paper or the icam) will not indicate a "positive" when samples containing botulinum toxin are tested. to confirm a diagnosis of botulinum toxin poisoning, therapeutically or to provide evidence in death investigations, botulinum toxin may be quantitated by immunoassay of human biological fluids; serum levels of 12–24 mouse ld50 units per milliliter have been detected in poisoned patients. japanese doomsday cult aum shinrikyo produced botulinum toxin and spread it as an aerosol in downtown tokyo during the 1990s, but the attacks caused no fatalities. during the early 1980s, german and french newspapers reported that the police had raided a baader-meinhof gang safe house in paris and had found a makeshift laboratory that contained flasks full of clostridium botulinum, which makes botulinum toxin. their reports were later found to be incorrect; no such lab was ever found. brand names botulinum toxin a is sold under the brand names jeuveau, botox, and xeomin. botulinum toxin b is sold under the brand name myobloc. in the united states, botulinum toxin products are manufactured by a variety of companies, for both therapeutic and cosmetic use. a u.s. supplier reported in its company materials in 2011 that it could "supply the world's requirements for 25 indications approved by government agencies around the world" with less than one gram of raw botulinum toxin. myobloc or neurobloc, a botulinum toxin type b product, is produced by solstice neurosciences, a subsidiary of us worldmeds. abobotulinumtoxina), a therapeutic formulation of the type a toxin manufactured by galderma in the united kingdom, is licensed for the treatment of focal dystonias and certain cosmetic uses in the u.s. and other countries. besides the three primary u.s. manufacturers, numerous other botulinum toxin producers are known. xeomin, manufactured in germany by merz, is also available for both therapeutic and cosmetic use in the u.s. lanzhou institute of biological products in china manufactures a botulinum toxin type-a product; as of 2014, it was the only botulinum toxin type-a approved in china. botulinum toxin type-a is also sold as lantox and prosigne on the global market. neuronox, a botulinum toxin type-a product, was introduced by medy-tox inc. of south korea in 2009. toxin production botulism toxins are produced by bacteria of the genus clostridium, namely c. botulinum, c. butyricum, c. baratii and c. argentinense, which are widely distributed, including in soil and dust. also, the bacteria can be found inside homes on floors, carpet, and countertops even after cleaning. food-borne botulism results, indirectly, from ingestion of food contaminated with clostridium spores, where exposure to an anaerobic environment allows the spores to germinate, after which the bacteria can multiply and produce toxin. critically, ingestion of toxin rather than spores or vegetative bacteria causes botulism. botulism is nevertheless known to be transmitted through canned foods not cooked correctly before canning or after can opening, so is preventable. infant botulism arising from consumption of honey or any other food that can carry these spores can be prevented by eliminating these foods from diets of children less than 12 months old. organism and toxin susceptibilities proper refrigeration at temperatures below 4.4 °c (39.9 °f) slows the growth of c. botulinum. the organism is also susceptible to high salt, high oxygen, and low ph levels. the toxin itself is rapidly destroyed by heat, such as in thorough cooking. the spores that produce the toxin are heat-tolerant and will survive boiling water for an extended period of time. the botulinum toxin is denatured and thus deactivated at temperatures greater than 85 °c (185 °f) for five minutes. as a zinc metalloprotease (see below), the toxin's activity is also susceptible, post-exposure, to inhibition by protease inhibitors, e.g., zinc-coordinating hydroxamates. research blepharospasm and strabismus