Botulism Fact Sheet

Last Reviewed: December 2025

What is botulism?

Botulism is a rare but serious illness caused by a toxin (poison that is released by bacteria) that attacks the body's nerves. The toxin is produced by the bacterium Clostridium botulinum (C. botulinum) and related bacteria. There are five main types of botulism: foodborne, wound, infant, adult intestinal colonization, and iatrogenic botulism. All types of botulism are considered medical emergencies because the illness can cause death unless proper medical treatment is received.

Who gets botulism?

Illness from botulism is rare. Certain activities, however, may increase your chances of becoming ill.

• People who drink homemade alcohol or eat improperly home-canned, preserved, or fermented foods (for example pickles, sauerkraut, kimchi) are at increased risk of developing foodborne botulism.
• Children under the age of one who eat honey or are exposed to botulism toxins in the environment (e.g., from nearby construction) are at greater risk of getting infant botulism.
• People who inject drugs are at increased risk of acquiring wound botulism.
• Those who receive botulism toxin injections for cosmetic or medical reasons are at increased risk of developing iatrogenic botulism.
• Adults with underlying medical conditions who have compromised function of their intestines, may be at higher risk to develop adult intestinal colonization.

How is botulism spread?

The bacteria that produce botulismtoxins are found naturally in the environment (i.e., in soil), but under certain conditions the bacteria make spores that grow to make toxin. Botulism is most often caused by bacteria that have produced the toxin in a wound or in a food product. Contaminated food products that have caused illness in the past include improperly home-canned foods, improperly canned commercial foods, herb infused oils, baked potatoes wrapped in foil, and cheese sauce. Wound botulism is commonly spread among illicit injection drug (heroin) users. Botulism in infants can be caused by exposure to honey, home-canned foods, corn syrup, or from inhaling toxin-producing bacteria naturally occurring in soil. Often the exact cause of infant botulism is not able to be identified. Botulism is not spread from person to person.

What are the symptoms of botulism and when do they appear?

All types of botulism produce symptoms that affect the body's nerves. The classic symptoms of botulism include double vision, blurred vision, drooping eyelids, difficulty moving eyes, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Individuals with food-borne botulism may also experience vomiting, stomach pain, or diarrhea. Infants with botulism typically appear sluggish and "floppy" (have poor muscle tone), feed poorly, become constipated (have difficulty passing stool or poop), and have a weak cry. If a wound becomes infected with botulism, it may appear red, swollen, and be painful, warm to the touch, full of pus, and accompanied by a fever. If untreated, these symptoms may progress to muscle paralysis (not able to move body parts, including muscles used for breathing). A person who develops any symptoms of botulism should immediately contact their physician or local hospital for medical evaluation. Persons who have a wound, regardless of whether the wound appears infected, and experience any symptoms of botulism, should seek immediate medical attention.

Symptoms begin 12-36 hours after eating or drinking a contaminated food or beverage but may occur as early as a few hours or as long as 10 days from exposure. In general, the shorter the incubation period, the greater the severity of the illness. For foodborne botulism, neurological symptoms typically appear within 12-72 hours after eating or drinking a contaminated food or beverage but can range from 2 hours to 8 days. For wound botulism, the incubation period typically ranges from 4-14 days following exposure. For infant botulism, the incubation period may span up to 30 days from exposure. For iatrogenic botulism, the incubation period can range from a few hours to several weeks depending on dose and location of the procedure.

How is botulism diagnosed?

Because botulism is a rare disease and has symptoms similar to other diseases such as Guillain-Barré syndrome, special laboratory tests must be performed to diagnose botulism. These lab tests can show if the bacteria and/or the toxin are present in your body, indicating infection.

What is the treatment for botulism?

The symptoms of botulism make hospitalization necessary. If diagnosed early, botulism can be treated with a drug called antitoxin, which stops the toxin from causing more harm to the body. The antitoxin can prevent further damage to the body but cannot repair damage that has already taken place. Even with intensive treatment, recovery can take weeks to months. If the disease is severe, a patient may experience breathing problems and be placed on a breathing machine called a ventilator. In some situations, there is the need for intensive medical and nursing care for recovery. Infant botulism is treated with a drug called immune globulin, which has similar effects as the antitoxin. For cases of wound botulism, surgery to remove the source of the toxin-producing bacteria and antibiotic treatment may be required. While most botulism cases recover, botulism can lead to death even if proper treatment (antitoxin or immune globulin) and intensive medical care has been received. Patients who survive may have fatigue and breathing problems for years following and need long-term therapy to help with recovery.

How can botulism be prevented?

Foodborne botulism often results after eating home-canned, preserved, or fermented foods contaminated with botulism toxins. All canned and preserved foods should be properly processed and prepared to prevent bacteria from getting into them and toxins from forming. Because high temperatures destroy botulism toxins, persons who eat home-canned foods should consider boiling the food for 10 minutes before eating it to ensure safety. Botulism can be present in cans that look normal and in foods that smell and taste normal; however, you can decrease the risk of getting foodborne botulism by throwing away canned food with bulging lids and not eating foods with an unusual taste or smell.

To reduce the risk of wound botulism, it is essential to keep wounds clean. In addition, avoid injection drug use and be alert for signs of illness following injuries and surgical wounds.

Botulism in infants under one year of age has been associated with ingestion of C. botulinum spores from the environment or specific foods such as honey. Known sources of infant botulism, such as honey, should not be fed to infants under 1 year of age. However, because botulism is present in the natural environment (found in soil and dust), most cases of infant botulism cannot be prevented.

Iatrogenic botulism can be prevented by using only licensed practitioners to administer injections of botulinum toxin, whether for medical or cosmetic reasons.