Apr 18, 2006 (CIDRAP News) The recent outbreak of botulism poisoning traced to bamboo shoots served at a religious festival in Thailand sickened 163 people, according to a report by the US Centers for Disease Control and Prevention (CDC).
Of that number, 141 patients had to be hospitalized, and 10 more were treated as outpatients. A majority experienced abdominal pain, dry mouth, and/or nausea. Forty-two of the hospitalized patients needed mechanical ventilation, the CDC said in the Apr 14 issue of Morbidity and Mortality Weekly Report.
Thai health officials quickly traced the outbreak to a Mar 14 religious rite in Nawaimai Village, Pakaluang subdistrict, Baan Luang district of Nan Province, the report said. Investigators interviewed 145 of the 200 people who had attended the festival about their food intake. The only food in common was home-canned bamboo shoots, which are often eaten with chili and shrimp paste.
The bamboo shoots had been produced locally by a women's group, the CDC wrote. They were processed in large containers that held roughly 26 pounds each. Most of the 53 cans made in September 2005 were sold locally. No other outbreaks have been recorded since those cans were produced.
Antitoxin was not available in Thailand, so Thai officials sought help from several international partners. The United Kingdom (with support form the World Health Organization) sent 20 vials of heptavalent antitoxin; CDC sent 50 vials of bivalent antitoxin; and the National Institute of Infectious Diseases in Japan sent 23 vials of trivalent antitoxin. A Canadian company sold Thailand an additional 10 vials of bivalent antitoxin.
By Apr 10, only 25 patients still remained in the hospital, 9 of them on respirators, the CDC noted. None of the 163 patients died. A study assessing the outcomes of some of the cases is ongoing, the agency noted.
The report said the outbreak occurred 8 years after a smaller botulism outbreak that also was associated with home-canned bamboo shoots. Following that episode, information on safe canning was disseminated throughout the country.
"This recurrence 8 years later indicates the importance of long-term follow up and continuous inspection and assurance of the quality of food canning," the CDC said.
CDC. Botulism from home-canned bamboo shootsNan Province, Thailand, March 2006. MMWR 2006: 55(14) 389-92 [Full text]
See also:
Mar 22 CIDRAP News story on outbreak
http://www.cidrap.umn.edu/cidrap/content/fs/food-disease/news/mar2206botu.html
