Wednesday, April 22, 2015

Over 20 Cases of Botulism with one death from Food at Church Potluck

One death and 23cases of botulism are being reported after the individuals ate at a church potluck in Lancaster. Ohio.

Antitoxin has been administered to the victims, which can reduce severity of the illness. 

The food has not yet been identified.

Botulism is the disease caused when the toxin produced by Clostridium botulinum is ingested.   The toxin is produced by the organism as it grows in a food. Generally we do not see many cases of this deadly disease, but it can be a risk when certain foods are not properly prepared. 
  • Improperly processed low acid canned foods like green beans that are not properly pressure canned and then those cans are stored on the shelf..  
  • Heated foods likes soups and stews when those foods are not properly cooled or are stored at the elevated temperatures (not refrigerated).
  • Vacuum packaged cooked foods that are not stored at the right temperature.
 Clostridium botulinum is a spore-forming organism, and these spores can survive normal cooking.  If conditions are right, then the spores germinate and the organism grows in the food.  Conditions include a notorious food, warm to high temperatures, non-acidic pH, and low oxygen level.

The toxin is a neurotoxin and stops vital functions including breathing.

Columbus Dispatch
Botulism death tied to Lancaster church potluck
Wednesday April 22, 2015 9:33 AM 
One person has died and at least 20 others were hospitalized as of late last night with suspected botulism that health officials are linking to a potluck on Sunday at a Lancaster church.
Fairfield Medical Center officials said a neurologist identified the first suspected case of botulism early yesterday, and two more likely cases were identified shortly thereafter.
The medical center sent 10 patients to Columbus hospitals. Of the other 10, five were in the intensive-care unit at Fairfield Medical and five were in the emergency department last night.
Most of those sickened are middle-aged, said hospital spokeswoman Donna Stalter. She said she could not provide details about the person who died.
Botulism, which causes paralysis, is caused by a nerve toxin produced by bacteria and is treated with an anti-toxin medication and supportive care.
Botulism is rare and sometimes linked to contaminated food. It is not passed from person to person.
About 50 or 60 people attended the potluck at the Cross Pointe Free Will Baptist Church, 657 E. Main St., Lancaster, hospital officials said.
The hospital is urging those who were at the potluck to seek medical attention immediately. An emergency hotline also is open for questions: 740-687-8053.
The hospital and the Fairfield Department of Health were awaiting official lab confirmation last night that the hospitalized people have botulism, Stalter said.
Approximately 145 people contract botulism in the United States each year, and 15 percent of the cases are food-borne, according to the Centers for Disease Control and Prevention. Two other types — infant botulism and wound botulism — represent most of the cases.
Outbreaks of food-borne botulism happen most every year and usually are linked to home-canned food, particularly low-acid foods such as green beans, asparagus, beets and corn, according to the CDC.
The agency points out that other, seemingly unlikely sources are found regularly as a result of improper food handling by manufacturers or by restaurants or home cooks. Some examples include chopped garlic in oil, canned cheese sauce, chili peppers, tomatoes, carrot juice and baked potatoes wrapped in foil.
Botulinum toxin is destroyed by high temperatures, so those who eat home-canned foods should consider boiling them for 10 minutes before eating, the CDC recommends.
Determining the precise source of any food-borne illness can take time. This case could be complicated because the people who were sickened potentially ate many of the same foods at the same event.
Botulism can cause double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth and muscle weakness. Infants who are sickened can appear lethargic, don’t eat well, have constipation and have a weak cry and poor muscle tone.
Symptoms usually start within 18 to 36 hours after a person consumes contaminated food, but they can show up as long as 10 days later.
The CDC has provided the anti-toxin to care for those sickened in the outbreak and — along with the Ohio Department of Health — is assisting the local hospital and health department.
Health officials quickly identified the church potluck as a common source because participants were in touch with one another and learned that several of them were ill, Fairfield Department of Health spokeswoman Jennifer Valentine said.
Potluck participants with severe illness could have a long and difficult road ahead. Respiratory failure sometimes requires patients to remain on breathing machines for weeks or months after a severe infection. Paralysis slowly improves with intensive medical care, according to the CDC.
The percentage of patients who die from botulism has fallen from about half to as little as 3 percent in the past 50 years.
Those who survive an episode of botulism poisoning might be fatigued and short of breath for years and might need long-term therapy, according to the CDC.
Update: Wednesday April 22, 2015 12:40 PM
The person who died at a church potluck on Sunday in Lancaster has been identified as a 54-year-old woman, a spokeswoman for Fairfield Medical Center said at a noon press conference.
Everyone at the potluck has been personally contacted by health officials. In addition to the 23 people being treated for symptoms, others are under observation.
The botulism anti-toxin was requested at 10 a.m. yesterday, immediately after the illness was identified, said Dr. Andrew Murry, an infectious-diseases doctor at the Lancaster hospital. It arrived about midnight.
"We feel like it came and was administered in an appropriate time frame," Murry said.
If administered within four days of infection, the anti-toxin can reduce the symptoms and length of the illness, he said.
Giving it to the dead woman sooner would not have saved her because she was so critically ill, he said.
"These people are really ill, and any time you're on a ventilator for that amount of time, things could go badly," he said.
Dr. Mark Aebi, commissioner of the Fairfield County health district, said officials have taken the trash container from the church and are examining items in homes to determine the source of the contamination.

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