Botulism

  • Posted: December 8th, 2011 - 8:58pm by Doug Powell

    It’s botulism week at Eurosurveillance as the on-line journal summarizes three different and recent Europe-based botulism outbreaks, which represents an alarming increase over previous years.

    In an overview editorial, Cowden notes the incidence of botulism in the European Union (EU) is described elsewhere, but that from 2006 and 2008, 477 confirmed cases were notified: an average of 119 cases per year, with a range of 104 to 132, and no discernable trend.

    The surveillance of cases of botulism in the EU includes the three main forms of the disease but does not distinguish between them.

    Food-borne botulism is caused by the ingestion of toxin produced by organisms in an anaerobic environment. It usually results from inadequately sterilised domestically canned or bottled foods.

    Intestinal botulism is caused by the production in the gut of toxin by organisms which have been ingested and have proliferated. This form predominantly affects infants under a year old, often associated with the consumption of honey.

    Wound botulism is caused by the production of toxin by organisms introduced into wounds. This is often associated with dirty wounds, including those following injecting drug use.

    Since 2009, Eurosurveillance has published only four reports of outbreaks of food-borne botulism in Europe and only three resulted from consumption of widely distributed, commercially produced foods.

    Despite only one of the four outbreaks being due to domestically prepared food, home-preserved food is generally acknowledged to be the major cause of botulism in those EU countries that have had most cases in recent years and outbreaks resulting from mass produced foods are rare.

    Against this background, from September to November 2011, there were three outbreaks in three different countries in Europe. In the outbreaks which feature in this issue of Eurosurveillance, the vehicles of intoxication were demonstrated, on the basis of strong toxicological and descriptive epidemiological evidence, to have been widely distributed, commercially produced foods.

    These three outbreaks present intriguing differences and similarities.

    In two outbreaks, the Finnish and the Scottish, cases were confined to single households. In France cases occurred in two household clusters.

    In the French and Finnish outbreaks the vehicles included olives: olive tapenades in the French outbreak, and almond-stuffed olives in the Finnish. In the Scottish outbreak, the vehicle was korma sauce.

    In all three outbreaks the vehicle of intoxication was marketed in glass jars with screw-top lids.

    In the French and the Scottish outbreaks the food was produced and distributed within the country of origin. In the Finnish outbreak, the food was distributed internationally from another country, Italy.

    In the Finnish and the Scottish outbreaks the food was produced in industrialized units. In the French outbreak the producer was described as an “artisanal producer” although the tapenade was commercially produced and widely distributed.

    In the French and the Scottish outbreaks the toxin was type A. In the Finnish outbreak it was type B.

    In two outbreaks, the Finnish and the French, defects potentially explaining the contamination were identified. In the Finnish outbreak, seals in other jars from the same batch were found to have defects, although none was found to be contaminated. In the French outbreak an improper sterilization process was identified. In the Scottish outbreak the food originated from a state-of-the-art food-production facility where intensive investigation has yet to find any shortcomings, and no post-production event has been identified which could explain the contamination.

    The number of cases in all three outbreaks was surprisingly low if a production fault is assumed to have affected the production of at least a whole batch of jars.

    This is particularly true of the Scottish outbreak where only one household was affected, and which could be explained by the contamination of a single jar from a batch of 1,836 jars. Likewise, the Finnish outbreak affected a single household, and could be explained by only one contaminated jar of stuffed olives, despite the batch being part of a lot of 900 imported into Finland, and the product having been exported to many countries in Europe and beyond.

    Only in the French outbreak does the contamination of more than one jar need to be hypothesized to explain the cases – and even here, contamination of only two jars could explain the cases. The size of the batch in the French outbreak was approximately 60 pots.

    The other 3 outbreak write-ups are available at the urls below, and full-text, as always, on bites-l.

    http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20035

    http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20034

    http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20036

     

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  • Posted: December 4th, 2011 - 1:52pm by Ben Chapman

    Author: 
    Ben Chapman

    Canning wasn't always my thing. Before arriving at N.C State, I didn't know a whole lot about it (other than the results). I like food, nerdy trends and science and have since embraced the world of home preservation. I even have a t-shirt to prove it (Pump up the Jam, right, exactly as shown).

    I've made pickles, jams, green beans, tomatoes, tomato sauces and a bunch of other stuff over the past couple of years. I'm not a seasoned veteran yet, but I'm trying. I figure that it's important to know a bit about what folks might be calling me about and where they might go wrong.  The philosophy I follow when it comes to providing food safety information is to share risks and provide risk-reduction strategies -- I don't answer whether something is safe or not, and I don't tell folks what they should do. I talk a lot about consequences, evidence and options.

    One of the best risk-based resources out there to provide evidence and options is the National Center for Home Food Preservation run by my friend Elizabeth Andress at the University of Georgia. Elizabeth and her team provide the science for every best practice they produce - and are happy to share data or say where data doesn't exist. Good communication comes from this open sharing of work.

    With home food preservation of low acid foods (like veggies and meats), the consequences of not following evidence-based practices are catastrophic. It's not just a bit of diarrhea or vomit; paralysis, leading to long-term heath problems and death are the norm, not the exception.

    Earlier this year a couple of folks were paralyzed after eating improperly stored commercial soups (that hadn't been acidified to reduce the outgrowth of botilinum toxin and required refrigeration). In the December issue of Journal of Food Protection, three outbreaks of foodborne botulism linked to home canned vegetables are detailed -- including the foods, the practices and correct risk-reduction strategies.

    Stuff like this is invaluable for food safety communication and extension-types.

    Three outbreaks of foodborne botulism caused by unsafe home canning of vegetables—Ohio and Washington, 2008 and 2009
    03.dec.11
    Journal of Food Protection®, Volume 74, Number 12, December 2011 , pp. 2090-2096(7)
    Date, Kashmira; Fagan, Ryan; Crossland, Sandra; MacEachern, Dorothy; Pyper, Brian; Bokanyi, Rick; Houze, Yolanda; Andress, Elizabeth; Tauxe, Robert
    Abstract:
    Foodborne botulism is a potentially fatal paralytic illness caused by ingestion of neurotoxin produced by the spore-forming bacterium Clostridium botulinum. Historically, home-canned vegetables have been the most common cause of botulism outbreaks in the United States. During 2008 and 2009, the Centers for Disease Control and Prevention (CDC) and state and local health departments in Ohio and Washington State investigated three outbreaks caused by unsafe home canning of vegetables. We analyzed CDC surveillance data for background on food vehicles that caused botulism outbreaks from 1999 to 2008. For the three outbreaks described, patients and their family members were interviewed and foods were collected. Laboratory testing of clinical and food samples was done at the respective state public health laboratories. From 1999 to 2008, 116 outbreaks of foodborne botulism were reported. Of the 48 outbreaks caused by home-prepared foods from the contiguous United States, 38% (18) were from home-canned vegetables. Three outbreaks of Type A botulism occurred in Ohio and Washington in September 2008, January 2009, and June 2009. Home-canned vegetables (green beans, green bean and carrot blend, and asparagus) served at family meals were confirmed as the source of each outbreak. In each instance, home canners did not follow canning instructions, did not use pressure cookers (canners? -ben), ignored signs of food spoilage, and were unaware of the risk of botulism from consuming improperly preserved vegetables. Home-canned vegetables remain a leading cause of foodborne botulism. These outbreaks illustrate critical areas of concern in current home canning and food preparation knowledge and practices. Similar gaps were identified in a 2005 national survey of U.S. adults. Botulism prevention efforts should include targeted educational outreach to home canners.

     

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  • Posted: November 17th, 2011 - 3:24pm by Doug Powell

    BBC News reports a third child in central Scotland has been admitted to hospital with suspected botulism.

    NHS Forth Valley said the child was a sibling of the other two being treated for the illness, which has been linked to Loyd Grossman branded korma sauce.

    The child is being treated at the Royal Hospital for Sick Children in Glasgow and is said to be stable.

    At present, health officials believe only one jar of the sauce was contaminated.

    The two siblings who were admitted to hospital last week are "stable and improving", NHS Forth Valley said in a statement.

    TV presenter Loyd Grossman was said to be "devastated" after the botulism poisoning cases came to light. The sauce was made by Premier Foods at its factory in Bury St Edmunds, Suffolk.

    The Food Standards Agency has warned people not to consume jars of Loyd Grossman korma sauce in 350g jars with a best-before date of February 2013. The batch code is: 1218R.

    Investigations carried out to date at the factory and on other jars from this and other batches, have not revealed any contamination.

     

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  • Posted: November 13th, 2011 - 3:44pm by Doug Powell

    Preliminary tests carried out by the U.K. Health Protection Agency (HPA) have identified the toxin that causes botulism from a used jar of Loyd Grossman Korma sauce. The Food Standards Agency (FSA) is advising consumers who have purchased the particular batch of the product to dispose of it and not consume. A full recall of this product batch has been issued and the sauce is being removed from shop shelves.

    This follows two cases of botulism in one family in Scotland where the contaminated jar of sauce was discovered. No further cases have been identified to date. There is no evidence to suggest that the samples taken from the jar for testing could have been separately contaminated from another source. Further tests on this and from another unused jar of the korma sauce taken from the home of the patients are underway.

    The affected batch is: 350g jars of Loyd Grossman Korma sauce with a best before date of February 2013. The sauce has a batch code of: 1218R 07:21

    Health professionals across the UK have been made aware of the suspected cases and advised to look out for people of all ages with possible symptoms.

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  • Posted: November 8th, 2011 - 3:21am by Doug Powell

    National Public Radio in the U.S. – or as Colbert calls their programming, state-sponsored jazz – ran a story entitled, Organic isn't always safer when it comes to botulism.

    When is organic ever safer? It’s a production standard.

    The story about Organic Italian olives is a timely reminder that if Clostridium botulinim, the bacteria that causes botulism, makes it as far as a jar packed with oil and not much oxygen, it can flourish.

    "It's the perfect environment for botulinum to grow," says Eric Johnson, a professor of microbiology at the University of Wisconsin-Madison.

    Johnson said the case reminded him of an outbreak in the 1980s, which was caused by chopped garlic packed in oil. "Garlic is from the soil, so it has spores of botulinum in it.” The oil floats on top of the jar and seals out air, leaving water to collect at the bottom, where it acts like a Petri dish for botulism.

    After the outbreak in chopped garlic, the FDA told garlic processors add phosphoric acid. The higher acid level thwarts bacterial growth. Another strategy used by big commercial processors is a "bot cook," which involves cooking foods at high temperatures under pressure to wipe out spores.

     

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  • Posted: October 28th, 2011 - 11:03pm by Doug Powell

    An elderly woman has died as a result of botulism poisoning, produced by the bacterium Clostridium botulinum, after eating some Italian olives that contained the toxin.

    According to the Helsinki and Uusimaa Hospital District, she succumbed to the illness on Thursday.

    Another adult member of the same family remains in hospital.

    Prior to their illness, both had eaten from a jar of stuffed organic olives, which was subsequently discovered to contain the toxin, as reported by THL, the National Institute for Health and Welfare.

    The olives in question were manufactured and packaged in Italy, and the jar contains the Finnish wording "Gaudiano Bio oliivi mantelitäytteellä" (Gaudiano Organic Olives Stuffed with Almonds).

    The best-before dates on the product are 08/2012 or 09/2012 and the batch numbers H2510X or L1810X.

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  • Posted: October 25th, 2011 - 9:02pm by Doug Powell

    A batch of olives produced in Italy has been withdrawn from sale in the UK after two people in Helsinki, Finland, were diagnosed with botulism.

    Both people reported having eaten Gaudiano Organic Olives Stuffed with Almonds. Lab tests confirmed that the jar from which they had eaten the olives contained botulinum toxin. The tainted olives were in 314ml glass jars with a 'best before' date of 09/2012.

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  • Posted: October 6th, 2011 - 1:45am by Doug Powell

    The Salt Lake Valley Health Department confirmed Wednesday it is investigating an illness — suspected to be foodborne botulism — in 12 inmates of the Utah State Prison.

    The Salt Lake Tribune reports eight inmates, three of whom are in critical condition, are receiving treatment at a local hospital, and four are under medical observation at the prison.

    All the affected inmates consumed home-made alcohol brewed inside a cell at the prison, according to a health department news release.

    The inmates affected likely came in contact with the bacteria by drinking brew, alcohol made in a cell, apparently in a plastic bag. Inmates often use fruit, water and sugar to craft the brew, which they often hide in the cell’s toilet, and when those foods are in an anaerobic environment they can create a breeding ground for the bacteria.

    According to confiscation reports obtained earlier this year by The Tribune, brew is made fairly frequently, with 44 confiscations of the substance occurring between October 2009 and December 2010. However, the prison has not ever had a case of botulism, according to Nicholas Rupp, public information officer for the health department.

    But "there’s always a health risk any time there is inappropriate food handling," Rupp added.

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  • Posted: September 6th, 2011 - 10:27pm by Doug Powell

    tapenade-olives-vertes.jpg

    Those stricken with botulism in France has climbed to eight as investigators determined the company that produced the suspect tapenade was never registered and had never undergone inspection.

    In Avignon, five people who had shared a family meal on Thursday evening were admitted over the weekend to intensive care, where they are still on life support. "Two are close to sixty and three octogenarians," said the prefecture.

    At Amiens (Somme), three young women, two sisters, aged 23 to 29, were placed for "at least three weeks" and a respirator under general anesthesia. The first symptoms manifested themselves in the aftermath of Sunday dinner.

    Cans of green olive tapenade with almonds produced by the establishment "hive" of Cavaillon (Vaucluse) and sold under the brand " The delights of Marie Claire" have been fingered in the outbreak.

    "The material used is unsuitable for sterilization was done with a washing machine type," said the secretary general of the prefecture, Martine Clavel.

    The factory, installed in 2000, had never been subject to control. The owners did not make any inspection themselves and they had not asked for technical assistance.

    According to the information provided, the suspect consignment contains about 60 jars of tapenade sold in grocery stores in the Bouches-du-Rhône, Drôme, Var and Vaucluse.

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  • Posted: September 4th, 2011 - 5:09pm by Doug Powell

     French friend Albert Amgar passes along the unfortunate story of five people in Avignon who were hospitalized this weekend including two in serious condition after being stricken with botulism toxin during a family dinner.

    "The evolution of clinical signs may suggest that this is a botulinum toxin infection," the prefecture said in a statement. Although several of the suspected foods were prepared at home, two products that were part of the meals of these people are the subject of analysis, including a green almond tapenade (180 g pot-lot No. 112005) and a sun-dried tomato spread (jar of 180g - Lot No. 112607) for optimal use by date 16/12/12. "Pending the results and as a precaution it is advisable to suspend use of the products from these two lots," according to the prefecture.

    "In 2009 , 13 outbreaks of botulism totaling 29 patients were identified. All occurred in the home and the number of patients per household varies from one to six."

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