Botulism is a paralytic disease caused by neurotoxins elaborated by Clostridium botulinum, an anaerobic spore-forming bacterium. The neurotoxin inhibits the release of the neurotransmitter acetylcholine. C. botulinum is found in soil and marine environments worldwide. C. botulinum toxin types A, B, E, and rarely F cause human disease. Most U.S. food-borne cases are associated with home-canned food, especially vegetables, fruits, and condiments. Type E is associated with fish products. Disease occurs when (1) spores contaminate food; (2) the food is subsequently preserved in a manner that kills other bacteria but not the spores and provides anaerobic conditions at a pH and temperature permissive for germination and toxin production; and (3) the food is ingested before being heated to a temperature adequate for toxin destruction. Toxin is heat-labile (inactivated when heated for 10 min at 100°C), and spores are heat-resistant (inactivated at 116°-121°C or with steam sterilizers or pressure cookers).