Botulism: 29 confirmed foodborne cases in the US in 2016, most linked to Mississippi outbreak

The Centers for Disease Control and Prevention (CDC) recently published the National Botulism Surveillance Summary for 2016 and reported 29 confirmed foodborne botulism cases that year.  Among the foodborne cases, 23 were associated with three outbreaks in three states; the remaining six cases were sporadic.

Sixty-two percent of the cases (18) were from a Mississippi outbreak associated with illicitly produced alcohol, known as “pruno” or “hooch”, in a federal correctional facility.

Other states reporting cases include Alaska- two cases, one linked to consumption of beaver tail and the other fish heads and seal oil. California reported three cases- one linked to commercial grain and vegetable product and two from unknown source.

Oklahoma saw two cases- one linked to the Mississippi outbreak and one linked to home canned food. Oregon reported one case linked to home-canned pickled vegetables and Texas saw one case linked to tamales.

Finally, Washington saw two cases linked to home canned fish.

In addition, eight cases of probable foodborne botulism (clinically compatible illness, not laboratory-confirmed, with an epidemiologic link to a food or drink suspected to be contaminated with botulinum toxin) were reported from two states.

In total, 205 botulism cases were reported. In addition to the foodborne cases, CDC reports 149 cases of infant botulism from 29 states and the District of Columbia, with California reporting the most (47, or 32%).

Twenty-four cases of wound botulism were reported from eight states, with California reporting the most (15, or 63%). An outbreak in New Mexico occurred among three persons who injected black tar heroin. Among the 21 sporadic cases, 19 occurred among persons who injected black tar heroin, one in a person who injected methamphetamine, and one in a person with a gunshot wound. The two cases of probable wound botulism (clinically compatible case with no suspected exposure to contaminated food and with a history in the 2 weeks before illness began of either a fresh, contaminated wound or injection drug use) were reported from two states.

Three cases of botulism of unknown or other etiology were reported from three states.  Two cases were suspected to be due to adult intestinal colonization, a rare form with a mechanism similar to infant botulism. A case of type F botulism occurred in a pregnant woman who experienced fetal death during the second trimester; the route of exposure was not determined.

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