{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T08:36:27Z","timestamp":1792485387112,"version":"4.5.0"},"reference-count":62,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T00:00:00Z","timestamp":1671494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Background: Botulism is a low incidence but potentially fatal infectious disease caused by neurotoxins produced mainly by Clostridium botulinum. There are different routes of acquisition, food-borne and infant\/intestinal being the most frequent presentation, and antitoxin is the treatment of choice in all cases. In Spain, botulism is under surveillance, and case reporting is mandatory. Methods: This retrospective study attempts to provide a more complete picture of the epidemiology of botulism in Spain from 1997 to 2019 and an assessment of the treatment, including the relationship between a delay in antitoxin administration and the length of hospitalization using the Cox proportional hazards test and Kruskal\u2013Wallis test, and an approach to the frequency of adverse events, issues for which no previous national data have been published. Results: Eight of the 44 outbreaks were associated with contaminated commercial foods involving \u22647 cases\/outbreak; preserved vegetables were the main source of infection, followed by fish products; early antitoxin administration significantly reduces the hospital stay, and adverse reactions to the antitoxin affect around 3% of treated cases.<\/jats:p>","DOI":"10.3390\/toxins15010002","type":"journal-article","created":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T05:08:54Z","timestamp":1671512934000},"page":"2","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Botulism in Spain: Epidemiology and Outcomes of Antitoxin Treatment, 1997\u20132019"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5909-7957","authenticated-orcid":false,"given":"Marina","family":"Pe\u00f1uelas","sequence":"first","affiliation":[{"name":"Escuela Internacional de Doctorado, Universidad Nacional de Educaci\u00f3n a Distancia (UNED), Calle de Bravo Murillo, 38, 28015 Madrid, Spain"},{"name":"Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C\/Monforte de Lemos 5, Pabell\u00f3n 12, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0575-789X","authenticated-orcid":false,"given":"Mar\u00eda","family":"Guerrero-Vadillo","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C\/Monforte de Lemos 5, Pabell\u00f3n 12, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3931-2162","authenticated-orcid":false,"given":"Sylvia","family":"Valdezate","sequence":"additional","affiliation":[{"name":"Laboratorio de Referencia e Investigaci\u00f3n en Taxonom\u00eda, Bacteriolog\u00eda, Centro Nacional de Microbiolog\u00eda, Instituto de Salud Carlos III, Carretera Pozuelo-Majadahonda Km 2.2, 28220 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Zamora","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda Alimentaria, Centro Nacional de Alimentaci\u00f3n, Agencia Espa\u00f1ola de Seguridad Alimentaria y Nutrici\u00f3n, Ctra. Pozuelo a Majadahonda Km 5.1, 28220 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inmaculada","family":"Leon-Gomez","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C\/Monforte de Lemos 5, Pabell\u00f3n 12, 28029 Madrid, Spain"},{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngeles","family":"Flores-Cu\u00e9llar","sequence":"additional","affiliation":[{"name":"Medicines for Human Use Department, Agencia Espa\u00f1ola de Medicamentos y Productos Sanitarios (AEMPS), C\/Campezo 1, Edificio 8, 28022 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0215-6503","authenticated-orcid":false,"given":"Gema","family":"Carrasco","sequence":"additional","affiliation":[{"name":"Laboratorio de Referencia e Investigaci\u00f3n en Taxonom\u00eda, Bacteriolog\u00eda, Centro Nacional de Microbiolog\u00eda, Instituto de Salud Carlos III, Carretera Pozuelo-Majadahonda Km 2.2, 28220 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliva","family":"D\u00edaz-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C\/Monforte de Lemos 5, Pabell\u00f3n 12, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Varela","sequence":"additional","affiliation":[{"name":"Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C\/Monforte de Lemos 5, Pabell\u00f3n 12, 28029 Madrid, Spain"},{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e12647","DOI":"10.1111\/cmi.12647","article-title":"Hsp90 is involved in the entry of clostridial neurotoxins into the cytosol of nerve terminals: Hsp90 chaperones the L chain refolding of CNTs","volume":"19","author":"Pirazzini","year":"2017","journal-title":"Cell. 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