Botulism associated with commercially canned chili sauce--Texas and Indiana, July 2007

Abstract

On July 7 and July 11, 2007, public health officials in Texas and Indiana, respectively, reported to CDC four suspected cases of foodborne botulism, two in each state. Investigations conducted by state and local health departments revealed that all four patients had eaten brands of Castleberry's hot dog chili sauce before illness began. Botulinum toxin type A was detected in the serum of one Indiana patient and in a leftover chili mixture obtained from his home. CDC informed the Food and Drug Administration (FDA) of the apparent link between illness and consumption of the chili sauce. On July 18, FDA issued a consumer advisory, and the manufacturer, Castleberry's Food Company (Augusta, Georgia), subsequently recalled the implicated brand and several other products produced in the same set of retorts (commercial-scale pressure cookers for processing canned foods) at the same canning facility. Examination of the canning facility in Georgia during the outbreak investigation had identified deficiencies in the canning process. On July 19, the U.S. Department of Agriculture Food Safety and Inspection Service (FSIS) issued a press release that announced a recall of chili and certain meat products from the Castleberry canning facility and provided recommendations to consumers. That recall was expanded on July 21 to include additional canned products. A fifth case of botulism potentially linked to one of the recalled products is under investigation in California. This report describes the ongoing investigation by members of OutbreakNet and others and the measures undertaken to control the outbreak, which is the first outbreak of foodborne botulism in the United States associated with a commercial canning facility in approximately 30 years. Clinicians should be vigilant for symptoms of botulism, including symmetric cranial nerve palsies, especially if accompanied by descending flaccid paralysis. Consumers should not eat any of the recalled chili sauce or other recalled products and should carefully dispose of all recalled products. Information regarding product disposal is available at http://www.cdc.gov/botulism/botulism_faq.htm.