title: Botulism, where are we now?
abstract: BACKGROUND
  Botulism is a neuroparalytic illness caused by botulinum toxin, a product of the Clostridium botulinum bacteria and characteristically presents as an acute, symmetrical, descending flaccid paralysis. Albeit it is the most poisonous substance known, which even poses a major threat as biological weapons, purified and highly diluted botulinum toxin can be used to treat a wide variety of conditions associated with muscular hyperactivity, glandular hypersecretions and pain. There are six clinical presentations associated with current occurring botulism, each results from absorption of botulinum toxin into the bloodstream.
  
  
  OBJECTIVE
  The aim of this review is to summarize the current knowledge on the microbiology, epidemiology, vaccine research and clinical management of human botulism.
  
  
  CONCLUSIONS
  Early diagnosis and management rely on history and physical examination. Delay in treatment may allow progression of paralysis, protracted hospitalization and deaths of long-term mechanical ventilation and intensive care unit care. The clinicians must take this disease into consideration of a possible outbreak. Awaiting laboratory confirmation is an egregious error, while awareness of the clinical sign and symptoms of botulism is critical for early diagnosis. Rapid management and followed public health surveillance may greatly alleviate disease severity and decrease mortality rates.
authors.affiliation: Department of Infectious Disease, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
authors.forename: Jiu-Cong
authors.initials: JC
authors.lastname: Zhang
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.forename: Qing-He
authors.initials: QH
authors.lastname: Nie
mesh_terms: D001428:Bacterial Vaccines / Q000276:immunology; D001905:Botulinum Toxins / Q000633:toxicity; D001906:Botulism / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D003014:Clostridium botulinum / Q000276:immunology / Q000472:pathogenicity; D006801:Humans
chemical_list: D001428:Bacterial Vaccines; D001905:Botulinum Toxins