Clostridium botulinim is a naturally occurring Gram positive organism.
The organism is isolated in only 41% of cases of Botulism
Human disease is caused by Serotypes A,B or E
The organism is found in soil, dust and aquatic sediments.
5 main vectors:
Food borne
Wound botulism (most common in UK)
Intestinal colonisation (infants)
Deliberate release (weapons)
Iatrogenic
Wound colonisation was first described in 2000, exclusively amongst the intravenous drug using population.
Direct injection of heroin, often dissolved in citric acid, into muscle or under the skin provides optimum conditions for bacterial growth. (“Skin popping”)