Botulism Watch

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Botulism_rdax_100The  Centers for Disease Control and Prevention is investigating a botulism outbreak at the federal prison in Yazoo City after 17 inmates became ill from drinking homemade alcohol.

Last week, the inmates consumed alcohol they made in the prison.

The inmates then began showing signs of botulism and required hospitalization. They were transferred to three hospitals in the Jackson area and each received an anti-toxin, Sharlot said.

To date, 15 of the 17 inmates remain hospitalized, according to a press release issued by the Federal Bureau of Prisons. One inmate was transferred to a federal prison in Oklahoma City before he began showing signs of botulism. He was also hospitalized.

Symptoms can occur six hours to 10 days after ingestion and include double vision, blurred vision, droopy eyes, slurred speech, difficulty swallowing, dry mouth, muscle weakness and paralysis.

The  CDC is conducting the lab analysis on patient samples.

The contents of the intoxicant were not immediately clear but the incident is being investigated by the Bureau of Prisons, Sharlot said.

FCI Yazoo City, a minimum security prison housing 1,310 male inmates, is currently on limited operations as a precautionary measure. It has temporarily ceased any outgoing movement of inmates and has suspended family visitation until further notice, the release stated.

The outbreak is the sixth botulism  in the United States prison system since 2004, Sharlot said.

The Washington State Public Health Laboratory confirmed botulism was the cause of two deaths in Grant County earlier in February. The deaths were announced on Feb. 19th by the Grant County Health District (GCHD) and said they were likely caused by botulism but awaited further testing. GCHD officials said both of the cases were from the same household and had “classic” botulism symptoms.

The food source still has not been found but GCHD officials said they are working closely with the family to “properly destroy any unopened home-canned food found in the residence.” “The thorough work by medical providers and staff at GCHD in coordination with Washington State Department of Health has lead to the confirmation of botulism (botulinum) toxin in the patient’s blood samples. This in turn confirmed the clinical suspicion and the results of our environmental investigation,” GCHD Environmental Health Manager Todd Phillips said in a press release. “This tragic event is a reminder to all of us about proper food preparation and canning.”

Botulism is a serious, muscle-paralyzing disease caused by a toxin made by a bacteria found naturally in soil.

Heath officials are investigating the death of two people that was likely caused by botulism. Leaders at the Grant County Health District (GCHD) said it is still early in the investigation but the suspected source is home-canned food, though it has not been confirmed yet.

The Washington State Department of Health reported an average of 0 to two cases of food-related botulism deaths each year over the last 10 years.

The identities of the two were not released by Grant County officials.

Botulism is a serious, muscle-paralyzing disease caused by a toxin made by a bacteria found naturally in soil. There are three main types of botulism: foodborne, infant, and wound.

Historically, home-canned vegetables, fruits and meat products have been the most common cause of foodborne botulism outbreaks in the United States.

Here is a list of the top ways to make sure you stay safe in your own kitchen.

Use proper canning techniques: make sure your recipes are always current with scientifically tested guidelines. Don’t use outdated publications or cookbooks, even if they were handed down to you from trusted family cooks.

Use the right equipment for the kind of foods that you are canning: always use a pressure canner when canning low-acid vegetables, meat, fish and poultry.

When it doubt, throw it out: if the container is leaking, bulging, swollen or if the jar spurts liquid or foam when you open it, toss it.

Botulism is considered a medical emergency. If symptoms of foodborne illness arise, go to a doctor right away.

The GCHD noted the disease is not spread from person to person but symptoms appear anywhere between six hours to ten days. Here is the list of symptoms provided by the GCHD:

Double vision
Blurred vision
Drooping eyelids
Slurred speech
Difficulty swallowing
Dry mouth
Difficulty breathing or shortness of breath
Muscle weakness

Experts say to never taste home-canned food to determine if it is safe.

On April 21, 2015, the Fairfield Medical Center (FMC) and Fairfield Department of Health contacted the Ohio Department of Health (ODH) about a patient suspected of having botulism in Fairfield County, Ohio. Botulism is a severe, potentially fatal neuroparalytic illness.* A single case is a public health emergency, because it can signal an outbreak (1). Within 2 hours of health department notification, four more patients with similar clinical features arrived at FMC’s emergency department. Later that afternoon, one patient died of respiratory failure shortly after arriving at the emergency department. All affected persons had eaten at the same widely attended church potluck meal on April 19. CDC’s Strategic National Stockpile sent 50 doses of botulinum antitoxin to Ohio. FMC, the Fairfield Department of Health, ODH, and CDC rapidly responded to confirm the diagnosis, identify and treat additional patients, and determine the source.

A confirmed case of botulism was defined as clinically compatible illness in a person who ate food from the potluck meal and had 1) laboratory-confirmed botulism or 2) two or more signs of botulism or one sign and two or more symptoms† of botulism. A probable case was a compatible illness that did not meet the confirmed case definition in a person who ate food from the potluck meal.

Among 77 persons who consumed potluck food, 25 (33%) met the confirmed case definition, and four (5%) met the probable case definition. The median age of patients was 64 years (range = 9–87 years); 17 (59%) were female. Among 26 (90%) patients who reported onset dates, illness began a median of 2 days after the potluck (range = 1–6 days).

Twenty-seven of the 29 patients initially went to FMC. Twenty-two (76%) patients were transferred from FMC to six hospitals in the Columbus metropolitan area approximately 30 miles away; these transfers required substantial and rapid coordination. Twenty-five (86%) patients received botulinum antitoxin, and 11 (38%) required endotracheal intubation and mechanical ventilation; no other patients died. Within 1 week of the first patient’s arrival at the emergency department, 16 patients (55%) had been discharged. Among 19 cases that were laboratory-confirmed, serum and stool specimens were positive for botulinum neurotoxin type A or Clostridium botulinum type A.

Interviews were conducted with 75 of 77 persons who ate any of the 52 potluck foods. Consumption of any potato salad (homemade or commercial) yielded the highest association with probable or confirmed case status (risk ratio [RR] = 13.9; 95% confidence interval [CI] = 4.6–41.8), followed by homemade potato salad (RR = 9.1; CI = 3.9–21.2). Of 12 food specimens collected from the church dumpster, six were positive for botulinum neurotoxin type A; five contained potato salad and one contained macaroni and cheese that might have been contaminated after being discarded.

The attendee who prepared the potato salad with home-canned potatoes reported using a boiling water canner, which does not kill C. botulinum spores, rather than a pressure canner, which does eliminate spores (2). In addition, the potatoes were not heated after removal from the can, a step that can inactivate botulinum toxin. The combined evidence implicated potato salad prepared with improperly home-canned potatoes, a known vehicle for botulism (3).

This was the largest botulism outbreak in the United States in nearly 40 years (Table). Early recognition of the outbreak by an astute clinician and a rapid, coordinated response likely reduced illness severity and facilitated early hospital discharge. This outbreak response illustrates the benefits of coordination among responders during botulism outbreaks. Close adherence to established home-canning guidelines can prevent botulism and enable safe sharing of home-canned produce (2).

Acknowledgments

Fairfield Medical Center, Lancaster, Ohio; Fairfield Department of Health, Lancaster, Ohio; Ohio Department of Health (ODH) Bureau of Infectious Diseases, Columbus, Ohio; ODH Bureau of Public Health Laboratory, Reynoldsburg, Ohio; ODH Office of Preparedness, Columbus, Ohio; Franklin County Public Health, Columbus, Ohio; Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Strategic National Stockpile, Office of Public Health Preparedness and Response, CDC; Office of Regulatory Affairs, CDC.
1Ohio Department of Health; 2Epidemic Intelligence Service, CDC; 3Division of Foodborne, Waterborne, and Infectious Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 4Fairfield Department of Health; 5Fairfield Medical Center. Corresponding author: Carolyn L. McCarty, wmw8@cdc.gov, 614-728-6941.

References

Sobel J. Botulism. Clin Infect Dis 2005;41:1167–73.
National Center for Home Food Preservation, US Department of Agriculture. USDA complete guide to home canning, 2009 revision. Washington, DC: US Department of Agriculture; 2009. Available at http://nchfp.uga.edu/publications/publications_usda.htmlExternal Web Site Icon.
Sobel J, Tucker N, Sulka A, McLaughlin J, Maslanka S. Foodborne botulism in the United States, 1990–2000. Emerg Infect Dis 2004;10:1606–11.

Based on laboratory tests and interviews with potluck attendees, public health officials have concluded that potato salad made with home-canned potatoes is the likely cause of a foodborne botulism outbreak following a church potluck in Lancaster on April 19.

Botulism is a rare but serious paralytic illness caused by a nerve toxin that is produced by certain kinds of bacteria.

As of today, there are 21 confirmed cases of botulism associated with this outbreak, including one death. There are 10 suspected cases in which the individuals are exhibiting symptoms consistent with botulism. Patients have been treated with a botulism antitoxin provided by the Centers for Disease Control and Prevention (CDC), and 12 remain hospitalized.

“This is a difficult time for our community, and our thoughts and prayers are with the affected individuals and their families,” said Mark Aebi, M.D., Health Commissioner & Medical Director for Fairfield Department of Health. “I want to thank our staff for their dedication and hard work during this outbreak as well as the tremendous support we have received from ODH and the CDC. FMC’s rapid assessment and participation in this response has been invaluable as well.”

Mary DiOrio, M.D., Medical Director of the Ohio Department of Health, noted the local, state and federal collaboration in responding to the outbreak. The response involved public health including Fairfield Department of Health, Ohio Department of Health, and CDC, as well as central Ohio hospitals including Fairfield Medical Center.

“I want to thank my colleagues in these public health agencies and hospitals for the tremendous work that they have done to treat individuals who have been sickened, and to investigate and control the outbreak,” she said.

One person is dead, and 24 others are being treated for botulism at Fairfield Medical Center.

Health officials say all of the people who are ill attended a potluck at Cross Pointe Free Will Baptist Church Sunday.

Health officials report 50 to 60 people attended the potluck.

Botulism is a rare paralytic illness caused by a nerve toxin, and can be foodborne. The hospital says a neurologist determined a patient had botulism Tuesday morning, and a short time later, two other cases were identified. All of the patients came in to the Emergency Department at Fairfield Medical Center, but the hospital says several have been transferred to other medical facilities.

All of the people affected had symptoms that included double vision, blurred vision, difficulty swallowing, and blurred vision. Doctors are working on getting an anti-toxin from the Centers for Disease Control to treat the patients.

The Fairfield Medical Center is reminding the community that botulism is not contagious, so there is no threat to the community. But medical officials are encouraging anyone who was at the potluck to come to the emergency department. The medical center has also set up an emergency hotline to answer questions at 740-687-8053.

The New Mexico Department of Health is cooperating with the Texas Department of State Health Services and the Centers for Disease Control and Prevention (CDC) on an investigation of two patients who are hospitalized in Texas with suspected botulism. The source is currently being investigated but is likely contaminated food. The patients are two adults from Lea County.

Botulism is a rare but potentially fatal illness caused by a nerve toxin that causes paralysis. All healthcare providers should consider botulism in patients presenting with the following signs and symptoms:

Double vision
Blurred vision
Drooping eyelids
Slurred speech
Difficulty swallowing
Dry mouth
Muscle weakness/descending paralysis
Difficulty breathing/shortness of breath

If untreated, these symptoms may progress to cause paralysis of the respiratory muscles, arms, legs, and trunk with subsequent death. Physicians should consider the diagnosis if physical examination suggest botulism.

The New Mexico Department of Health recommends:

If you or someone you know experiences any of the symptoms listed above immediately seek professional medical care.

All clinicians be alert for cases of botulism and consult New Mexico Department of Health for all suspect cases.

Report any suspect case to the Department of Health 24/7/365 at: 505-827-0006 so that antitoxin can be obtained as soon as possible if indicated.

Alaska news reports a botulism outbreak in Bristol Bay communities is being closely monitored by state and local health officials. The Department of Epidemiology said Wednesday that at least 25 individuals have so far been linked to a batch of contaminated seal oil produced in the village of Twin Hills. Of the 25, several have been hospitalized, some are being monitored, and health officials are still trying to contact others.

The botulism infections were reported Friday, after two individuals were flown from the village of Quinhagak to Bethel. The two were later medevaced to Anchorage, and remain on respiratory support Wednesday, reportedly unable to breathe on their own. Three others from Quinhagak were treated for symptoms of botulism, and others in Twin Hills and Dillingham have reported symptoms or are being monitored. One child has also shown symptoms of the disease, which can be fatal, according to Dr. Michael Cooper, the Infectious Disease Program Manager at the State Department of Epidemiology.

Botulism is a paralytic illness caused by the Clostridium botulinum bacteria. In Alaska, botulism occurs almost always in fermented or preserved foods like improperly canned fish and stink heads.

Symptoms may appear as early as one day after consuming contaminated food, but could also not appear for up to ten days. Health care officials are urging those who may have eaten some of the contaminated seal oil to seek medical advice, and perhaps plan to be near a medical care facility for observation.

California Department of Public Health (CDPH) Director and State Health Officer Dr. Ron Chapman warned consumers today not to eat VR Green Farms jarred food products because they may have been improperly produced, making them susceptible to contamination with Clostridium botulinum.

Ingestion of botulism toxin from improperly processed jarred and canned foods may lead to serious illness and death. CDPH is coordinating with the US Food and Drug Administration and the Ohio Department of Health in the investigation of two cases of suspected food-borne botulism infections that may be associated with consumption of the firm’s Pine Nut Basil Pesto.  Marler Clark represents the two victims and has filed suit in California Federal Court.

VR Green Farms of San Clemente, California, is voluntarily recalling the following varieties of jarred food products: Pine Nut Basil Pesto, Pickled Farm Mix, Old World Tomato Sauce, Sundried Tomatoes in Olive Oil, Tuscan Grilling Sauce, and Pasta Sauce. These food products were sold under the VR Farms label and packaged in Mason-style glass jars with screw-on metal lids. The product labels do not include any coding or “use by” dates. Photographs can be found on Recalled Product Photos Page. The products were sold at the VR Green Farms stand in San Clemente, California and via the Internet to consumers throughout the United States.

Botulism:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Botulism outbreaks. The Botulism lawyers of Marler Clark have represented thousands of victims of Botulism and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Botulism lawyers have litigated Botulism cases stemming from outbreaks traced to carrot juice and chili.

If you or a family member became ill with Botulism after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Botulism attorneys for a free case evaluation.

Tullia’s is recalling Tullia’s Italian Meatless Pasta Sauce after tests revealed its acidity was low enough to allow the growth of the organism that causes botulism.  The sauce is labeled in blue ink with the code 530140. The batch includes 16 and 32 ounce sizes.

The sauce is sold at Rosauer’s, Yoke’s, Egger’s on West Rosewood, Trading Company Stores in Spokane, Main Market and Albertson’s at Wandermere Mall.

Botulism is potentially fatal, but the company has not been notified of any illnesses associated with the sauce. The decision to recall the product was made after a review by the Washington state Department of Agriculture.