Guest Contributor Doralice Goes: On botulism

October 25, 2026

Doralice Goes is an inspirational and tireless advocate working to raise awareness about foodborne botulism. Her personal experience with the disease, including the challenges of obtaining a diagnosis and the lack of preparedness for such a situation, motivated her to investigate the study of this condition and to track recent cases worldwide. She gives presentations within the food industry, sharing not only her story of survival but also critical information regarding the symptoms of botulism and the vital importance of food safety. With sensitivity and impact, she addresses how minor lapses in food handling can lead to serious health consequences, offering a unique opportunity to promote a sense of responsibility in both food production and consumption. She also speaks at universities and hospitals, demystifying the disease and highlighting the importance of early diagnosis.

eFoodAlert is pleased to share with our readers this contribution from Doralice Goes, in her own words.


Botulism is a serious, non-contagious, potentially fatal neuroparalytic disease caused by neurotoxins produced by strains of Clostridium botulinum, Clostridium baratii, and Clostridium butyricum. While commonly found in the soil, the bacteria only multiply and produce their toxin under favorable conditions.

Five forms of botulism have been recognized: infant botulism, foodborne botulism, wound botulism, iatrogenic botulism (as a result of injections with Botox), and adult intestinal toxemia. Although rare, the disease has been observed in all five contemporary forms across six continents, necessitating efficient monitoring by health authorities.

Among the five known types, foodborne botulism caused by Clostridium botulinum is the most prevalent, affecting homemade, artisanal, and industrial products alike. This spore-forming bacterium is found in soil and is far more heat resistant than more common foodborne disease organisms. It is able to multiply in food when favorable growth conditions are present: an anaerobic (oxygen-free) environment, the presence of moisture and sugar, a water activity level between 0.93 and 0.97, and a pH greater than 4.6.

An analysis of cases recorded over the last three years across six continents points to various sources. In 2023, these included canned sardines served at a restaurant, sun-dried tomatoes, and chicken pot pies. In 2024, cases were linked to artisanal pesto sauce sold at a street market, artichoke soup, homemade cactus-based products, industrially canned mackerel, canned beans, chicken mortadella, pickled eggs, almond milk, and mayonnaise. In 2025, instances involved carrot cake, garlic confit, Neapolitan-style broccoli in sandwiches, chicken pie from a bakery, and avocado pulp.

These occurrences emphasize the need to broaden our understanding of the foods associated with this disease, which extend well beyond the common perception of canned goods, cured meats, preserves, and hearts of palm. Such awareness is essential for preventing further contamination, minimizing associated risks, and executing product recalls, all of which are vital to upholding the fundamental right to healthy and safe food.

Most importantly, the disease can be prevented by adopting food safety practices, such as heating canned or preserved foods to at least 80°C for 10 minutes before consumption , as well as by paying proper attention to expiration dates and ensuring proper storage, especially in tropical countries where temperatures can easily reach 30°C or 40°C.

Botulinum toxin causes paralysis of organs and muscles and typically requires a long hospital stay, including support for breathing, urinating, and eating. Following hospital discharge, the patient must remain off work to focus on motor rehabilitation. There is only one antidote—botulinum antitoxin—which is stored in strategic locations and distributed on request by health authorities.The antitoxin is not kept on-site at individual hospitals and must be administered within seven days of the onset of intoxication. Currently, the case fatality rate is approximately 5% to 10%.

I experienced this lack of preparedness firsthand during a year spent in the ICU after contracting foodborne botulism here in Brazil. It was then that I decided to study this disease in depth, raise awareness, become a reference on the subject, and offer support to people around the world going through the same thing.

As soon as I left the hospital, I began researching botulism. It has been nearly four years of study. I am currently pursuing a master’s degree, with plans to continue into a PhD and postdoctoral research. I want to advance botulism diagnosis and treatment globally. Above all, I want to prevent this terrible disease that shatters lives.

Every week, I receive inquiries from all over the world. From people who have used Botox and are still experiencing symptoms of botulism but have not received timely diagnosis or treatment. From people who contracted foodborne botulism and endured the unimaginable with receiving any proper care—both during the acute phase and in the subsequent, long-term stages. Recently, for example, I heard from a person in Crimea.

I don’t speak English, though I am currently learning the language. Thanks to Google Translate, I can communicate with anyone, in any language. Since contracting botulism, I sometimes struggle with typing, and because the keys on my phone are so close together, I often hit the wrong one. As a result, my texts sometimes contain errors. But none of that matters when you can simply be human and help others. I truly believe I have made a difference regarding botulism.

People who had never heard of it are now paying attention. Doctors who previously failed to diagnose it now consider it when treating patients in the ICU. Academics are delving deeper into the scientific literature. And those living with the disease anywhere in the world now have someone they can turn to. I feel useful! This goes far beyond just “work.” It is my life’s purpose. Even on a Sunday, I am here, fully committed to this cause.


Doralice Goes is a Brazilian master’s student in health sciences and is dedicated to researching botulism. She is also a survivor of the disease. In 2022, she spent 314 days hospitalized in an intensive care unit (ICU), completely quadraplegic and dependent on a ventilator. Her book, BOTULISMO. Um risco invisível à vida, was published in 2024. It is now out of print.

You can connect with Doralice on Instagram at @doralice.goes and on LinkedIn at Doralicegoes.

Clostridium botulinum found in sealed cans of ByHeart infant formula

IEH Laboratories & Consulting Group, a third-party laboratory hired by ByHeart Inc. to test its powdered infant formula has recovered Clostrodium botulinum from an unspecified number of samples.

IEH tested sealed cans of ByHeart’s powdered infant formula, thus confirming that the contamination came from the product and was not as a result of consumer mishandling of the powdered formula during preparation or storage.

In a letter addressed “To families everywhere,” and posted on the company’s website, ByHeart did not reveal how many samples tested positive, or whether the positive samples represented more than one production lot.

On November 19, 2025, the CDC posted an update on its investigation into the infant botulism outbreak linked to ByHeart infant formula, announcing that 31 confirmed and suspect cases have been identified so far.

Unlike the better known form of botulism that results from ingesting of a pre-formed toxin, infant botulism occurs when a baby ingest spores of Clostridium botulinum. The spores travel through the stomach, grow and produce there toxin in the infant’s intestine.

To date, the Marler Clark law firm has filed three separate complaints against ByHeart Inc. on behalf of families whose infants were hospitalized after being fed the company’s infant formula.

Typical initial symptoms of infant botulism can include: poor feeding, loss of head control, difficulty swallowing, and decreased facial expression. If untreated, infant botulism can be deadly.

ByHeart has pledged to work with the FDA to identify the root cause of the Clostridium botulinum contamination.

Consumers need to be aware that, even though ByHeart did not distribute its products internationally, their infant formula was available for sale online. Both Canada and Trinidad and Tobago have issued warnings to consumers in those countries to avoid feeding ByHeart powdered infant formula to their infants.

According to the FDA, customer information provided by Amazon shows that a limited quantity of recalled ByHeart infant formula was distributed to Argentina, Brazil, Brunei, Canada, Chile, China, Colombia, Ecuador, Egypt, Hong Kong, Israel, Jamaica, Japan, Republic of Korea, Peru, Philippines, Romania, Singapore, South Africa, Thailand, and Virgin Islands.

  • Do not use any ByHeart Whole Nutrition infant formula. This includes formula sold in cans and single serve packets.
    • If possible, take a picture or record the lot number and best by date.
    • If you have leftover ByHeart powdered formula, label it “DO NOT USE” and keep it stored in a safe place for at least a month.
    • If your infant develops symptoms of infant botulism, your state health department may want to collect it for testing. If no symptoms appear after a month, throw the leftover formula away.
  • Wash items and surfaces that may have touched the formula using hot soapy water or a dishwasher.
  • Seek immediate medical care if your infant has consumed ByHeart Whole Nutrition Infant Formula and has any of these symptoms:
    • Poor feeding
    • Loss of head control
    • Difficulty swallowing
    • Decreased facial expression
  • Symptoms of infant botulism can take as long as several weeks to develop, so parents should remain vigilant if they used ByHeart Whole Nutrition infant formula.
  • California Department of Public Health has a public hotline to support caregivers with concerns about this outbreak and infant botulism.
    • Available Monday to Sunday, 7 a.m. to 11 p.m. Pacific Standard Time
    • 1-833-398-2022

TAINTED formats 3
“Reads like a true crime novel” – Food Safety News

Interested in learning more about food safety and the history of foodborne disease outbreaks and investigations?

Click on the link to listen to a short excerpt, then follow the buy links to add a digital, print or audio copy to your personal library.

Chapter 6. Birth of a Pathogen

Infant botulism outbreak expands to more states

November 19, 2025

The infant botulism outbreak linked to consumption of powdered infant formula has expanded to encompass 15 states, according to an update released today by the CDC.

Confirmed and suspect cases now total 31 infants. All of the victims have been hospitalized and treated with the BabyBIG® antitoxin. There have been no deaths.

Infant botulism occurs when a baby ingests spores of Clostridium botulinum and those spores germinate in the intestine and produce toxin.

Cases have been reported in Arizona (3), California (4), Idaho (1), Illinois (2), Kentucky (1), Maine (1), Michigan (1), Minnesota (2), North Carolina (2), New Jersey (1), Oregon (3), Pennsylvania (1), Rhode Island (1), Texas (6), and Washington (2).

Epidemiology and lab data appear to link the illnesses to ByHeart Whole Nutrition powdered infant formula, according to the CDC.

ByHeart Inc. has recalled all batches of ByHeart Whole Nutrition Infant Formula cans and Anywhere Pack™. The recalled products were sold online and through major retailers across the USA.

ByHeart infant formula represents  approximately 1% of all infant formula sold in the USA, according to the FDA.

  • Do not use any ByHeart Whole Nutrition infant formula. This includes formula sold in cans and single serve packets.
    • If possible, take a picture or record the lot number and best by date.
    • If you have leftover ByHeart powdered formula, label it “DO NOT USE” and keep it stored in a safe place for at least a month.
    • If your infant develops symptoms of infant botulism, your state health department may want to collect it for testing. If no symptoms appear after a month, throw the leftover formula away.
  • Wash items and surfaces that may have touched the formula using hot soapy water or a dishwasher.
  • Seek immediate medical care if your infant has consumed ByHeart Whole Nutrition Infant Formula and has any of these symptoms:
    • Poor feeding
    • Loss of head control
    • Difficulty swallowing
    • Decreased facial expression
  • Symptoms of infant botulism can take as long as several weeks to develop, so parents should remain vigilant if they used ByHeart Whole Nutrition infant formula.
  • California Department of Public Health has a public hotline to support caregivers with concerns about this outbreak and infant botulism.
    • Available Monday to Sunday, 7 a.m. to 11 p.m. Pacific Standard Time
    • 1-833-398-2022

TAINTED formats 3
“Reads like a true crime novel” – Food Safety News

Interested in learning more about food safety and the history of foodborne disease outbreaks and investigations?

Click on the link to listen to a short excerpt, then follow the buy links to add a digital, print or audio copy to your personal library.

Chapter 6. Birth of a Pathogen