According to a report by Dr. Ali Bayani, ead of the Provincial Department of Environment for the province encompassing the Miankaleh Peninsula, over 40,000 migratory birds including flamingos, ducks, and pelicans have died around the shores of the Peninsula which lies between the Caspian Sea and Gorgan Bay.  The Peninsula is approximately 30 miles long and approximately 1.5 miles wide and is a major migratory stopover and a designated sanctuary. 

Among wild waterfowl and other free-living bird species, botulism is essentially an enterotoxemia in addition to ingestion of preformed toxin from decaying plant material or cannibalism of carcasses or ingestion of maggots.

The extent of mortality both with regard to geographic area and numbers of birds involved suggests that highly pathogenic avian influenza should be considered as an alternative diagnosis or a concurrent cause of mortality.