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Review
. 2023 Sep;29(9):1730-1737.
doi: 10.3201/eid2909.230409.

Foodborne Botulism, Canada, 2006-20211

Richard A Harris, Christine Tchao, Natalie Prystajecky, Kelly Weedmark, Yassen Tcholakov, Manon Lefebvre, John W Austin
Review

Foodborne Botulism, Canada, 2006-20211

Richard A Harris et al. Emerg Infect Dis. 2023 Sep.

Abstract

During 2006-2021, Canada had 55 laboratory-confirmed outbreaks of foodborne botulism, involving 67 cases. The mean annual incidence was 0.01 case/100,000 population. Foodborne botulism in Indigenous communities accounted for 46% of all cases, which is down from 85% of all cases during 1990-2005. Among all cases, 52% were caused by botulinum neurotoxin type E, but types A (24%), B (16%), F (3%), and AB (1%) also occurred; 3% were caused by undetermined serotypes. Four outbreaks resulted from commercial products, including a 2006 international outbreak caused by carrot juice. Hospital data indicated that 78% of patients were transferred to special care units and 70% required mechanical ventilation; 7 deaths were reported. Botulinum neurotoxin type A was associated with much longer hospital stays and more time spent in special care than types B or E. Foodborne botulism often is misdiagnosed. Increased clinician awareness can improve diagnosis, which can aid epidemiologic investigations and patient treatment.

Keywords: Canada; Clostridium botulinum; antitoxin; bacteria; botulinum toxins; botulism; food safety; foodborne botulism; foodborne illness; outbreak; serotype.

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Figures

Figure 1
Figure 1
Number of foodborne botulism cases, Canada, 1960–2021. A) Number of cases during 1960–2021; B) detail of number of cases during 2006–2021. Inset pie graphs represent the percentage of cases among non-Indigenous and Indigenous persons.
Figure 2
Figure 2
Box and whisker plots of length of hospitalization and special care among persons affected by foodborne botulism serotypes A, B, and E, Canada, 2006–2021. A) Length of hospitalization; B) length of time in a special care unit. The box and whiskers represent the data as quartiles; the whiskers (vertical lines) represent the top and bottom values, the box represents the 1st (bottom) to 3rd (top) quartiles of values, and the horizontal line in the middle of the box represents the median. The circles indicate individual data points including outliers. A single outlier for time in special care occurred for serotype E.
See this image and copyright information in PMC

References

    1. Botulism SJ. Clin Infect Dis. 2005;41:1167–73. 10.1086/444507 - DOI - PubMed
    1. Montecucco C, Schiavo G. Mechanism of action of tetanus and botulinum neurotoxins. Mol Microbiol. 1994;13:1–8. 10.1111/j.1365-2958.1994.tb00396.x - DOI - PubMed
    1. Sheth AN, Wiersma P, Atrubin D, Dubey V, Zink D, Skinner G, et al. International outbreak of severe botulism with prolonged toxemia caused by commercial carrot juice. Clin Infect Dis. 2008;47:1245–51. 10.1086/592574 - DOI - PubMed
    1. Yu PA, Lin NH, Mahon BE, Sobel J, Yu Y, Mody RK, et al. Safety and improved clinical outcomes in patients treated with new equine-derived heptavalent botulinum antitoxin. Clin Infect Dis. 2017;66(suppl_1):S57–64. 10.1093/cid/cix816 - DOI - PMC - PubMed
    1. Richardson JS, Parrera GS, Astacio H, Sahota H, Anderson DM, Hall C, et al. Safety and clinical outcomes of an equine-derived heptavalent botulinum antitoxin treatment for confirmed or suspected botulism in the United States. Clin Infect Dis. 2020;70:1950–7. 10.1093/cid/ciz515 - DOI - PubMed

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