Table 1. Number and proportion of foodborne botulism outbreaks, illnesses, deaths, serotype, and setting by PLAD, China, 2004–2020.
| PLADs |
No. of outbreaks
(%) |
No. of illnesses
(%) |
No. of deaths
(%) |
Annual
average |
No. of misdiagnoses* |
Case-fatality
rate † ( %) |
Serotype § | Setting¶ |
Adjusted
χ 2 ** |
p | ||
| Type A | Type B | Household | ||||||||||
| Abbreviation: PLAD=provincial-level administrative division. * Misdiagnosis: Patients with botulism can be misdiagnosed as having other illnesses such as Guillain-Barré Syndrome, common cold, malnutrition and myasthenia gravis. † Case-fatality rate = number of deaths / number of illnesses. § Serotype: the remaining includes 26 serotypes not identified and 3 type E, 2 type AB, 2 types Mangan and 1F. ¶ Setting: the remaining 2 outbreaks occurred in unit canteens, 1 outbreak occurred in school canteens, supermarkets, stores and large restaurants respectively; 2 outbreaks not identified. ** The Adjusted chi-square test (χ2) of case-fatality rate between Xinjiang and Qinghai was performed and the result was: Adjusted χ2=2.22, P>0.05. †† 20 cases of botulism in Xinjiang include 3 in Xinjiang Production and Construction Corps. | ||||||||||||
| Xinjiang†† | 20(25.00) | 53(13.63) | 4(7.27) | 4 | 3 | 8.00 | 11 | 4 | 18 | 0.64 | 0.14 | |
| Qinghai | 13(16.25) | 101(26.17) | 18(32.73) | 13 | 4 | 17.82 | 0 | 0 | 13 | |||
| Hebei | 9(11.25) | 23(5.96) | 0(0.00) | 8 | 2 | 0.00 | 1 | 3 | 9 | |||
| Gansu | 5(6.25) | 17(4.40) | 9(16.36) | 3 | 2 | 52.94 | 0 | 0 | 4 | |||
| Guizhou | 4(5.00) | 14(3.63) | 4(7.27) | 4 | 0 | 28.57 | 1 | 2 | 4 | |||
| Henan | 3(3.75) | 15(3.89) | 0(0.00) | 5 | 1 | 0.00 | 1 | 2 | 3 | |||
| Guangdong | 3(3.75) | 6(1.55) | 0(0.00) | 2 | 1 | 0.00 | 1 | 1 | 2 | |||
| Shaanxi | 3(3.75) | 10(2.59) | 1(1.82) | 3 | 2 | 10.00 | 5 | 2 | 3 | |||
| Tibet | 2(2.50) | 42(10.88) | 3(5.45) | 21 | 0 | 7.14 | 1 | 0 | 2 | |||
| Jiangxi | 2(2.50) | 8(2.07) | 0(0.00) | 4 | 1 | 0.00 | 0 | 0 | 2 | |||
| Shanxi | 2(2.50) | 5(1.30) | 0(0.00) | 3 | 0 | 0.00 | 0 | 0 | 2 | |||
| Anhui | 2(2.50) | 17(4.40) | 6(1.25) | 9 | 0 | 35.29 | 1 | 0 | 2 | |||
| Sichuan | 2(2.50) | 19(4.92) | 9(16.36) | 10 | 0 | 47.37 | 1 | 1 | 2 | |||
| Yunnan | 2(2.50) | 27(6.99) | 1(1.82) | 14 | 1 | 3.70 | 0 | 0 | 1 | |||
| Hunan | 1(1.25) | 2(0.52) | 0(0.00) | 2 | 1 | 0.00 | 1 | 1 | 0 | |||
| Jiangsu | 1(1.25) | 1(0.26) | 0(0.00) | 1 | 1 | 0.00 | 1 | 0 | 1 | |||
| Guangxi | 1(1.25) | 2(0.52) | 0(0.00) | 2 | 1 | 0.00 | 1 | 1 | 1 | |||
| Shandong | 1(1.25) | 4(1.04) | 0(0.00) | 4 | 1 | 0.00 | 1 | 1 | 1 | |||
| Ningxia | 1(1.25) | 11(2.85) | 0(0.00) | 11 | 1 | 0.00 | 0 | 0 | 1 | |||
| Jilin | 1(1.25) | 3(0.78) | 0(0.00) | 3 | 0 | 0.00 | 0 | 0 | 1 | |||
| Beijing | 1(1.25) | 2(0.52) | 0(0.00) | 2 | 0 | 0.00 | 1 | 0 | 0 | |||
| Inner Mongolia | 1(1.25) | 4(1.04) | 0(0.00) | 4 | 0 | 0.00 | 0 | 1 | 0 | |||
| Total | 80(100.00) | 386(100.00) | 55(100.00) | 5 | 22 | 14.25 | 28 | 18 | 72 | |||