Botulism

Botulism is a rare but potentially fatal syndrome of diffuse, flaccid paralysis caused by botulinum neurotoxin (BoNT), a neurotoxin elaborated by the bacterium and 6 other clostridial genospecies. Several other etiologies of botulism have been described since its recognition as a foodborne entity in Germany and Belgium in the 1800s, including wound botulism, iatrogenic botulism, and inhalational botulism. The administration of polyvalent antitoxin to BoNT mitigates the clinical course of botulism. However, no true antidote exists, and disease management relies on potentially weeks of mechanical ventilation and other resource-heavy therapies while the body's neuromuscular signaling mechanisms recover. BoNT, the most potent poison known to man, is relatively simple to produce, store, and disperse. Thus, this toxin is a subject of intense interest for defense organizations worldwide. Due to its toxicity, BoNT has been previously implicated in biological warfare and bioterrorism plans with state-based actors and terror groups such as the Red Army Faction and Aum Shinrikyo in the 1980s and 1990s. Despite this, BoNT can be managed in accredited biosafety level 2 containment facilities as it is not transmissible following initial exposure.