Really depends on your definition of “worst”, but mad cow disease is pretty darn bad. It’s actually quite rare for humans to get infected, and huge steps have been taken to eliminate cattle with the disease, but it’s pretty nasty when it does infect people. The prion that causes the disease invades the central nervous system and causes death in a few months to a year.
I think that botulism is particularly bad, especially because it can be found in seemingly harmless food products like honey, home-canned vegetables and corn syrup. It is caused by the Clostridium botulinum bacteria, found in soil and untreated water, whose spores can survive in foods that have been improperly preserved or canned. Even small amounts of the toxin can cause strong poisoning and may result in death if not swiftly treated.
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