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Two unusual neurotoxigenic clostridia isolated from fecal specimens from patients with type F and type E infant botulism were phenotypically identical to the existing species Clostridium baratii and C. butyricum, respectively. DNA hybridization experiments confirmed that one strain was C. baratii and that the other was C. butyricum. These species therefore do contain neurotoxigenic strains and are possible causes of infant botulism. Infant botulism, recognized as a new disease in 1976 (6, 7), results from the absorption of neurotoxins produced by Clostridium botulinum when colonizing the intestinal tract. Since its discovery, infant botulism has become recognized as the most frequent form of botulism in the United States, with up to 100 confirmed cases per year (Centers for Disease Control, unpublished data). There have been two reports of infant botulism due to clostridia quite different from C. botulinum (1, 4). The first report described a case of type F infant botulism in New Mexico (4), and the second described two cases of type E infant botulism in Rome, Italy (1). The organisms that produced the toxins responsible for the illnesses phenotypically resembled C. baratii (3) and C. butyricum (5), respectively. The two unusual organisms were examined as an adjunct to a recent DNA relatedness study of clostridia that included neurotoxigenic and nontoxigenic organisms (J.

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This is the first nationally conducted survey targeting the full population of all local public health jurisdictions to assess the three core functions of public health: assessment, policy development, and assurance, as well as overall capabilities. Data were analyzed from 2,007 local public health jurisdictions in 47 states, the District of Columbia, and 3 U.S. territories (American Samoa, Northern Mariana Islands, and Puerto Rico) between July 2000 and April 2002, in a collaborative effort between the Centers for Disease Control and Prevention and the Department of Justice. An unweighted overall mean summary score of 65.4% (on a scale of 0% to 100%) was calculated from the responses to the 20-question survey. The mean summary scores across all 2,007 local public health jurisdictions for assessment, policy development, and assurance were 66.8%, 67.4%, and 63.0%, respectively. Also, data was analyzed by the population size of jurisdiction and the type of jurisdiction. The results provide national population baseline data for estimates of local public health jurisdiction capabilities and core functions that may be useful in identifying areas for improvement, in building a stronger U.S. public health system to better serve each community, and in educating the public about the core functions of public health to help ensure that public health agencies are accountable to those they serve.

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