Globally,<unk>  is fairly rare, with approximately 1,000 identified cases yearly. United States In the United States an average of 145 cases are reported each year. Of these, roughly 65% are infant<unk> , 20% are wound<unk> , and 15% are foodborne. Infant<unk>  is predominantly sporadic and not associated with epidemics, but great geographic variability exists. From 1974 to 1996, for example, 47% of all infant<unk>  cases reported in the U.S. occurred in California. Between 1990 and 2000, the Centers for Disease Control and Prevention reported 263 individual foodborne cases from 160<unk>  events in the United States with a case-fatality rate of 4%. Thirty-nine percent (103 cases and 58 events) occurred in Alaska, all of which were attributable to traditional Alaska aboriginal foods. In the lower 49 states, home-canned food was implicated in 70 events (~69%) with canned asparagus being the most frequent cause. Two restaurant-associated outbreaks affected 25 persons. The median number of cases per year was 23 (range 17–43), the median number of events per year was 14 (range 9–24). The highest incidence rates occurred in Alaska, Idaho, Washington, and Oregon. All other states had an incidence rate of 1 case per ten million people or less. The number of cases of food borne and infant<unk>  has changed little in recent years, but wound<unk>  has increased because of the use of black tar heroin, especially in California. All data regarding<unk>  antitoxin releases and laboratory confirmation of cases in the US are recorded annually by the Centers for Disease Control and Prevention and published on their website. * On July 2, 1971, the U.S. Food and Drug Administration (FDA) released a public warning after learning that a New York man had died and his wife had become seriously ill due to<unk>  after eating a can of Bon Vivant vichyssoise soup. * Between March 31 and April 6, 1977, 59 individuals developed type B<unk> . All ill persons had eaten at the same Mexican restaurant in Pontiac, Michigan and all had consumed a hot sauce made with improperly home-canned jalapeño peppers, either by adding it to their food, or by eating a nacho that had had hot sauce used in its preparation. The full clinical spectrum (mild symptomatology with neurologic findings through life-threatening ventilatory paralysis) of type B<unk>  was documented. * In April 1994, the largest outbreak of<unk>  in the United States since 1978 occurred in El Paso, Texas. Thirty persons were affected; 4 required mechanical ventilation. All ate food from a Greek restaurant. The attack rate among persons who ate a potato-based dip was 86% (19/22) compared with 6% (11/176) among persons who did not eat the dip (relative risk RR = 13.8; 95% confidence interval CI, 7.6–25.1). The attack rate among persons who ate an eggplant-based dip was 67% (6/9) compared with 13% (24/189) among persons who did not (RR = 5.2; 95% CI, 2.9–9.5).<unk>  toxin type A was detected in patients and in both dips. Toxin formation resulted from holding aluminum foil-wrapped baked potatoes at room temperature, apparently for several days, before they were used in the dips. Food handlers should be informed of the potential hazards caused by holding foil-wrapped potatoes at ambient temperatures after cooking. * In 2002, fourteen Alaskans ate muktuk (whale blubber) from a beached whale, resulting in eight of them developing<unk> , with two of the affected requiring mechanical ventilation. * Beginning in late June 2007, 8 people contracted<unk>  poisoning by eating canned food products produced by Castleberry's Food Company in its Augusta, Georgia plant. It was later identified that the Castleberry's plant had serious production problems on a specific line of retorts that had under-processed the cans of food. These issues included broken cooking alarms, leaking water valves and inaccurate temperature devices, all the result of poor management of the company. All of the victims were hospitalized and placed on mechanical ventilation. The Castleberry's Food Company outbreak was the first instance of<unk>  in commercial canned foods in the United States in over 30 years. * One person died, 21 cases were confirmed, and 10 more were suspected in Lancaster, Ohio when a<unk>  outbreak occurred after a church potluck in April 2015. The suspected source was a salad made from home-canned potatoes. * A<unk>  outbreak occurred in Northern California in May 2017 after 10 people consumed nacho cheese dip served at a gas station in Sacramento County. One man died as a result of the outbreak. United Kingdom The largest recorded outbreak of foodborne<unk>  in the United Kingdom occurred in June 1989. A total of 27 patients were affected; one patient died. Twenty-five of the patients had eaten one brand of hazelnut yogurt in the week before the onset of symptoms. Control measures included the cessation of all yogurt production by the implicated producer, the withdrawal of the firm's yogurts from sale, the recall of cans of the hazelnut conserve, and advice to the general public to avoid the consumption of all hazelnut yogurts. China From 1958 to 1983 there were 986 outbreaks of<unk>  in China involving 4,377 people with 548 deaths. Qapqal disease After the Chinese Communist Revolution in 1949, a mysterious plague (named Qapqal disease) was noticed to be affecting several Sibe villages in Qapqal Xibe Autonomous County. It was endemic with distinctive epidemic patterns, yet the underlying cause remained unknown for a long period of time. It caused a number of deaths and forced some people to leave the place. In 1958, a team of experts were sent to the area by the Ministry of Health to investigate the cases. The epidemic survey conducted proved that the disease was primarily type A<unk> , with several cases of type B. The team also discovered that, the source of the botulinum was local fermented grain and beans, as well as a raw meat food called mi song hu hu. They promoted the improvement of fermentation techniques among local residents, and thus eliminated the disease. Canada From 1985 to 2015 there were outbreaks causing 91 confirmed cases of foodborne<unk>  in Canada, 85% of which were in Inuit communities, especially Nunavik and First Nations of the coast of British Columbia from eating traditionally prepared marine mammal and fish products. Ukraine In 2017, there were 70 cases of<unk>  with 8 deaths in Ukraine. The previous year there were 115 cases with 12 deaths. Most cases were the result of dried fish, a common local drinking snack. Vietnam In 2020, several cases of<unk>  were reported in Vietnam. All of them were related to a product containing contaminated vegetarian pâté. Some patients were put on life support.
Botulism
Guillain–Barré syndrome
Tardive dyskinesia
Lambert–Eaton myasthenic syndrome
Quadrigia
Myasthenia gravis
Sadism
Amyotrophic lateral sclerosis