6381: 6379: 6376: 6374: 6371: 6370: 6368: 6366: 6362: 6358: 6354: 6347: 6342: 6340: 6335: 6333: 6328: 6327: 6324: 6312: 6311:Toxoplasmosis 6309: 6307: 6304: 6302: 6299: 6297: 6294: 6292: 6289: 6287: 6284: 6282: 6279: 6277: 6274: 6272: 6269: 6267: 6264: 6262: 6259: 6257: 6254: 6252: 6249: 6247: 6244: 6242: 6241: 6237: 6235: 6232: 6230: 6227: 6225: 6222: 6220: 6217: 6215: 6212: 6210: 6207: 6205: 6202: 6200: 6197: 6195: 6192: 6190: 6187: 6185: 6182: 6180: 6177: 6175: 6172: 6170: 6167: 6165: 6164:Aspergillosis 6162: 6161: 6159: 6157: 6153: 6147: 6144: 6142: 6139: 6137: 6134: 6132: 6129: 6127: 6124: 6122: 6119: 6118: 6116: 6114: 6110: 6104: 6101: 6099: 6096: 6094: 6091: 6089: 6088:Chick culling 6086: 6084: 6081: 6079: 6076: 6074: 6071: 6069: 6068:Beak trimming 6066: 6064: 6061: 6059: 6056: 6054: 6051: 6049: 6046: 6044: 6041: 6039: 6036: 6034: 6031: 6030: 6028: 6026: 6022: 6016: 6013: 6011: 6008: 6007: 6005: 6003: 5999: 5993: 5990: 5988: 5985: 5983: 5980: 5978: 5975: 5973: 5970: 5966: 5963: 5962: 5961: 5958: 5957: 5955: 5953: 5949: 5945: 5938: 5933: 5931: 5926: 5924: 5919: 5918: 5915: 5897: 5894: 5893: 5892: 5891: 5887: 5886: 5884: 5882: 5878: 5870: 5867: 5866: 5865: 5864: 5860: 5858: 5857: 5853: 5849: 5846: 5845: 5844: 5843: 5839: 5838: 5836: 5834: 5830: 5827: 5825: 5821: 5811: 5810: 5806: 5805: 5803: 5800: 5799: 5794: 5786: 5783: 5782: 5781: 5780: 5776: 5775: 5773: 5770: 5766: 5765: 5760: 5748: 5745: 5743: 5740: 5739: 5738: 5737: 5733: 5732: 5730: 5728: 5724: 5716: 5713: 5712: 5711: 5710: 5706: 5702: 5699: 5698: 5697: 5696: 5692: 5691: 5689: 5687: 5683: 5680: 5677: 5673: 5672: 5667: 5664: 5662: 5658: 5642: 5639: 5638: 5637: 5636: 5632: 5631: 5629: 5627: 5626: 5621: 5613: 5610: 5609: 5608: 5607: 5603: 5599: 5596: 5595: 5594: 5593: 5589: 5588: 5586: 5584: 5583: 5578: 5566: 5565: 5561: 5560: 5559: 5556: 5552: 5551: 5547: 5546: 5545: 5543: 5539: 5538: 5536: 5534: 5530: 5522: 5519: 5517: 5514: 5512: 5509: 5508: 5507: 5506: 5502: 5501: 5499: 5497: 5493: 5490: 5488: 5487: 5482: 5479: 5476: 5471: 5467: 5457: 5456: 5452: 5448: 5445: 5444: 5443: 5442: 5437: 5434: 5433: 5431: 5429: 5428: 5423: 5413: 5412: 5407: 5404: 5402: 5399: 5398: 5396: 5394: 5390: 5378: 5375: 5374: 5373: 5372: 5368: 5367: 5365: 5361: 5353: 5350: 5349: 5348: 5347: 5346:S. agalactiae 5342: 5338: 5337: 5335: 5333: 5329: 5321: 5318: 5316: 5313: 5311: 5310:Scarlet fever 5308: 5306: 5303: 5301: 5298: 5297: 5296: 5295: 5291:susceptible: 5290: 5287: 5286: 5284: 5282: 5278: 5275: 5273: 5269: 5259: 5257: 5253: 5251: 5250: 5246: 5244: 5243: 5239: 5237: 5236: 5232: 5230: 5229: 5225: 5223: 5222: 5217: 5214: 5213: 5211: 5207: 5199: 5196: 5195: 5194: 5193: 5192:S. pneumoniae 5189: 5188: 5186: 5183: 5179: 5176: 5174: 5170: 5167: 5165: 5164: 5163:Streptococcus 5159: 5156: 5153: 5148: 5144: 5141: 5139: 5135: 5129: 5125: 5122: 5120: 5116: 5112: 5109: 5108: 5103: 5098: 5096: 5091: 5089: 5084: 5083: 5080: 5067: 5063: 5062: 5058: 5056: 5052: 5051: 5047: 5045: 5041: 5040: 5036: 5035: 5032: 5028: 5021: 5017: 5016: 5012: 5010: 5006: 5005: 5001: 4999: 4995: 4991: 4987: 4986: 4982: 4978: 4976: 4972: 4971: 4967: 4963: 4961: 4957: 4956: 4952: 4948: 4947: 4944: 4939: 4935: 4929: 4926: 4924: 4920: 4917: 4914: 4912: 4909: 4907: 4904: 4902: 4898: 4896: 4893: 4892: 4889: 4888: 4881: 4872: 4863: 4859: 4855: 4850: 4845: 4840: 4835: 4831: 4827: 4820: 4815: 4814: 4810: 4795: 4791: 4787: 4783: 4776: 4773: 4768: 4766:0-684-87158-0 4762: 4758: 4757: 4752: 4748: 4742: 4740: 4738: 4736: 4734: 4732: 4730: 4728: 4726: 4724: 4722: 4720: 4716: 4711: 4707: 4703: 4699: 4695: 4691: 4687: 4683: 4679: 4675: 4671: 4664: 4662: 4660: 4656: 4644: 4640: 4634: 4632: 4628: 4623: 4619: 4614: 4609: 4605: 4601: 4596: 4591: 4587: 4583: 4579: 4572: 4569: 4564: 4557: 4554: 4541: 4537: 4531: 4528: 4515: 4511: 4505: 4502: 4497: 4491: 4487: 4480: 4477: 4473: 4472:0-8138-0430-2 4469: 4463: 4460: 4455: 4451: 4447: 4443: 4440:(5): 427–46. 4439: 4435: 4428: 4425: 4412: 4408: 4402: 4399: 4386: 4382: 4376: 4373: 4360: 4356: 4352: 4346: 4343: 4338: 4334: 4329: 4324: 4320: 4316: 4312: 4308: 4304: 4297: 4294: 4281: 4277: 4273: 4266: 4263: 4258: 4254: 4250: 4246: 4242: 4238: 4234: 4230: 4223: 4221: 4217: 4212: 4208: 4201: 4199: 4195: 4190: 4186: 4182: 4178: 4174: 4170: 4163: 4160: 4155: 4151: 4146: 4141: 4137: 4133: 4130:(3): 389–95. 4129: 4125: 4121: 4114: 4111: 4098: 4094: 4088: 4085: 4072: 4068: 4062: 4059: 4054: 4050: 4047:(30): 767–9. 4046: 4042: 4035: 4032: 4019: 4015: 4011: 4007: 4003: 3999: 3992: 3989: 3984: 3980: 3975: 3970: 3966: 3962: 3958: 3951: 3948: 3943: 3939: 3935: 3931: 3927: 3923: 3916: 3913: 3908: 3904: 3900: 3896: 3892: 3888: 3881: 3878: 3873: 3869: 3864: 3859: 3855: 3851: 3847: 3843: 3839: 3832: 3829: 3816: 3812: 3806: 3804: 3802: 3798: 3785: 3781: 3777: 3771: 3768: 3755: 3751: 3747: 3741: 3738: 3733: 3729: 3724: 3719: 3715: 3711: 3707: 3703: 3699: 3692: 3689: 3684: 3680: 3675: 3670: 3666: 3662: 3658: 3654: 3650: 3646: 3642: 3635: 3633: 3629: 3624: 3620: 3615: 3610: 3607:(5): 462–71. 3606: 3602: 3598: 3591: 3589: 3585: 3580: 3576: 3571: 3566: 3562: 3558: 3554: 3550: 3546: 3539: 3537: 3533: 3520: 3516: 3512: 3506: 3503: 3498: 3494: 3489: 3484: 3480: 3476: 3472: 3468: 3464: 3457: 3455: 3451: 3446: 3442: 3438: 3434: 3427: 3424: 3411: 3407: 3401: 3399: 3395: 3390: 3386: 3381: 3376: 3371: 3366: 3362: 3358: 3354: 3347: 3344: 3331: 3327: 3323: 3319: 3315: 3311: 3307: 3304:(5): 481–92. 3303: 3299: 3295: 3288: 3285: 3272: 3268: 3264: 3258: 3256: 3254: 3252: 3248: 3243: 3239: 3234: 3229: 3225: 3221: 3217: 3213: 3209: 3205: 3201: 3194: 3191: 3186: 3182: 3177: 3172: 3168: 3164: 3161:(3): 357–62. 3160: 3156: 3152: 3145: 3142: 3129: 3125: 3119: 3116: 3103: 3099: 3095: 3088: 3085: 3072: 3068: 3067: 3062: 3055: 3052: 3036: 3029: 3023: 3021: 3017: 3004: 3000: 2994: 2991: 2986: 2982: 2978: 2974: 2970: 2966: 2959: 2956: 2951: 2947: 2946:Safefood News 2943: 2937: 2934: 2929: 2925: 2921: 2917: 2913: 2909: 2902: 2899: 2886: 2882: 2876: 2874: 2872: 2870: 2868: 2864: 2859: 2855: 2851: 2847: 2843: 2839: 2832: 2829: 2816: 2812: 2806: 2803: 2798: 2794: 2788: 2785: 2780: 2776: 2772: 2765: 2762: 2749: 2745: 2739: 2736: 2723: 2719: 2713: 2710: 2705: 2701: 2694: 2691: 2686: 2682: 2678: 2675:(39): 782–4. 2674: 2670: 2666: 2650: 2646: 2640: 2636: 2632: 2625: 2622: 2606: 2602: 2596: 2592: 2585: 2578: 2575: 2570: 2566: 2561: 2556: 2552: 2548: 2545:(3): 629–36. 2544: 2540: 2536: 2529: 2526: 2521: 2517: 2512: 2507: 2503: 2499: 2496:(3): 379–85. 2495: 2491: 2487: 2480: 2477: 2474: 2470: 2469: 2463: 2460: 2447: 2443: 2437: 2435: 2431: 2419: 2415: 2409: 2406: 2394:. 1 June 2021 2393: 2389: 2383: 2380: 2367: 2363: 2362: 2357: 2351: 2348: 2332: 2325: 2319: 2317: 2315: 2311: 2298: 2294: 2290: 2284: 2281: 2276: 2272: 2267: 2262: 2258: 2254: 2250: 2246: 2242: 2238: 2234: 2227: 2224: 2219: 2215: 2211: 2207: 2203: 2199: 2195: 2191: 2187: 2183: 2179: 2172: 2169: 2164: 2160: 2155: 2150: 2146: 2142: 2138: 2131: 2128: 2123: 2119: 2115: 2111: 2107: 2103: 2098: 2093: 2089: 2085: 2081: 2074: 2071: 2058: 2054: 2050: 2046: 2040: 2037: 2024: 2020: 2014: 2011: 2007: 2002: 1999: 1994: 1990: 1986: 1982: 1978: 1974: 1967: 1965: 1961: 1956: 1952: 1946: 1942: 1941: 1933: 1930: 1917: 1913: 1911: 1903: 1900: 1895: 1891: 1887: 1883: 1879: 1875: 1872:(1): e73-82. 1871: 1867: 1860: 1857: 1852: 1848: 1844: 1840: 1836: 1832: 1828: 1824: 1817: 1814: 1801: 1797: 1793: 1787: 1784: 1779: 1775: 1771: 1767: 1764:(6): 653–62. 1763: 1759: 1755: 1748: 1746: 1742: 1734: 1730: 1723: 1716: 1714: 1710: 1705: 1701: 1697: 1691: 1688: 1683: 1679: 1674: 1669: 1665: 1661: 1657: 1650: 1648: 1646: 1644: 1642: 1640: 1638: 1636: 1634: 1632: 1628: 1620: 1613: 1610: 1603: 1599: 1596: 1594: 1591: 1590: 1586: 1584: 1582: 1578: 1574: 1573:Aum Shinrikyo 1566: 1564: 1561: 1557: 1549: 1547: 1545: 1541: 1537: 1534:, even after 1533: 1532: 1527: 1523: 1519: 1515: 1508:United States 1507: 1502: 1500: 1496: 1492: 1485: 1483: 1480: 1476: 1472: 1464: 1462: 1460: 1456: 1451: 1448: 1446: 1442: 1438: 1437:Domestic dogs 1434: 1432: 1428: 1424: 1420: 1419: 1414: 1410: 1408: 1404: 1403:lame sickness 1400: 1395: 1391: 1388: 1382: 1381:and leeches. 1380: 1376: 1372: 1371:invertebrates 1368: 1360: 1358: 1356: 1352: 1344: 1342: 1340: 1332: 1330: 1328: 1324: 1323:First Nations 1320: 1316: 1312: 1304: 1302: 1300: 1299:mi song hu hu 1294: 1292: 1288: 1287:Sibe villages 1284: 1280: 1272: 1270: 1264: 1262: 1255: 1250: 1247: 1243: 1239: 1235: 1231: 1228: 1224: 1223: 1218: 1214: 1211: 1207: 1204: 1200: 1196: 1193: 1190: 1186: 1182: 1181: 1180: 1177: 1175: 1171: 1166: 1163: 1158: 1152:United States 1151: 1149: 1143: 1141: 1139: 1138:case fatality 1134: 1127: 1125: 1123: 1119: 1115: 1111: 1106: 1103: 1099: 1095: 1091: 1086: 1084: 1080: 1076: 1071: 1066: 1064: 1062: 1057: 1055: 1051: 1047: 1042: 1040: 1032: 1030: 1028: 1021: 1019: 1017: 1013: 1009: 1004: 1001: 995: 991: 987: 983: 979: 977: 973: 969: 968:chili peppers 965: 964:acidification 961: 957: 952: 950: 946: 945:beached whale 942: 938: 934: 930: 926: 922: 918: 914: 910: 906: 900: 898: 892: 885: 883: 881: 877: 873: 869: 865: 861: 857: 853: 849: 845: 841: 836: 834: 830: 826: 818: 816: 813: 811: 807: 803: 799: 798:acetylcholine 794: 790: 788: 783: 779: 777: 772: 768: 766: 765:serologically 762: 761:antigenically 757: 753: 751: 747: 746: 741: 739: 738: 733: 725: 723: 721: 720:boxed warning 717: 709: 707: 705: 697: 695: 693: 689: 685: 677: 675: 673: 669: 665: 660: 657: 656: 650: 648: 644: 635: 633: 631: 627: 623: 615: 613: 610: 608: 603: 601: 597: 593: 589: 585: 581: 577: 576:acetylcholine 574: 570: 566: 562: 558: 554: 553:Gram-positive 550: 546: 545: 537: 536: 530: 523: 521: 519: 515: 510: 505:Complications 504: 502: 499: 497: 496: 490: 489: 484: 480: 478: 474: 470: 469:acetylcholine 466: 461: 459: 455: 451: 447: 446: 441: 432: 425: 423: 421: 416: 414: 410: 406: 402: 398: 393: 391: 387: 383: 379: 375: 371: 367: 363: 359: 355: 351: 350:Double vision 347: 343: 339: 335: 334:eye movements 331: 323: 321: 318: 314: 310: 306: 302: 298: 292: 290: 285: 281: 277: 272: 270: 266: 265:consciousness 262: 261:feeling tired 258: 257: 252: 248: 244: 235: 233: 229: 226: 222: 219: 215: 211: 207: 204: 200: 196: 192: 189: 187: 183: 179: 177: 173: 170: 169: 165: 161: 157: 153: 149: 145: 142: 139: 137: 136:Complications 133: 129: 128:feeling tired 125: 123: 119: 116: 112: 109: 107: 103: 94: 59: 58: 56: 54:Pronunciation 52: 48: 44: 39: 35: 30: 25: 19: 7393:Food quality 7300:Institutions 7134: 7100: 7091: 7082: 6966:Nitrosamines 6729:Benzoic acid 6691:Chlorpyrifos 6670: 6664: 6655: 6638: 6621: 6613: 6605: 6598: 6591: 6584: 6579: 6562:Trichuriasis 6547:Toxocariasis 6517:Enterobiasis 6393:Formaldehyde 6238: 6188: 6146:Rooster Flag 6131:Cockfighting 6083:Chick sexing 6033:Battery cage 5888: 5861: 5854: 5840: 5807: 5796: 5777: 5762: 5742:Gas gangrene 5734: 5726: 5707: 5700: 5693: 5685: 5669: 5633: 5623: 5604: 5590: 5580: 5562: 5557: 5548: 5540: 5503: 5484: 5453: 5439: 5427:Enterococcus 5425: 5409: 5369: 5344: 5292: 5256:S. anginosus 5255: 5247: 5242:S. sanguinis 5240: 5233: 5226: 5219: 5190: 5161: 5059: 5048: 5037: 5013: 5002: 4979: 4964: 4949: 4885: 4829: 4825: 4797:, retrieved 4785: 4775: 4754: 4677: 4673: 4646:. 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