Botulinum Neurotoxin

Testing site      

Alaska State Public Health Laboratory – Anchorage 

Anchorage Lab Request Form 

Diseases 

Botulism infection forms: 

• foodborne 
• wound 
• intestinal 
• iatrogenic 
• infant botulism 

Organisms 

• Botulinum neurotoxin-producing species of Clostridium  
• Isolated botulinum neurotoxin  

Test Method 

Culture and/or toxin assays  

Availability

Botulism testing is intended for confirmation of the presence of botulinum neurotoxin or toxin-producing Clostridia. If botulism is suspected:

1. All clients must consult with the Section of Epidemiology for approval before testing.  
2. If approved by Epidemiology, Contact ASPHL Biothreat Team before submitting samples.

  Botulinum neurotoxin is detected in the laboratory in clinical specimens or suspect food samples. Specimens from patients treated with the heptavalent botulinum antitoxin (HBAT) will be tested. 

Specimen type 

• stool 
• enema fluid 
• gastric aspirate 
• pre-antitoxin serum 
• food 
• environmental samples 

Specimen collection instructions 

Refer to ASM Sentinel Level Clinical Microbiology Guideline and contact ASPHL with questions

• Pre-antitoxin serum, 10 mL minimum: It is critical that 20 mL of blood be drawn prior to the administration of HBAT. The time the HBAT is given is required on the Anchorage Lab Request Form B. Be certain the actual time of blood draw appears on the tubes and the request form. 
• Stool, 10 g minimum: Collect stool as soon as possible. Package without transport media. Ten grams is about the size of a walnut. 
• Gastric Contents, 20 mL minimum: Collect gastric contents in sterile leak-proof container. 
• Food, 10 mL oil or 10 g of solid material minimum: Leave food in original containers if possible. Package in sterile leak-proof containers. 

All samples must be: 

• Clearly labeled 
• Placed in a leak-proof container 
• Sealed with parafilm (please use duct tape for sealing oil samples) 
• Placed in a sealable plastic bag with absorbent material 
• Placed in second sealable plastic bag with completed Anchorage Lab Request Form B 
• Shipped independently of other specimens for testing 

Storage and transport  

• Store refrigerated 
• Ship with cool packs 
• Package, label, and ship as UN3373 Biological Specimen, Category B  

With approval, ship to: Anchorage Public Health Laboratory, ATNN: Special Pathogens Unit. 

Results  

Toxin assays

• Botulinum neurotoxin detected (type specified) 
• No toxin detected 

A normal result is no toxin detected. 

Culture                    

• Clostridium botulinum isolated (toxin produced typed) 
• Clostridium botulinum not isolated 
• No growth 

A normal result is not isolated. 

Turnaround time  

• Toxin Assay: 14 days 
• Culture: 7-30 days 

Resources