Division Clinical Criteria

Any person with at least one of the following clinical forms:

• Food-borne and wound botulism

  At least one of the following two:

  • Bilateral cranial nerve impairment (for example, diplopia, blurred vision, dysphagia, bulbar weakness);

  • Peripheral symmetric paralysis.

• Infant botulism

  Any infant with at least one of the following six:

  • Constipation;

  • Lethargy;

  • Difficulty in sucking or feeding;

  • Ptosis;

  • Dysphagia;

  • General muscle weakness.

The type of botulism usually encountered in infants (< 12 months of age) can affect children also over 12 months of age and occasionally adults, with altered gastrointestinal anatomy and microflora