“…The outbreaks are primarily caused by the intake of preformed BoNTs, owing to osteophagia as consequence of mineral deficiency, particularly phosphorus, and the consumption of poorly conserved food products, decaying animal carcasses, and contaminated water sources (Döbereiner et al 1992, Dutra et al 2001, Myllykoski et al 2009). Once ingested, the active toxin is absorbed in the small intestine, released into the bloodstream, and eventually reaches the peripheral cholinergic nerve endings.…”