Botulism, canned food, fish - Russia (Lipetsk)

International Society for Infectious Diseases
<http://www.isid.org>

Source: IA Lipetsk News [Russian, trans. Mod.NR; edited]
< http://www.lipetsknews.ru/polezno/?id=3618>

According to Anna Dolgova, the deputy chief of the sanitary
surveillance center of the Lipetsk region, 7 people have suffered
from botulism in Lipetsk. One of them, a 51-year-old man, had died.

The cause of the disease is usually domestically canned food. One of
the 7 affected individuals ate canned mushrooms; another one consumed
canned stewed meat, which proved fatal. The other 5 people with
botulism consumed domestically prepared fish.

Botulinum toxin can be destroyed during heating. If canned food is
boiled for 10-15 minutes [the botulinum toxin is destroyed]. It is
recommended not to use iron caps when mushrooms are canned. Mushrooms
should be carefully washed to rid them of various debris, since the
dirt and other organic debris may contain spores of botulism.

Depending on the geography, the most common cause is either fish
(canned, dried or salted, stockfish) or domestically cooked
mushrooms. Canned meat and fruit are in 2nd place as causal factors
of botulism.

Fish is the cause throughout the southern steppes of Russia, close to
large rivers and in the regions along the Baykal river. Group
outbreaks are registered more frequently. It is enough to boil food
for 10-15 minutes to destroy the botulinum toxin; boiling denatures
the proteins, as well as the toxin.

Botulism is most often caused by the pre-formed toxin produced by
the bacterium _Clostridium botulinum_. Animals are most often exposed
to the organism through oral ingestion or through wound contamination.

Classically, botulism is a food-borne disease caused by the ingestion
of preformed toxin, although there also exists wound botulism (in
which _C. botulinum_ spores germinate in a wound), and infant
botulism (in which the spores germinate in the intestinal tract).

Botulism is a potentially fatal toxemia caused by ingestion of the
toxin of _C. botulinum_. There are 8 recognized types and subtypes of
the organisms.

The sporulating anaerobic gram-positive bacillus _C. botulinum_
elaborates 7 types of antigenetically distinct neurotoxins, 4 of
which affect humans: type A, B, E, or rarely type F. Toxin types A
and B are highly poisonous proteins resistant to digestion by
gastro-intestinal enzymes.

Types A, B, and E of human botulism are the most common. Although
each type has a similar symptom complex, Hughes and colleagues report
that type E is much more likely to produce initial lethargic mental
status and more autonomic dysfunction (2).

The method of diagnosis of botulism is not stated here nor is the
method of testing for the food products discussed, assuming that the
preserved food was not consumed in its entirety.

Individual cases of paralysis can be confused with other diseases,
but a cluster of such cases is certainly likely to be botulism. Type
E botulism is the type frequently associated with fish products (1).

1. Weber JT, Hibbs RG, Darwish A, et al: A massive outbreak of type E
botulism associated with traditional salted fish in Cairo. J Infect
Dis 1993;167: 451-4.

2. Hughes JM, Hatheway CL, Ostroff SM: Botulism. In: Scheld WM,
Whitley RJ, Durack DT, editors. Infections of the central nervous
system. 2nd edition. Philadelphia: Lippincott-Raven, 1997, 615-28.