An outbreak of type A foodborne botulism in Taiwan due to commercially preserved peanuts

An outbreak of type B botulism in southern Viet Nam, 2020

Objective

To investigate the cause of a botulism outbreak in several provinces in Viet Nam in 2020.

Methods

An initial investigation was conducted to confirm the outbreak and to form hypotheses about the potential causes, followed by a case–control assessment of the plausible causative food item. Collected food samples were tested to identify the pathogen, and mouse bioassays were performed. Control measures were introduced to stop the outbreak and to prevent similar events in the future.

Results

Twelve people in six southern provinces of Viet Nam were identified as having symptoms of botulism, of whom 11 were in critical condition requiring breathing support. A history of foods eaten in the 4 days before illness onset indicated that all the cases had eaten a tinned vegetarian pâté, and a case–control assessment showed that this was significantly associated with the outbreak, with an odds ratio of 35.2 (95% confidence interval: 3.4–¥). Clostridium botulinum type B was detected in three of eight pâté samples collected from the houses of cases. In the mouse bioassay for the toxicity of the pâté samples, all the mice died with clinical symptoms of botulism.

Discussion

A tinned vegetarian pâté was the plausible cause of a botulism outbreak in Viet Nam in 2020. Revision of food safety regulations to improve quality control of tinned foods to prevent future outbreaks is recommended.

Microbial safety of oily, low water activity food products: A review

Oily, low water activity (OL a_w) products including tahini (sesame seed paste), halva (tahini halva), peanut butter, and chocolate, have been recently linked to numerous foodborne illness outbreaks and recalls. This review discusses the ingredients used and processing of OL a_w products with a view to provide greater understanding of the routes of their contamination with foodborne pathogens and factors influencing pathogen persistence in these foods. Adequate heat treatment during processing may eliminate bacterial pathogens from OL a_w foods; however, post-processing contamination commonly occurs. Once these products are contaminated, their high fat and sugar content can enhance pathogen survival for long periods. The physiological basis and survival mechanisms used by pathogens in these products are comprehensively discussed here. Foodborne outbreaks and recalls linked to OL a_w foods are summarized and it was observed that serotypes of Salmonella enterica were the predominant pathogens causing illnesses. Further, intervention strategies available to control foodborne pathogens such as thermal inactivation, use of natural antimicrobials, irradiation and hydrostatic pressure are assessed for their usefulness to achieve pathogen control and enhance the safety of OL a_w foods. Sanitation, hygienic design of manufacturing facilities, good hygienic practices, and environmental monitoring of OL a_w food industries were also discussed.

Nuts and Grains: Microbiology and Preharvest Contamination Risks

Low-water-activity foods have been involved in recalls and foodborne disease outbreaks. Increased consumption; better detection methods and reporting systems; improved surveillance, trace-back, and ability to connect sporadic foodborne illnesses; and inadequate implementation of food safety programs are some of the likely reasons for the increase in frequency of recalls and outbreaks linked to dry foods. Nuts and grains can be contaminated with foodborne pathogens at any stage during production, processing, storage, and distribution. Focusing on preharvest contamination, the various potential sources of contamination include soil, animal intrusion, contaminated harvesting equipment, harvest and preharvest handling, storage conditions, and others. The low water activity of nuts and grains prevents the growth of most foodborne pathogens on their surfaces. The long-term survival of bacterial foodborne pathogens (Salmonella, Escherichia coli O157:H7, and Listeria monocytogenes) on dry foods has been documented in the literature for different nut types. Preventing contamination is the key to avoiding foodborne disease risks linked to dry foods. The implementation of good agricultural practices and other food safety systems provides a proactive approach to address concerns thoroughly. A plethora of research is available on preventing the growth of mycotoxin-producing fungi on the surface of nuts and grains. Milling is an effective mechanism to reduce the microbial load on grains. This review focuses on providing information about associated foodborne microorganisms, preharvest contamination sources, and good agricultural practice recommendations for nuts and grains.

An outbreak of botulism in a family in Eastern Anatolia associated with eating süzme yoghurt buried under soil

Cases of botulism in a family in eastern Anatolia were studied. In late September 2005, an outbreak of botulism developed in our region, first in 2 patients, a teenage boy and his mother, in whom the disease culminated in respiratory insufficiency and death. An additional 8 cases of botulism were identified later; most of them presented to our medical centre the next d. These patients with milder symptoms recovered gradually. All the patients received anti-botulinum toxin. The investigation of the source of the outbreak showed an unexpected vehicle for botulism infection in the these patients, süzme (condensed) yoghurt buried under soil. Type A botulinal toxin was detected in the yoghurt sample. The clinical diagnosis was also confirmed by a mouse bioassay performed with the serum samples of the patients. The most common symptoms were dry mouth, difficulty in speaking and swallowing, and change in voice quality. The 10 identified patients with botulism constitutes the largest-ever outbreak of botulism reported in Turkey to date. The present study shows the importance of considering a diagnosis of botulism soon after patients present with acute cranial nerve dysfunction and of promptly treating suspected cases with antitoxin.

Clostridium botulinum and the safety of minimally heated, chilled foods: an emerging issue?

Foodborne botulism is caused by consumption of preformed botulinum neurotoxin, with as little as 30 ng of neurotoxin being potentially lethal. Consumption of minute quantities of neurotoxin-containing food can result in botulism. In view of the severity of foodborne botulism, it is essential that new foods be developed safely without an increase in incidence of this disease. Minimally heated, chilled foods are a relatively new type of food, sales of which are currently increasing by about 10% per annum. These products meet consumer demand for high-quality foods that require little preparation time. Their safety and quality depends on mild heat treatment, chilled storage, restricted shelf life and sometimes on intrinsic properties of the foods. The principal microbiological hazard is nonproteolytic Clostridium botulinum, and there is a concern that this may become an emerging issue. A considerable amount of research and development over the last 15 years has underpinned the safe production of commercial, minimally heated, chilled foods with respect to foodborne botulism, and it is essential that safe food continues to be developed. In particular, the desire to use lighter heat processes and a longer shelf life presents a challenge that will only be met by significant developments in quantitative microbiological food safety.

An outbreak of foodborne botulism associated with contaminated hazelnut yoghurt

The largest recorded outbreak of foodborne botulism in the United Kingdom occurred in June 1989. A total of 27 patients was affected; one patient died. Twenty-five of the patients had eaten one brand of hazelnut yoghurt in the week before the onset of symptoms. This yoghurt contained hazelnut conserve sweetened with aspartame rather than sugar. Clostridium botulinum type B toxin was detected in a blown can of hazelnut conserve, opened and unopened cartons of hazelnut yoghurt, and one faecal specimen. Cl. botulinum type B was subsequently cultured from both opened and unopened cartons of the hazelnut yoghurt and from one faecal specimen. Investigations indicated that the processing of the conserve was inadequate to destroy Cl. botulinum spores. Control measures included the cessation of all yoghurt production by the implicated producer, the withdrawal of the firm's yoghurts from sale, the recall of cans of the hazelnut conserve, and advice to the general public to avoid the consumption of all hazelnut yoghurts.