Botulism is a medical emergency, and rapid clinical diagnosis is essential to ensure appropriate treatment. High index of suspicion is necessary to consider the diagnosis; patients presenting with signs and symptoms of botulism have had delayed or missed diagnoses at initial presentation, potentially resulting in more severe outcomes. However, confirmatory diagnosis requires a specialized public health laboratory test and may takes weeks to finalize. Therefore, treatment should be based on clinical diagnosis and not be delayed for laboratory confirmation of botulism.

Please note that botulism treatment and laboratory testing is only available through consultation with the local health department. For further botulism testing information, see CDPH Microbial Diseases Laboratory (MDL) Adult Botulism Diagnostic Testing.

Treatment for botulism includes administering botulinum antitoxin (or BabyBIG for infant botulism) as soon as possible. Antitoxin does not reverse paralysis but arrests its progression by binding to free botulinum toxin, which prevents it from being internalized further in the neuromuscular junction. Therefore, the sooner that patient is treated, the sooner the toxin is neutralized, with likely better outcomes by halting further paralysis.