The first victim reported persistent dizziness, blurry vision, a drooping eyelid, and difficulty swallowing. She was admitted and received mechanical ventilation within 6 hours of arrival because of impending respiratory failure; botulism was suspected because of progressive descending paralysis, a primary clinical characteristic of botulism.
"Among 31 persons who attended one or both gatherings, 10 patients sought evaluation at one of two hospitals in Fresno County (five patients at each hospital) during June 23–June 27, with illness onsets ranging from June 23 to June 27, and an interval of 1–5 days from symptom onset until evaluation (Figure 1). Eight of the 10 patients (patients A–F, H, and I) received a clinical diagnosis of botulism; the most common clinical findings included diplopia (eight patients), hoarseness (seven), dizziness (six) and difficulty swallowing (six) (Table). All patients were Hispanic or Latino, the median age was 44 years (range = 24–59 years), and five were women."
Epidemiologic investigation identified home-preserved prickly pear cactus pads (nopales) included in a homemade salad and served at both events as a food item of interest; laboratory testing confirmed the nopales salad as the source of BoNT/A."
"Patient D reported that she had prepared the nopales salad using fresh onions, fresh tomatoes, and home-preserved nopales stored in glass jars. She had prepared the empty jars by immersing them in boiling water, and then added chopped, uncooked nopales mixed with a small amount of salt. She closed the jars with new metal lids and stored them for 6 weeks in an outdoor shed behind her home. The nopales salad she had prepared was not shared outside of these gatherings. She had been home preserving foods for years using this technique, which was taught to her by friends and relatives, and said she was unaware of the risk for botulism associated with this practice."
"Foods that are not properly processed, fermented, preserved, stored, or refrigerated can facilitate C. botulinum growth and toxin production, particularly if the food is in a low-acid, unrefrigerated, and anaerobic environment (7). Home canning or fermentation of vegetables are common practices used to preserve various foods by persons from diverse backgrounds and are the most common causes of foodborne botulism in the continental United States (8–10)."
https://www.cdc.gov/mmwr/volumes/74/wr/mm7424a1.htm
Foodborne Botulism Outbreak After Consumption of Home-Canned Cactus (Nopales) — Fresno County, California, June 2024
"Patient D reported that she had prepared the nopales salad using fresh onions, fresh tomatoes, and home-preserved nopales stored in glass jars. She had prepared the empty jars by immersing them in boiling water, and then added chopped, uncooked nopales mixed with a small amount of salt. She closed the jars with new metal lids and stored them for 6 weeks in an outdoor shed behind her home. The nopales salad she had prepared was not shared outside of these gatherings. She had been home preserving foods for years using this technique, which was taught to her by friends and relatives, and said she was unaware of the risk for botulism associated with this practice."
"Foods that are not properly processed, fermented, preserved, stored, or refrigerated can facilitate C. botulinum growth and toxin production, particularly if the food is in a low-acid, unrefrigerated, and anaerobic environment (7). Home canning or fermentation of vegetables are common practices used to preserve various foods by persons from diverse backgrounds and are the most common causes of foodborne botulism in the continental United States (8–10)."
https://www.cdc.gov/mmwr/volumes/74/wr/mm7424a1.htm
Foodborne Botulism Outbreak After Consumption of Home-Canned Cactus (Nopales) — Fresno County, California, June 2024
