Question

Part II – Descriptive epidemiology and hypothesis generation

Staff members from the local health department where the terminal stop of the bus route was located were invited to participate in the investigation.

In addition, physicians attending to the cases of botulism were asked to provide demographic and clinical information on their patients. (Table 1)

Question: Given the available data, what would you hypothesize was the most likely period of exposure among these cases?

Table 1: Characteristics of cases of botulism, Montevideo, January 1994 Patient Work shift Onset of neuro- Age No.(years) Gender logic symptoms Symptoms 42 Morning blurred vision, double vision, drooping eyelids, upper and lower extremity weakness, respiratory difficulty, fatigue January 6 blurred vision, double vision, drooping eyelids, upper and lower extremity weakness 31 Morning January 5 23 blurred vision, drooping eyelids, upper extremity weakness, fatigue Morning January 9 46 Morning January 8 drooping eyelids, difficulty speaking blurred vision, double vision, drooping eyelids, difficulty speaking, respiratory difficulty 54 Morning January 5 49 blurred vision, drooping eyelids, difficulty speaking Morning January 10 blurred vision, double vision, drooping eyelids, upper and lower extremity weakness, respiratory difficulty, fatigue 31 Morning January 15 respiratory difficulty, fatigue, drooping eyelids Morning January 14 24 Morning January 12 drooping eyelids, fatigue *M-male gender

Answer 1

Botulism is a serious,fatal illness caused by toxin produced by kind of Bacteria.

Based on the data most likely period of exposure among these cases in the morning shift,onset starts from January with the symptoms of blurred vision, double vision,dropping eyelid, upper and lower extremities weakness,respiratory difficulty, fatigue..it affects mostly males than females in the middle age group..