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October 24, 1977

Coproexamination for Botulinal Toxin and Clostridium botulinum: A New Procedure for Laboratory Diagnosis of Botulism

Author Affiliations

From the Bureau of Laboratories (Drs Dowell, Hatheway, and Lombard, and Ms McCroskey) and Bureau of Epidemiology (Drs Hughes and Merson), Center for Disease Control, Public Health Service, Department of Health, Education and Welfare, Atlanta.

JAMA. 1977;238(17):1829-1832. doi:10.1001/jama.1977.03280180033021

Stool or serum specimens or both from 318 persons pertaining to 165 botulism investigations over a three-year period were examined. Botulinal toxin was detected in stools of 19 of 56 patients and in sera of 20 of 60 patients with clinical botulism; it was not detected in specimens from 246 persons with an illness other than botulism or well contacts of patients. Clostridium botulinum was identified in stools of 36 of 60 clinical botulism patients and in four of 27 asymptomatic contacts of patients with botulism victims, but not in stools of 65 persons not associated with confirmed botulism. When stool and serum samples were examined, confirmatory evidence was obtained for 72.9% of the botulism cases. Detection of botulinal toxin or C botulinum in the stool of a person should be considered evidence supporting the clinical diagnosis of botulism.

(JAMA 238:1829-1832, 1977)