The management of botulism cases requires a coordinated effort between health care providers and local and state health agencies. Antitoxin is the sole treatment specific to botulism and is obtainable only through the public health system.

Steps for obtaining antitoxin through the Public Health Department:

1.      Health Care Provider contacts the Public Health Department at 681-5280 (this number is operable 24/7) about a patient with an illness suspicious for botulism.

2.      The Public Health Department evaluates the likelihood of botulism being the correct diagnosis and collects pertinent demographic and clinical information.

3.      If botulism is suspected, botulinal antitoxin will be needed, and the Public Health Department will contact the California Department of Public Health Disease Control Duty Officer of the Day (DOD). The Public Health Department will need to provide the following information to the DOD:

a.       basic patient demographics (name, birthdate or age),

b.      description of the clinical presentation (onset date, type and progression of symptoms),

c.       epidemiologic data (risk factor(s) for wound or foodborne botulism, number of associated persons with similar illnesses (if pertinent), results of, or plans for, a home visit if foodborne botulism is suspected), and

d.      information for contacting the requesting provider (provider name, hospital name and location, and the phone number at which the requesting provider is immediately reachable).

4.      If antitoxin will be released, the provider will be instructed to collect pre-treatment laboratory specimens.  The antitoxin will be released from the CDC quarantine station nearest to the hospital

5.      The CDC quarantine station calls the hospital. The hospital is responsible for arranging transportation of the antitoxin from the quarantine station to the patient and for any transport-related costs.

For more information, please visit the Botulism Emergency Preparedness and Response page. You may also contact 1-800-CDC-INFO, or e-mail coca@cdc.gov.

Infant botulism is treated with BabyBIG®, Botulism Immune Globulin Intravenous (Human) (BIG-IV), which is an orphan drug that consists of human-derived botulism antitoxin antibodies. BabyBIG is approved by the U.S. Food and Drug Administration for the treatment of infant botulism types A and B. This drug differs from the equine antitoxin used in adult cases. If you have a patient with suspect infant botulism please contact the Botulism Treatment and Prevention Program (IBTPP) on-call physician at (510) 231-7600 (this number is operable 24/7).

More information about IBTPP can be obtained at the following website: http://www.infantbotulism.org/.