{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T17:52:28Z","timestamp":1775152348905,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Foodborne botulism, caused by ingestion of pre-formed botulinum neurotoxin, is the most common form of botulism. While large outbreaks linked to commercial foods are rare, smaller outbreaks associated with home-processed products are more frequent, reflecting local dietary habits and traditional preservation practices. The aim of this paper is to provide a public health overview of reported foodborne botulism outbreaks in Romania over an 18-year period to raise awareness among clinicians and public health officials. Between 2007 and 2024, a total of 337 foodborne botulism cases were reported in Romania, of which 43% (147) were related to 55 outbreaks (median number of cases per outbreak: 2; IQR: 2\u20133). Most outbreaks were reported in Bihor County (11 outbreaks with 29 cases) and its neighboring county, Satu Mare (seven outbreaks, accounting for a total number of 20 cases). Outbreak-related cases were observed in younger persons with a median age of 31 years (compared to 45 years for sporadic cases) and were statistically significantly associated with consumption of pork products (p &lt; 0.001). Fifteen deaths occurred (case fatality ratio: 4%), including three outbreak-related cases (case fatality ratio: 2%). These findings highlight the ongoing public health challenge of foodborne botulism in Romania and the need for robust surveillance, targeted educational initiatives in high-incidence counties to deliver information about safe food preparation and preservation practices, and the continuous availability of botulinum antitoxin supplies.<\/jats:p>","DOI":"10.3390\/microorganisms14040819","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:51:02Z","timestamp":1775148662000},"page":"819","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology of Foodborne Botulism Outbreaks in Romania, 2007\u20132024"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0376-8088","authenticated-orcid":false,"given":"Bianca Georgiana","family":"Enciu","sequence":"first","affiliation":[{"name":"Department of Epidemiology II, Carol Davila University of Medicine and Pharmacy, 050463 Bucharest, Romania"},{"name":"National Centre for Communicable Diseases Surveillance and Control (CNSCBT), National Institute of Public Health, 050463 Bucharest, Romania"},{"name":"ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), 16973 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodica","family":"Popescu","sequence":"additional","affiliation":[{"name":"National Centre for Communicable Diseases Surveillance and Control (CNSCBT), National Institute of Public Health, 050463 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina Daniela","family":"Zaharia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology II, Carol Davila University of Medicine and Pharmacy, 050463 Bucharest, Romania"},{"name":"National Centre for Communicable Diseases Surveillance and Control (CNSCBT), National Institute of Public Health, 050463 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0126-1021","authenticated-orcid":false,"given":"Barbara","family":"Schimmer","sequence":"additional","affiliation":[{"name":"ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), 16973 Stockholm, Sweden"},{"name":"Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4118-8268","authenticated-orcid":false,"given":"Daniela","family":"Pi\u021bigoi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology I, Carol Davila University of Medicine and Pharmacy, 021105 Bucharest, Romania"},{"name":"National Institute for Infectious Disease \u201cProf. Dr. Matei Bal\u0219\u201d, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anca Mirela","family":"S\u00eerbu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology II, Carol Davila University of Medicine and Pharmacy, 050463 Bucharest, Romania"},{"name":"National Centre for Communicable Diseases Surveillance and Control (CNSCBT), National Institute of Public Health, 050463 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Pistol","sequence":"additional","affiliation":[{"name":"Department of Epidemiology II, Carol Davila University of Medicine and Pharmacy, 050463 Bucharest, Romania"},{"name":"National Centre for Communicable Diseases Surveillance and Control (CNSCBT), National Institute of Public Health, 050463 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3892\/br.2022.1524","article-title":"Foodborne botulism: A brief review of cases transmitted by cheese products (Review)","volume":"16","author":"Chaidoutis","year":"2022","journal-title":"Biomed. 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