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Mouse bioassay (MBA) is the standard test for botulinum neurotoxin detection. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) can be 10–100 times more sensitive than MBA (1), but is not yet widely available. This report describes two patients whose serum initially tested negative for botulinum neurotoxin by MBA and subsequently tested positive by MALDI-TOF MS. Los Angeles County Department of Public Health (LACDPH) routinely sends botulism test specimens to the CDC for MALDI-TOF MS while performing MBA in-house.

morbidity and mortality weekly report

<i>Notes from the Field:</i> Intestinal Colonization and Possible Iatrogenic Botulism in Mouse Bioassay–Negative Serum Specimens — Los Angeles County, California, November 2017

Notes from the Field: Intestinal Colonization and Possible Iatrogenic Botulism in Mouse Bioassay–Negative Serum Specimens — Los Angeles County, California, November 2017