Food Safety Talk 79: You’re Into Botulism Country (with Merlin Mann)

Posted on August 7, 2015 by Ben Chapman

Food Safety Talk, a bi-weekly podcast for food safety nerds, by food safety nerds. The podcast is hosted by Ben Chapman and barfblog contributor Don Schaffner, Extension Specialist in Food Science and Professor at Rutgers University. Every two weeks or so, Ben and Don get together virtually and talk for about an hour. They talk about what’s on their minds or in the news regarding food safety, and popular culture. They strive to be relevant, funny and informative — sometimes they succeed. You can download the audio recordings right from the website, or subscribe using iTunes.

Merlin Mann joins Don and Ben for a discussion on food safety and cooking using science at home.

The episode starts off with a discussion on sous vide and time/temperature combinations for pathogen reduction.

The discussion goes to Harold McGee’s On Food and Cooking and the science of cooking, sensory and how heat changes food quality and safety. The guys talk about ground meats risks compared to intact muscle meats and then deconstruct risk assessments with bullet analogies. The guys move into pork and trichinosis and how risks have changed but messages stay sticky.

The show ends with a discussion on food safety myths, including confusing food safety and spoilage; storing butter on the counter and ketchup in the refrigerator.

They decided to leave an in-depth discussion of Sloan for another day.

Largest botulism outbreak in 40 years in US: Botulism at church potluck in Ohio, 2015

Posted on July 30, 2015 by Douglas Powell

The U.S. Centers for Disease Control reports that 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.

*Botulinum neurotoxin and botulinum neurotoxin–containing species of Clostridium are subject to the select agent regulations (42 CFR Part 73).

†Symptoms of botulism include blurred vision, diplopia (double vision), dizziness, slurred speech, thick-feeling tongue, change in sound of voice, hoarseness, dry mouth, and dysphagia (difficulty swallowing). Signs of botulism include extraocular palsy (paralysis of eye muscles), ptosis, sluggishly reactive pupils, facial paralysis, palatal weakness, impaired gag reflex, musculoskeletal weakness or paralysis, and objective evidence of declining respiratory function.

Botulism in canned tomatoes in Russia

Posted on July 27, 2015 by Douglas Powell

Botulinum toxin F was found in industrially canned tomatoes linked to a case of botulism. It was registered in the republic of Mariy El, the branch of Rospotrebnadzor reported (Federal agency for protection of consumer rights and human wellbeing).

The man had eaten tomatoes “Pomidorka” produced by LLC “Agro-Invest” (Kabardino-Balkaria) series 055N 5 N from 17/09/14. The staff of the Rospotrebnadzor have withdrawn this product from the store “Pyaterochka.”

Rotten meat paste linked to botulism cases in Algiers

Posted on July 5, 2015 by Ben Chapman

Botulism is no joke. Whether it’s from home-canned potatoes, pruno, fermented seal flipper, or meat paste.

There might be something lost in translation but according to Ennahar Online, at least two people have died and another eight are ill from bot toxin-containing meat paste.

A second person died, Friday, July 3, following a cardiopulmonary problem in Batna. This is the second death of botulism after the death of a child Thursday in Khenchla.

This is a sexagenarian hospitalized on June 23 in the University Hospital of the province along with 8 other patients suspected of having contracted the disease, according to the APS agency quoting the director of the abovementioned health facility.

The consumption of rotten meat paste (cachir) would be the cause of this serious disease, pending “the result of bacteriological analysis by the Pasteur Institute of Algiers.” Quantities of nearly a ton of cachir and 339 kg of chicken paste were withdrawn from sale in the provinces of Batna and Khenchela

Seven suspected cases of botulism in Algeria

Posted on June 26, 2015 by Douglas Powell

Seven people, four adults residing in Batna and three children, were evacuated from the wilaya of Khenchela, with symptoms of botulism are under medical supervision at the resuscitation department of the university hospital center (CHU) of Batna.

Some of these patients have consumed cachir and other rotten pie, whose origin has been identified and whose samples were sent to a lab for analysis.

Botulism seen and heard: seal flipper, symptoms and bamboo

Posted on May 13, 2015 by Ben Chapman

Adding to my neurosis around botulism there are multiple stories about the devastating foodborne illness this week. I’ve never had fermented seal flippers but the traditional method of making the northern delicacy usually includes burying the appendages. It used to be directly in the ground but plastic containers are generally used now.

And when the fermentation is done incorrectly the outcomes can be dangerous.

According to KDLG, three Alaskans are ill with suspected botulism after eating seal flipper.

Three people have contracted botulism after eating separate batches of fermented seal flipper in Koyuk.

Alaska’s Division of Public Health says the first case presented signs of the illness on Friday, with two more becoming sick by Monday afternoon. All three have been transported to Anchorage for emergency medical treatment, and officials say an investigation to “identify and monitor” others who may be at risk is currently underway.

Last August a botulism outbreak in Lower Kalskag killed one person and sickened two others. Just before Christmas, an outbreak attributed to a batch of seal oil from Twin Hills hospitalized several people in Quinhagak, Twin Hills, and Dillingham.

In related news via ABC6 while Ohio medical officials were prepared for crisis, managing the tragic Cross Pointe Free Will Baptist Church botulism outbreak was emotional.

One of the doctors who was on the front lines during the outbreak was Dr. Jared Bruce. “It was pretty stressful, I mean as a hospital, you prepare and drill for times like that, but when it actually happens that is when everybody comes together.”

Bruce said family members were dealing with grief and anger, but they were always supportive. “I can’t count the number of times somebody came up to me that day during all of that and said we are praying for you, and these are family members who are by their loved one who is sick.”

And there’s some commercially preserved bamboo shoots that have been recalled in Thailand – for botulism concerns.

Home-canned carrots linked to North Carolina botulism case

Posted on May 12, 2015 by Ben Chapman

A couple of weeks ago I ran into a barfblog reader who commented to me, ‘You’re really scared of botulism, aren’t you?’ This wasn’t a random question, it was related to a few things I had posted following over 20 illnesses linked to a potluck dinner at Cross Pointe Free Will Baptist Church in Lancaster, Ohio.

Scared isn’t how I would describe it. Rattled and in awe of are probably better terms. The toxin blocks motor nerve terminals at the myoneural junction, causing paralysis. It starts with the mouth, eyes, face and moves down through the body. It often results in paralysis of the chest muscles and diaphragm, making a ventilator necessary. Months of recovery follow an intoxication.

Maybe I am scared.

There isn’t a whole lot of botulism in the U.S. every year, and not all of it is foodborne – (infant botulism is more common); over the past two decades, improperly home preserved foods are the main source.

Any case is notable.

Earlier this year there was a botulism illness in Ashe County, North Carolina that was

The case was first reported during a panel at the NC Food Safety and Defense Task Force annual meeting. Rose Hoban of North Carolina Health News captured the highlights.
It only took one bite.

Five days later, an Ashe County woman lay in the hospital, on a ventilator, unable to breathe.

Home canning food has a technical aspect to it that’s dangerous to ignore, said Ben Chapman from N.C. State University.

The woman, who’s name has not been released, told health officials she didn’t even swallow the carrot. She opened the home-canned jar of carrots, tasted one, decided it looked and tasted off, and spit it out.

But that was enough to give her botulism, sending her to the hospital for an 11-week stay.

She was lucky there was an off flavor, said Ben Chapman, a food-safety expert from N.C. State University.

“The toxin itself doesn’t have the sensory attributes that we associate with spoilage,” Chapman said this week at a presentation about the case during a meeting of the Governor’s Task Force on Food Safety and Defense that was held at the N.C. Biotechnology Center in Research Triangle Park.

Chapman said the procedure the woman had used to treat the carrots may have left some other bacteria behind that created the off taste. But her canning technique was not correct, which also left behind botulism spores in her carrots.

She was fortunate to have ingested a small enough amount that her hospital stay was relatively short compared to what happens in many botulism cases, Chapman said.

And he offered the story as a cautionary tale as we head into the main growing season when many people pull out pots and jars to preserve the fruits of the season.

It took several days for a possible diagnosis of botulism poisoning to show up in the woman’s medical record, said Nicole Lee, an epidemiologist from the state Department of Health and Human Services. The woman’s daughters and a friend told doctors that she canned her own food. Before she was intubated, the woman said she suspected the carrots.

But doctors also needed to rule out a stroke or other neurological problems. It took more than a week for doctors to tell state health officials that they suspected botulism.

“That immediately got our attention,” said Lee. “We had gotten wind that this person was canning her own food. We weren’t sure if these items were being sold in commerce or across state lines.”

“I was on my way to Morganton and I got a call to divert,” recounted Susan Parrish, a food regulatory supervisor for the state Department of Agriculture and Consumer Services.

Parrish, who monitors food outbreaks around the state, was given the carrots by one of the woman’s friends.

“They were in a quart jar,” said Parrish, who put on a biohazard suit to handle it. “Obviously, she had only tasted a bite, because the jar was full.”

A sample of the carrots was shipped to the Food and Drug Administration.

The results came back from the FDA “barely positive,” said the FDA’s Mancia Walker. “But with [botulism], barely positive is like a little bit pregnant.”

“This was a tragic mistake that can happen to anyone not using proper canning procedures,” he said, explaining that the woman had not pressure canned the carrots, which would have created temperatures high enough to kill botulism spores.

“There are very passionate people who are maybe not doing canning with science-based recommendations,” said Chapman, who has studied how people preserve food.

He said that when he’s asked canners where they learned to can, they tell him the knowledge has been passed down rather than learned in a home economics class or a workshop that’s strong on the science.

“We’ve seen in other cases where [a] family link perpetuates error,” said Chapman, who said there are plenty of books, classes and online instructions from agricultural extension services.

Ensure that ‘the bread we break is safe to share’

Posted on May 7, 2015 by Ben Chapman

Lisa Abraham of the Columbus Dispatch writes in a column about the tragic potluck dinner at Cross Pointe Free Will Baptist Church that social aspects and community building of potluck dinners are important – but safety should rise above fellowship.

People often ask me why I prefer to write about food.

My answer is always the same: Food unites us.

It is our common denominator; we all need nourishment.

They were “breaking bread together,” church pastor Bill Pitts recently told The Dispatch.
Many of us have taken part in similar events.

The end-of-the-year potluck is the highlight of the gatherings of my church book club. I look forward to trying the different dishes that club members bring, and we convince one another that it’s rude not to sample every dessert (wouldn’t want to offend the person who made it).

I have a few friends who are squeamish about eating at potlucks; they worry about the conditions under which the food was prepared.

I understand their concerns, and the Lancaster case certainly gives them credence.
Instead of making us more wary of others’ food, though, I hope that the incident makes us more cautious when preparing food.

I thought about the jars of home-canned jelly, relish and other foods that friends have shared with me through the years. As long as the seal was tight, I didn’t ask about the canning method used.

Let’s learn a lesson from Lancaster — by ensuring that the bread we break is safe to share.

Food safety should not be faith-based (but often is)

Posted on April 28, 2015 by Douglas Powell

As hundreds pray for the revival of Blue Bell ice cream in Texas, Cross Pointe, Ohio, Free Will Baptist Church Pastor Bill Pitts spoke of the mundane moments in life during his April 19 sermon.

Little did he know that life would soon become anything but mundane as a botulism outbreak was set to strike and kill one church member and sicken others after a potluck lunch.

“There’s always one defining moment in our lifetime,” Pitts said. “And that defining moment will determine the rest of our future and how we handle the rest of our future, if we’re going to trust God or we don’t during that time. So it seems like it was almost a preparation for what was going to happen 15 minutes later.”

The Ohio Department of Health said Monday that home-canned potatoes in a potato salad are the likely cause of the botulism outbreak that led to Kennetha “Kim” Shaw’s death. There are 20 other confirmed cases and 10 suspected cases.

Pitts said there are still church members who are in critical but stable condition, while others are improving and going home.

Pitts said he never imagined something like botulism breaking out in Lancaster or the church, and he said it was unprecedented.

“We have to understand that, since things have happened, I personally believe, according to Scripture, that death came because of sin. So instead of me really questioning God, getting mad at God, I need to get mad at the sin that’s in the world and make the world better, rather than what sin has done to it.”

Death and illness came because of botulism, because someone didn’t know what they were doing, and had nothing to do with sin.

Believe fairytales if you like.

Canned potatoes used in potato salad likely culprit in botulism outbreak

Posted on April 27, 2015 by Ben Chapman

Home canning is not something to mess around with. Low acid foods need to be processed using a pressure canner to inactivate Clostridium botulinum spores – boiling water baths (like what is used for pickles and jams) won’t do it.

According to the Columbus Dispatch, home-canned potatoes used in potato salad are the likely vehicle that caused over 20 illnesses and a death last week in Ohio.

State health officials say this afternoon that potato salad made with home-canned potatoes is the likely source of a deadly botulism outbreak at a Lancaster church potluck.

Last week, the Ohio Department of Health said tests showed that six food samples taken from the April 19th potluck had tested positive for botulism.

Sietske de Fijter, chief of the Bureau of Infectious Diseases for the state, said health officials were able to narrow the likely food culprits by interviewing nearly everyone who became ill – as well as those who didn’t – at the potluck.

Case-control study is the next step to confirm.

barfblog

safe food from farm to fork

Tag Archives: Botulism