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MMWR Says Botulism Was Responsible For One of 11 Outbreak Deaths In 2006

We are very fortunate that while botulism is deadly it is also rare.

Today’s issue of Morbidity & Mortality Weekly Report (MMWR) published by the Centers for Disease Control & Prevention (CDC) carries an article that dissects all the food-borne disease outbreaks that occurred in 2006.

In “Surveillance for Foodborne Disease Outbreaks — United States, 2006;” CDC looks at all 1,270 Food-borne Disease Outbreak (FBDOs) that were reported during that year, resulting in 27,634 confirmed illnesses and 11 deaths.

Only one of the 11 deaths was from Clostridium botulinum or botulism. That fatality was attributed to the C. botulinum toxin being transmitted by carrot juice.

Writing on his personal blog last December, Seattle food safety attorney Bill Marler told us what happened:

"For those that do not recall, in September 2006, three people living in Georgia developed food-borne botulism that was eventually traced to commercial carrot juice from a single bottle. Soon thereafter an additional case in Florida and two in Ontario, Canada surfaced. One of the 6 botulism patients died 90 days after illness onset. One year later, two others were still on ventilators. The remaining three were taken off ventilator support after 54, 90, and 129 days. Two survivors were at home, two were in rehabilitation facilities, and one was still hospitalized. All the patients had consumed carrot juice from the same manufacturer.

"Now, here is the interesting part, according to Dr. Anandi N. Sheth at the Centers for Disease Control in Atlanta, Georgia and colleagues, an investigation eventually determined that inadequate refrigeration probably led to botulinum toxin production. As the investigators pointed out, the pasteurized carrot juice had no protection against the bacterium Clostridium botulinum other than refrigeration. "This investigation demonstrates that carrot juice and other processed foods with no natural barriers to C. botulinum germination require additional chemical or thermal barriers," the investigators wrote in the medical journal Clinical Infectious Diseases. Accordingly, they report, "In June 2007, the FDA modified its guidance for refrigerated low-acid juices to recommend adding a validated juice-treatment method, such as acidification or appropriate thermal treatment, to decrease the risk of C. botulinum contamination, should any breaches in refrigeration occur."

Its comforting to know FDA may have addressed the problem and implemented the fix for the 2006 carrot juice outbreak.  However, it also shows that botulism from food products remains a concern.