Abstract
To the Editor: As Vasa et al. mention in the Clinical Problem-Solving case of foodborne botulism (Sept. 6 issue),1 botulinum antitoxin is most effective when given early in the course of illness.2 Antitoxin is available only from the Centers for Disease Control and Prevention (CDC) through state public health departments. Clinicians suspecting botulism should contact their state health department immediately, even if other possible diagnoses are still being evaluated. Unfortunately, in many cases ultimately confirmed as botulism, antitoxin is not requested until several days after hospitalization, by which time symptoms may have progressed to respiratory failure. Botulism should be suspected . . .
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