Do the household contacts of patients exposed to botulism, who themselves were not directly exposed to the toxin, need to be administered therapy?
No. Person-to-person transmission of botulinum toxin does not occur; therefore, household contacts of individuals exposed to the toxin would not be administered therapy. The only documented modes of transmission of botulinum toxin are absorption via the gastrointestinal tract or open wounds or through inhalation. References: Arnon SS, Schechter R, Inglesby TV, et al. Botulinu m toxin as a biological weapon. Medical and public health management. JAMA 2001;285:1059-70.
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