The Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first case of botulism in a 66-year-old female who resides in Pingtung County.

Taiwan map/CIA
Taiwan map/CIA

On February 25, 2016, she sought medical attention at a hospital after she developed symptoms such as slurred speech and muscle paralysis. During hospitalization, she subsequently developed other symptoms such as difficulty in swallowing, eye muscle disorder, weakness in limbs and difficulty in breathing. On March 9, infection with botulinum was confirmed in the case.

According to the epidemiological investigation, prior to the case’s disease onset, the case had consumed canned eel, seaweed sauce and fish floss. A sample of the aforementioned foods has been submitted to the Food and Drug Administration for laboratory testing to determine the source of the case’s infection. All of the samples tested negative for Clostridium botulinum. Currently, none of 4 the family members residing in the same household and coworkers has developed any symptoms.

Although it could not be confirmed that the source of the case’s infection is canned food, Clostridium botulinum, the bacteria that causes botulism, is ubiquitous in the environment. The sporulation of the bacterium occurs in an anaerobic environment. Any food product can be contaminated with Clostridium botulinum spores if the food product is not properly sterilized during the manufacturing and packaging processes. In a vacuum-packaged environment, food can be unsafe from Clostridium botulinum growth. The toxin produced by Clostridium botulinum is sensitive to heat and can be destroyed by heating it at 100°C for 10 minutes. Any homemade pickled products or vacuum-packaged food should be boiled for 10 minutes prior to consumption in order to ensure food safety.

Botulism infection can be fatal if left untreated. Taiwan CDC urges all physicians to remain vigilant for suspected cases of botulism. Physicians may consider the diagnosis if a patient displays gastrointestinal symptoms or fatigue accompanied by neurological symptoms and signs related to botulism such as deterioration of sight, dilated pupils, drooping eyelids and/or weakness of the arms and legs. Physicians should report such cases to the health authority immediately to facilitate provision of antitoxin to treat the case and lower the risk of death.