About Botulism

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About Botulism Blog

Bread recalled over Botulism risk

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King’s Hawaiian is voluntarily recalling its Pretzel Slider Buns, Pretzel Hamburger Buns and Pretzel Bites products out of an abundance of caution following a recall of an ingredient used in the pretzel products from one of its suppliers, Lyons Magnus. Lyons Magnus is recalling this ingredient due to the potential for it to cause microbial contamination including from the organisms Cronobacter sakazakii and Clostridium botulinum. While no illnesses associated with King’s Hawaiian pretzel bread have been reported, and no pathogens have been found in any King’s Hawaiian products to date, the recall is being conducted to ensure consumer safety.

This recall does not impact any other King’s Hawaiian products, as no other products use this ingredient from Lyons Magnus. King’s Hawaiian will resume producing all pretzel products once the company has ensured all current product has been disposed of and has confirmed the safety of all ingredients.

Consumers in possession of any King’s Hawaiian Pretzel Slider Buns, King’s Hawaiian Pretzel Hamburger Buns or King’s Hawaiian Pretzel Bites should dispose of the product. Consumers can contact King’s Hawaiian at 877-695-4227, Monday through Friday from 8:30 a.m. to 5:00 p.m. PT, if they have any questions, or to request replacement product.

King’s Hawaiian advises that consumers in possession of any King’s Hawaiian Pretzel Slider Buns, King’s Hawaiian Pretzel Hamburger Buns or King’s Hawaiian Pretzel Bites should dispose of the product.

Washington man dies of botulism from home-canned food

This past weekend, a Grays Harbor County man aged 55-65 passed away from a probable cause of botulism. No further information on the deceased is available. Confirmation of the cause of death is pending confirmatory test results.

Grays Harbor County Environmental Health assisted the property owner with the safe disposal of around 170 pint-sized jars of home-canned food and canning jars per CDC guidelines.

Botulism is odorless and cannot be seen or tasted; however, even a small taste of food containing the toxin can be deadly, according to the CDC.

The CDC stresses that home canning, while a fun and productive way to preserve everything from seafood to vegetables, can put people at risk of botulism if not done correctly.

Using proper canning techniques, the right kind of equipment, and disposing of any canned foods that may not have been properly preserved is the best way to keep your home canned goods safe.

Two excellent resources for safe canning practices include the CDC – https://www.cdc.gov/foodsafety/communication/home-canning-and-botulism.html – and Washington State University Extension Grays Harbor – https://extension.wsu.edu/graysharbor/family/food/.

If you’re new to canning or need a refresher, the USDA has a great resource, the Complete Guide to Home Canning, available for free download at https://nchfp.uga.edu/publications/usda/GUIDE01_HomeCan_rev0715.pdf.

Beans Recalled over Botulism risk

Faribault Foods, Inc. is voluntarily recalling 15 ounce cans of S&W Organic Black Beans, 15 ounce cans of O Organic Brand Black Beans and 15 ounce cans of O Organic Brand Chili Beans because the cans may have a compromised hermetic seal.  The compromised hermetic seal may affect can integrity and may cause the cans to leak, bloat or allow bacteria to grow inside the product which could lead to serious illness.  Clostridium botulinum poisoning in humans can begin from six hours to two weeks after eating food that contains the toxin. Symptoms may include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, and muscle weakness. Botulism poisoning can cause paralysis of the breathing muscles, which can result in death unless assistance with breathing (mechanical ventilation) is provided.

The recalled products were distributed nationwide in retail stores.

This event only affects the lot codes listed below:  The lot codes are printed on the bottom of the can.

Product

Lot Number

Distribution Dates

S&W Organic Black Beans, 15 oz. Best By JAN 31 2023  1329A 032 21 February 2021-April 2021
S& W Organic Black Beans, 15 oz. Best By FEB 01 2023 1329A 033 21 February 2021-April 2021
S&W Organic Black Beans, 15 oz. Best By FEB 02 2023 1329A 034 21 February 2021-April 2021
S&W Organic Black Beans, 15 oz. Best By FEB 03 2023 1329A 035 21 February 2021-April 2021
O Organic Organic Black Beans, 15 oz. Best By FEB 03 2023 981A 035 21 February 2021-April 2021
O Organic Organic Chili Beans, 15 oz. Best By FEB 04 2023 978A 036 21 February 2021-April 2021

No other production codes, sizes or brands of Faribault Foods, Inc. products are affected by this recall.

Consumers who may have purchased the products listed above should return them to the store where purchased for a refund or replacement.

The recall was initiated after the firm had received consumer and customer complaints regarding failure of the hermetic seal.  The problem related to the hermetic seal failure was corrected and no other product is affected.

What to know about Botulism

Botulism is a life-threatening paralytic illness caused by neurotoxins produced by an anaerobic, gram-positive, spore-forming bacterium—Clostridium botulinum. 

Foodborne botulism is the type that is typically associated with classic botulism symptoms; it is caused by eating foods or ingesting substances that contain botulinum toxin. In foodborne botulism, it is the pre-formed toxin that causes illness, not the bacterium itself. The incidence of foodborne botulism is extremely low, usually fewer than 25 cases per year in the United States. Nonetheless, the extreme risk to public health posed by the toxin requires  that “intensive surveillance is maintained for botulism cases in the United States, and every case is treated as a public health emergency.” Botulism poisoning carries a mortality rate of up to 65% when victims are not treated immediately and properly. Medical treatment is supportive (including mechanical ventilation if required), and an antitoxin may be given to bind free toxin and reverse or delay the progression of symptoms, when used early in the course of illness. Most foodborne botulism reported annually in the United States is associated with home-canned foods that have not been safely processed. Occasionally, though, commercially processed foods are implicated in botulism poisoning, including sausages, beef stew, canned vegetables, and seafood products.

Cheese recalled over Botulism risk

Primula Ltd. has recalled cheese spread in tubes in the United Kingdom and Ireland because of possible contamination with Clostridium botulinum due to a production fault.

Primula, part of the Kavli Group, recalled 10 varieties after finding one product contained Clostridium botulinum during a routine test and due to concerns other items in the range could be affected.

Manufacturing controls that could potentially affect safety of the products could not be demonstrated satisfactorily by the company, according to the Food Standards Agency (FSA).

The Food Safety Authority of Ireland (FSAI) reported the issue relates to controlling factors to prevent the growth and toxin production by Clostridium botulinum. There’s currently been no reports of illness.

All 150-gram chilled Primula plain original cheese spread, cheese spread with smoked paprika, cheese spread with jalapeno, light cheese spread, cheese spread with ham, cheese spread with chive and cheese spread with prawn with best before dates from Dec. 25, 2020, to Jan. 28, 2021, are affected.

The ambient 100-gram versions of Primula original cheese spread, cheese spread with ham and cheese spread with chives with best before dates Oct. 30, to Dec 10, 2020, are also involved.

Botulism in Alaska linked to home canned Salmon

TEXAS HEALTH ALERT: Infant Botulism and Risk of Honey

Honey can contain spores of Clostridium botulinum, an organism that produces a potent neurotoxin known to cause severe illness in infants. Infant botulism occurs when C. botulinum spores in food, dust, or other materials are inhaled or ingested and germinate in the gut of infants who have not yet developed mature intestinal flora. For this reason, parents are advised not to feed honey (raw or otherwise) to children younger than 12 months old.

Infant botulism: Symptoms of botulism in infants under 12 months of age typically start with constipation and may include poor feeding and/or weak sucking, weakness, drooping eyelids, loss of head control and difficulty breathing. Severity can range from mild illness with gradual onset to paralysis, respiratory failure, and death. Prompt recognition of a suspect case, administration of antitoxin, and initiation of supportive care can halt progression of the disease.

The Texas Department of State Health Services will coordinate confirmatory testing at the DSHS laboratory. To obtain the antitoxin (Baby BIG) for treatment, physicians can contact the DSHS Emerging and Acute Infectious Disease Branch or the California Infant Botulism Treatment and Prevention Program.

Recent trends: Cases are rare; between 2013 and 2017, Texas has averaged 7 to 8 cases of infant botulism annually. However, since August, four patients have been treated for infant botulism and have a history of using a honey pacifier purchased in Mexico.

Investigators noted that these honey pacifiers and other food-containing pacifiers are available for sale at retailers as well as online, and that parents may not be aware of their potential danger.

Recommendations: Infants (children less than 12 months of age) should not be given honey, or pacifiers containing honey or other food products, because of the risk of contracting infant botulism. Consumption of honey is widely recognized as a risk factor for infant botulism by healthcare and public health professionals.

Infant botulism is a serious illness that requires urgent medical attention. All suspect cases should be immediately reported to public health officials.

Botulism Risk in LA Heroin

Los Angeles County officials have detective three new cases of suspected botulism associated with the use of black tar heroin.

Three more cases were discovered in June, the Los Angeles County Department of Public Health said in a prepared statement.

Six cases in one summer is unusual, DPH Health Officer Dr. Muntu Davis said.

“We normally see two to three cases of botulism among heroin users per year, so this is a significant increase,” he said. “We are asking community providers and partners, particularly those serving people that use heroin such as substance use providers, to inform patients and colleagues about the increased risk.”

There are no visible signs that heroin is tainted , health officials said. Heating, or “cooking,” the drugs won’t kill the bacteria.

While the illness cannot be transmitted from person to person, sharing contaminated needles can spread it, according to the health department warning. The risk is greatest when the drug is injected.

Officials warn that botulism is a serious and potentially deadly condition.

Symptoms include drooping eyelids, blurred vision or double vision, difficulty speaking or swallowing and shortness of breath. They may occur within days or weeks of injecting the contaminated heroin, and can be mistaken for a drug overdose.

Health officials are being reminded to consider the possibility of botulism when treating heroin-using patients showing neurological symptoms.

Davis urged anyone trying to kick a heroin addiction to contact the DPH’s Substance Abuse Service Helpline at 844-804-7500.

What You and Your Family Need to Know About Botulism

BOTULISM—A Rare, But Deadly Disease

Botulism is a rare, life-threatening paralytic illness caused by neurotoxins produced by an anaerobic, gram-positive, spore-forming bacterium, Clostridium botulinum.[1]  Unlike Clostridium perfringens, which requires the ingestion of large numbers of viable cells to cause symptoms, the symptoms of botulism are caused by the ingestion of highly toxic, soluble exotoxins produced by C. botulinum while growing in foods.[2]  These rod-shaped bacteria grow best under anaerobic (or, low oxygen), low-salt, and low-acid conditions.[3]  Bacterial growth is inhibited by refrigeration below 4° C., heating above 121° C, and high water-activity or acidity.[4]  And although the toxin is destroyed by heating to 85° C. for at least five minutes, the spores formed by the bacteria are not inactivated unless the food is heated under high pressure to 121° C. for at least twenty minutes.[5] C. botulinum bacteria and spores are widely distributed in nature, because they are indigenous to soils and waters.[6] They occur in both cultivated and forest soils, bottom sediment of streams, lakes, and coastal waters, in the intestinal tracts of fish and mammals, and in the gills and viscera of crabs and other shellfish.[7]

The incidence of foodborne botulism is extremely low.[8]  Nonetheless, the extreme danger posed by the bacteria has required that “intensive surveillance is maintained for botulism cases in the United States, and every case is treated as a public health emergency.”[9] This danger includes a mortality rate of up to 65% when victims are not treated immediately and properly.[10] Most of the botulism events[11] that are reported annually in the United States are associated with home-canned foods that have not been safely processed.[12]  Occasionally, though, commercially-processed foods are implicated as the source of a botulism events, including sausages, beef stew, canned vegetables, and seafood products.[13]

Symptoms of Botulism

After their ingestion, botulinum neurotoxins are absorbed primarily in the duodenum and jejunum, pass into the bloodstream, and travel to synapses in the nervous system.[14] There, the neurotoxins cause flaccid paralysis by preventing the release of acetylcholine, a neurotransmitter, at neuromuscular junctions, thereby preventing motor-fiber stimulation.[15] The flaccid paralysis progresses symmetrically downward, usually beginning with the eyes and face before moving to the throat, chest, and extremities.[16] When the diaphragm and chest muscles become fully involved, respiration is inhibited and, unless the patient is ventilated, death from asphyxia results.[17]

Classic symptoms of botulism include nausea, vomiting, fatigue, dizziness, double vision, drooping eyelids, slurred speech, difficulty swallowing, dryness of skin, mouth, and throat, lack of fever, muscle weakness, and paralysis.[18]  Infants with botulism appear lethargic, feed poorly, are constipated, and have a weak cry and poor muscle tone.[19] Throughout all such symptoms, the victims are fully alert and the results of sensory examination are normal.[20]

In foodborne botulism cases, symptoms usually begin anywhere between 12 and 72 hours after the ingestion of toxin-containing food.[21]  Longer incubation periods—up to 10 days—are not unknown, however.  The duration of the illness is from 1 to 10 (or more) days, depending on host-resistance, the amount of toxin ingested, and other factors.[22]  Full recovery often takes from weeks to months.[23] And, as earlier indicated, mortality rate can be from 30% to 65%, with rates generally lower in European countries than in the United States.[24]

Detection and Treatment  of Botulism

Although botulism can be diagnosed based on clinical symptoms, its differentiation from other diseases is often difficult—especially in the absence of other known persons affected by the condition.[25] Once suspected, the most direct and effective way to confirm the diagnosis of botulism in the laboratory is testing for the presence of the botulinum toxin in the serum, stool, or gastric secretions of the patient.[26]  The food consumed by the patient can also be tested for the presence of toxins.[27]  Currently, the most sensitive and widely used method for the detection of the toxins is the mouse neutralization test, which involves injecting serum into mice and looking for signs of botulism.[28]  This test typically takes 48 hours, while the direct culturing of specimens takes 5-7 days.[29] Some cases of botulism may go undiagnosed because symptoms are transient or mild, or are misdiagnosed as Guillain-Barre Syndrome.[30]

If diagnosed early, foodborne botulism can be treated with an antitoxin that blocks the action of toxin circulating in the blood.[31] This can prevent patients from worsening, but recovery still takes many weeks.[32] The mainstay of therapy is supportive treatment in intensive care, and mechanical ventilation in case of respiratory failure, which is common.[33]

Long-Term and Permanent Injury

Although a minority of botulism patients eventually recover their pre-infection health, the majority do not. For those who fully recover, the greatest improvement in muscle strength occurs in the first three months after the acute phase of illness.[34]  The outside limit for such improvement appears, however, to be one year.[35]  Consequently, physical limitations that still exist beyond the one-year mark are more probably than not permanent.  Recovery from acute botulism symptoms may also be followed by persistent psychological dysfunction that may require intervention.[36]

According to a recently-published study that tracked the long-term outcomes of 217 cases of botulism, a large majority of patients reported “significant health, functional, and psychosocial limitations that are likely the consequences of the illness.”[37]  These limitations included: fatigue, weakness, dizziness, dry mouth, and difficulty lifting things.  The victims also reported difficulty breathing caused by moderate exertions, such as walking or lifting heavy items.  They were also more likely to have limitations in vigorous activities, like running or playing sports, climbing up three flights of stairs, or carrying groceries. Summarizing its finding, the study concluded that:

Even several years after acute illness, patients who had botulism were more likely than control subjects to experience fatigue, generalized weakness, dizziness, dry mouth, difficulty lifting things, and difficulty breathing caused by moderate exertion….In addition, patients…reported worse overall psycho-social status than did control subjects, with patients being significantly less likely to report feeling happy, calm and peaceful, or full of pep.[38]

There is, as a result, no question that the damaging effects of botulism are life-long.

[1]           See J. Sobel, et al., Foodborne Botulism in the United States, 1990-2000, Emerging Infectious Diseases, Vol. 10, No. 9, at 1606 (Sept. 2004).

[2]           James M. Jay, MODERN FOOD MICROBIOLOGY, 466 (6th Ed. 2000)

[3]           Id. at 469-71; see also Sobel, supra note 2, at 1606.

[4]           Sobel, supra note 2, at 1606.

[5]           Id.

[6]           Jay, supra note 3, at 467-69.  See also, generally H. Houschild, Clostridium Botulinum, in FOODBORNE BACTERIAL PATHOGENS, at 112-89  (M. Doyle Ed. 1989)

[7]           Jay, supra note 3, at 467-69.

[8]           Sobel, supra note 2, at 1607-09; Jay, supra note 3, at 472-76.

[9]           Sobel, supra note 2, at 1606-07 (also noting that the CDC maintains a 24-hour clinical consultation and emergency antitoxin release service).

[10]          Jay, supra note 3, at 474.

[11]          With botulism, the broader term “event” is used to encompass both outbreaks—i.e., two or more cases of botulism caused by a common-source, as well as individual (or sporadic) cases.

[12]          Sobel, supra note 2, at 1610; Jay, supra note 3, at 474.

[13]          Id.

[14]          Thomas P. Bleck, Clostridium botulinum (Botulism), in MANDELL, DOUGLAS AND BENNETT’S PRINCIPLES AND PRACTICE OF INFECTIOUS DISEASE 2543, 2544 (5th ed. 2000).

[15]          Id.; Sobel, supra note 2, at 1606.

[16]          Bleck, supra note 15, at 2545; see also BOTULISM FACT SHEET, National Agricultural Bio-Security Center, Kansas State University, online at http://nabc.ksu.edu/content/factsheets/category/Botulism#f26

[17]          Bleck, supra note 15, at 2545; Sobel, supra note 2, at 1606.

[18]          Sobel, supra note 2, at 1606; Jay, supra note 3, at 474.

[19]          Jay, supra note 3, at 476-77.

[20]          Sobel, supra note 2, at 1606.

[21]          Jay, supra note 3, at 474.

[22]          Id.

[23]          R. Shapiro, et al., Botulism in the United States: A Clinical and Epidemiologic Review, Ann. Intern. Med. 1998; 129:221-28.

[24]          Jay, supra note 3, at 474.

[25]          Bleck, supra note 15, at 2546 (noting that “botulism has a limited differential diagnosis”).

[26]          Sobel, supra note 2, at 1607; see also FDA/CFSAN Bad Bug Book, Clostridium Botulinum, available at http://vm.cfsan.fda.gov/~mow/chap2.html

[27]          Id.

[28]          Bleck, supra note 15, at 2546.  See also, e.g. MMWWR, supra note 1, at 2 (“CDC detected botulinum toxin Type A by mouse bioassay in the man’s serum sample”).

[29]          Bad Bug Book, supra note at 25.

[30]          Sobel, supra note 2, at 1606; Shapiro, supra note 23, at 223.

[31]          Jay, supra note 3, at 474; Sobel, supra note 2, at 1606.

[32]          Id.; Bleck, supra note 15, at 2546-67.

[33]          Sobel, supra note 2, at 1606.

[34]          Bleck, supra note 15, at 2547. See also P. Wilcox, et al., Recovery of Ventilatory and Upper Airway Muscles and Exercise Performance After Type-A Botulism, Chest, 98:620-26 (1990); J. Mann, et al., Patient Recovery From Type-A Botulism: Morbidity Assessment Following a Large Outbreak, Am. J. Public Health, 71 (3):266-69 (Mar. 1981).

[35]          Id.

[36]          Bleck, supra note 15, at 2547. See also F. Cohen, et al., Physical and Psychosocial Health Status 3 Years After Catastrophic Illness—Botulism, Issues Mental Health Nurs., 9:387098 (1988)

[37]          S. Gottlieb, et al., Long-Term Outcomes of 217 Botulism Cases in the Republic of Georgia, Clin. Infectious Disease, 45: 174-80, at 180 (220&).

[38]          Id. at 179.

Honey and Babies Do Not Mix - Botulism

34380zdyq33t7dg-300x225The Tokyo Metropolitan Government has announced that a 6-month-old Adachi Ward boy died of infant botulism after his family gave him honey.

According to the metro government, it is the first death caused by infant botulism reported in Japan since 1986, when statistics started being kept.

The government warned that babies younger than 1 should not be given honey, after announcing on Friday that the boy died on March 30. Government officials said the boy had been having coughs since Feb. 16, and was taken to a hospital by ambulance on Feb. 20 after developing convulsions and suffering respiratory failure. He was diagnosed as having infant botulism on Feb. 28.

They said that the boy’s family had been giving him honey by mixing it into juice twice a day for about a month, and that the family told them they were not aware babies should not be given honey.

The bacteria Clostridium botulinum was found from an unsealed honey container kept at the boy’s house and in the boy’s stool, and a public health center confirmed that the boy’s death was caused by botulism poisoning.

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