Upload
lorin-stanley
View
214
Download
0
Tags:
Embed Size (px)
Citation preview
Outbreak of Botulism Associated with
Fermented Beaver – Alaska, 2001
Louisa Castrodale, DVM, MPHSection of EpidemiologyAlaska Division of Public
Health
Outbreak
Southwestern Alaska village14 Alaska NativesBeaver paw and tailLunchtime on January 17Following morning, symptoms
compatible with botulism
Botulism
Ingestion of toxin produced by Clostridium botulinum
Blocks Ach release at neuromuscular junctions
Symmetrical descending paralysisIncubation 12-36 hrs (range 6-240)Case fatality rate 5-10%
Symptoms
GI, neurologic, respiratoryDiagnostic Pentad
Nausea or vomitingDysphagiaDiplopiaDilated, fixed pupilsDry throat
Botulism in Alaska
First outbreak in 1940sHighest rate in United StatesCase-patients all Alaska NativesConsuming traditional foodsRecent decline coincident with
prevention efforts by AIP-CDC
Methods
Interviews of exposed persons–Symptoms and onset–Food history
Details of food preparationSpecimens collected–Serum, stool, gastric aspirate–Beaver
Persons Exposed
Person Pentad Level Antitoxin # (n/5) of care (A/B & E)
1 4 tertiary* Y2 3 tertiary* Y3 3 tertiary Y4-14 < 1 observed N
each for >48 hrs
*placed on ventilator
Beaver Paws Tested for BotulinumToxin at CDC, Atlanta, GA
Results
Toxin type E–Serum from Persons 1 and 2–Stool from Person 3–Beaver paws–Cultures pending
Fermentation Process
Beavers hunted Nov ‘00 - Jan ‘01Cut up and placed in heavy paper
sack; left to ferment in entryway
C. botulinum spores ubiquitous; toxin production facilitated by–Anerobic conditions–Warm environment
Summary
Outbreak associated with consumption of fermented beaver
Three cases of botulism confirmed
Recommendations
Still a need to evaluate educational messages and prevention strategies that emphasize safe fermentation and consumption practices
Acknowledgments
Coauthor: Michael Beller
Andrea Horn, RS, BBAHCSusan Maslanka, CDC/Bot LabArctic Investigations ProgramAK State Public Health
Laboratory