Part I – Outbreak detection
Foodborne botulism is a severe illness that results from the ingestion of a preformed toxin produced by a bacterium, Clostridium botulinum, in contaminated food. Death can occur in up to 60% of untreated cases; supportive care and prompt administration of antitoxin have reduced mortality in the United States to less than 10%. Outbreaks of botulism have been linked to improperly preserved vegetables, fruits, and meats including fermented fish products, sausages, smoked meat, and seafood.
On January 12, 1994, an infectious diseases physician at a Montevideo-area hospital telephoned the Directorate of Epidemiology of the Uruguayan Ministry of Health (MoH) to report two possible cases of botulism. The patients, both male, presented with drooping eyelids, double vision, difficulty swallowing, and respiratory problems. One patient had onset of symptoms on January 5 and the other one on January 6. The physician had drawn sera and collected stool specimens from the men to test for botulinum toxin but no results were available.
As a public health practitioner in Montevideo, how might you go about swiftly determining if there are other cases of botulism associated with these initial hospitalized cases in the larger, Montevideo metro area?
1. Find out any relevance in consumption of canned or preserved foods and place of consumption.
2. Confirm if the individuals or a group of people involved when they consumed the canned or preserved foods.
3. Rule out that differential diagnoses - guillain barre syndrome, Miller- Fisher syndrome, stroke or staphylococcal food poisoning.
4. Find out from The Other medical and nursing homes if there are any reported cases with the same signs and symptoms.
5. If other cases are reported, necessary surveillance should be made on canned and processed foods in Montevideo Metro area for the presence of botulinum toxin.
6. When the botulinum toxin the nerve endings it may disappear from the blood serum creating fatal signs and symptoms after which it is difficult to rescue the patient.
7. Identify the people at risk from the informations collected and try to provide them with antitoxins as soon as possible to prevent fatal complications.
8. Create awareness among the public if the incident is related to canned and processed foods, so that the further spread of the disease is restricted.
9. Provide public education on food hygiene, signs and symptoms of botulinum toxin and the importance of its early treatment.
Part I – Outbreak detection Foodborne botulism is a severe illness that results from the ingestion of a preformed toxin...
Foodborne botulism is a severe illness that results from the ingestion of a preformed toxin produced by a bacterium, Clostridium botulinum, in contaminated food. Death can occur in up to 60% of untreated cases; supportive care and prompt administration of antitoxin have reduced mortality in the United States to less than 10%. Outbreaks of botulism have been linked to improperly preserved vegetables, fruits, and meats including fermented fish products, sausages, smoked meat, and seafood. On January 12, 1994, an infectious...