Abstract
Botulism is a rare paralytic illness resulting from a potent neurotoxin produced by Clostridium botulinum. Botulism in Canada is predominately due to C botulinum type E and affects mainly the First Nations and Inuit populations. The most recent outbreak of botulism in Ontario was in Ottawa in 1991 and was caused by C botulinum type A. We report an outbreak of foodborne type B botulism in Ontario, which implicated home-canned tomatoes. The outbreak was characterized by mild symptoms in two cases and moderately severe illness in one case. The investigation shows the importance of considering the diagnosis of botulism in patients presenting with cranial nerve and autonomic dysfunction, especially when combined with gastrointestinal complaints; it also highlights the importance of proper home canning technique.
Highlights
We report an outbreak of foodborne type B botulism in Ontario, which implicated home-canned tomatoes
Epidemiological findings Eight people were at risk of exposure to the botulinum toxincontaining food: an Italian family consisting of the father, the mother, three daughters, a son-in-law, a boyfriend and a priest visiting from Italy
Tomatoes were purchased from a farm in southwestern Ontario, boiled for 1 h, placed in glass jars without added salt or acidifying agent
Summary
Clinical and epidemiological investigation Hypothesis-generating interviews and food histories were carried out with the three patients and all available persons present at the three meals. Each step in the preparation and storage of foods was reviewed. All persons present at the meals except one were questioned regarding symptomology and examined for signs consistent with botulism. Laboratory investigation Stool and serum samples were obtained from those interviewed and were assayed for botulinum toxin. Stool specimens were cultured for C botulinum as described elsewhere [18].
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