The bacteria Clostridium botulinum produces a toxin (botulinum neurotoxin) that causes the neuroparalytic disease known as botulism. Botulinum neurotoxin (BoNT)—the agent of botulinum—is the most poisonous substance known. It has been cited as 100,000 to 3 million times more potent than the nerve gas sarin, which is considered one of the most dangerous chemical weapons and was the predominant chemical weapon used in World War II. The Centers for Disease Control and Prevention (CDC) categorize BoNT as a Category A bioweapon threat because of its tremendous potency and lethality, relative ease of production and transport, and the need for prolonged intensive care among infected individuals.
Botulism was first discovered in 1793 by Justinius Kerner, a German physician. This case was of foodborne botulism, and Kerner cited a substance, endemic to spoiled sausage, that would later be discovered and termed botulinum neurotoxin. At that time, sausage was crudely produced and preserved by filling a pig's stomach with meat and blood, boiling it in water, and storing it at room temperature for days. These processes allowed spores of C. botulinum to survive and infect individuals with foodborne botulism. In 1897, Emile von Ermengem isolated C. botulinum from a foodborne outbreak in Ellezelles, Belgium. Von Ermengem is credited with identifying C. botulinum as the cause of botulism.3
Botulism got its name from those first discovered cases that implicated spoiled sausage as the causative agent of the disease. The term is derived from the Latin word botulus, which means “sausage.” The derivation was particularly