Foodborne botulism in the Republic of Georgia

Abstract

Foodborne botulism is a potentially fatal, paralytic illness that can cause large outbreaks. A possible increase in botulism incidence during 2001 in the Republic of Georgia prompted this study. We reviewed surveillance data and abstracted records of patients with botulism who were hospitalized from 1980 to 2002. During this period, 879 botulism cases were detected. The median annual incidence increased from 0.3 per 100,000 during 1980 to 1990 to 0.9 per 100,000 during 1991 to 2002. For 706 botulism patients hospitalized from 1980 to 2002, 80% of their cases were attributed to home-preserved vegetables. Surveillance evaluation verified that botulism incidence varied greatly by region. Georgia has the highest nationally reported rate of foodborne botulism in the world. A strategy addressing individual behaviors in the home is needed to improve food safety; developing this strategy requires a deeper understanding of why botulism has increased and varies by region.

Figure 1

Number of botulism cases and cases per 100,000 persons in Georgia, 1980–2002. Data are derived from routine, passive national surveillance. Data are presented as one trend line because the incidence and absolute case count trend lines are indistinguishable.

Figure 2

umulative incidence of botulism events by region of residence, per 100,000 persons, in Georgia, 1980–2002. Outbreaks and sporadic cases are counted as one event. Data are derived from review of medical records at hospitals. For comparison, the cumulative incidence rate of botulism events for the country was 6.7 per 100,000. Asterick indicates autonomous regions not under government control.