Annals of Tropical Medicine and Public Health
Home About us Ahead Of Print Instructions Submission Subscribe Advertise Contact e-Alerts Editorial Board Login 
Users Online:889
  Print this page  Email this page Small font sizeDefault font sizeIncrease font size
 


 
Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1360-1361
Preventing the outbreaks of food-borne botulism and minimizing the risk of fatality


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Tamil Nadu, India

Click here for correspondence address and email

Date of Web Publication6-Nov-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Preventing the outbreaks of food-borne botulism and minimizing the risk of fatality. Ann Trop Med Public Health 2017;10:1360-1

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Preventing the outbreaks of food-borne botulism and minimizing the risk of fatality. Ann Trop Med Public Health [serial online] 2017 [cited 2018 May 22];10:1360-1. Available from: http://www.atmph.org/text.asp?2017/10/5/1360/196826


Dear Editor,

Food-borne botulism among humans is a neuroparalytic disease resulting in respiratory and muscular paralysis, occurring due to the ingestion of food contaminated with botulinum toxins.[1] Even though the condition is rare in nature, nevertheless, delayed detection or lack of timely management can be lethal with 5-10% of cases being fatal.[1] The condition precipitates due to the consumption of poorly processed food containing the preformed toxins.[2]

Apart from that, the disease can even present in other uncommon forms like intestinal infection in infants (due to the ingestion of spores) or infections of the wound or even by inhalation.[1],[2],[3]

The toxin has been isolated from a wide range of food substances (viz. spinach, mushrooms, fish, meat products, etc.), and it might vary between different nations due to the local eating habits and food preservation procedures.[2],[3] However, special precautions should be taken while dealing with homemade, canned, preserved or fermented food items, and any such suspicious food item has to be obtained promptly, stored in sealed containers, and dispatched to laboratory to ascertain the probable cause and prevent subsequent cases.[2],[3]

It is important to understand that it is a big challenge for the clinicians to establish a diagnosis as the clinical manifestations are quite varied and even the disease has a variable course.[1],[4] Still, it can be diagnosed on the basis of history, clinical examination, and laboratory confirmation through either the demonstration of toxin in serum-faecal sample-food items or the culture of causative organism in the faecal sample-food items-wound specimens.[3],[4] However, at no stage the physician should wait for the laboratory results to initiate the desired treatment.[1] Administration of the antitoxin is the only available intervention after the establishment of the diagnosis, as the case fatality can be reduced by its early administration.[4] Further, supportive treatment often plays an important role in improving the prognosis, especially in severe cases.[1],[4]

From the prevention perspective, the disease can be easily prevented by adhering to the best practices during food preparation, its preservation, and maintenance of hygiene standards.[5] At the same time, strategies like refrigerating foods at recommended temperatures and combining them with salt content and/or acidic conditions will play an important role in averting bacterial growth and toxin release.[1],[5] Further, compliance with the standard guidelines of maintaining cleanliness of food items, segregating raw and cooked foods, ensuring complete cooking, and utilizing safe water or raw materials for cooking is also expected to minimize the emergence of such cases.[1],[2],[4]

In addition, interventions like strengthening of the national surveillance, initiating an alert system to facilitate prompt outbreak detection, assessing the risk of the disease to ascertain the possible origin of the outbreak, implementing specific targeted measures to contain the outbreak at the source itself, and ensuring collaboration between different stakeholders (like international organizations, experts, laboratories, airlines, etc.) to mobilize desired resources will play a crucial role in preventing the outbreak of the disease to become an international emergency.[1],[3],[5]

To conclude, even though botulism outbreaks are not frequent, they are an important public health emergency and have to be addressed promptly to prevent the emergence of additional cases and also to minimize fatality.

Acknowledgments

S.R.S. contributed to the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

P.S.S. contributed to the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed to revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

None

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization Botulism - Fact sheet N 270;2013. Available from: http://who.int/mediacentre/factsheets/fs270/en/. [LastAccessed 2016 May 27].  Back to cited text no. 1
    
2.
Czerwiński M, Czarkowski MP, Kondej B. Foodborne botulism in Poland in 2012. Przegl Epidemiol 2014;68:249-52.  Back to cited text no. 2
    
3.
Espelund M, Klaveness D. Botulism outbreaks in natural environments: an update. Front Microbiol 2014;5:287.  Back to cited text no. 3
[PUBMED]    
4.
Proverbio MR, Lamba M, Rossi A, Siani P. Early diagnosis and treatment in a child with foodborne botulism. Anaerobe 2016;39:189-92.  Back to cited text no. 4
[PUBMED]    
5.
Shrivastava SR, Shrivastava PS, Ramasamy J. Global food safety: challenges and recommended public health strategies. Int J Prev Med 2016;7:8.  Back to cited text no. 5
[PUBMED]    

Top
Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai village, Thiruporur Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.196826

Rights and Permissions




 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Email Alert *
    Add to My List *


    References

 Article Access Statistics
    Viewed631    
    Printed8    
    Emailed0    
    PDF Downloaded4    
    Comments [Add]    

Recommend this journal