Volume 10, Issue 6 (November-December 2016)                   IJT 2016, 10(6): 45-50 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Nejadrahim R, Delirrad M. Foodborne Botulism: A Study of 57 Cases in Northwest Iran. IJT. 2016; 10 (6) :45-50
URL: http://ijt.arakmu.ac.ir/article-1-525-en.html
Department of Forensic Medicine & Toxicology, Food & Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran. , delirrad@umsu.ac.ir
Abstract:   (1648 Views)

Background: Foodborne botulism (FBB) is a rare paralyzing disease caused by ingestion of foods contaminated with botulinum neurotoxin (BoNT). It is still a health concern in many countries. This study aimed to investigate the epidemiology of FBB in West Azerbaijan Province, Iran.

Methods: Botulism surveillance data of the Health Deputy of Urmia Medical Sciences University, northwestern Iran was used in this retrospective survey from 2010 to 2014. Demographics, clinical features, bioassay results, implicated foods and outcome were analyzed. Clinically, patients were classified to three groups (mild, moderate, and severe).

Results: During the five years, 57 cases of FBB were identified involving 36 men (63.2%) and 21 women (37.8%). Mean age was 22.35±17.84 yr. Most events were sporadic (86%). Bioassay confirmed serotype A of BoNT in 19 patients (33.3%). The most implicated food was locally-made cheese (n=10). Average incubation period was 24.35±12.35 h. Clinically, mild, moderate and severe forms were observed in 68.4%, 19.3% and 12.3% of patients, respectively. All cases were hospitalized and treated with trivalent antitoxin. Mean hospital stay was 7.71±3.94 days Eight patients (14%) required mechanical ventilation and three of them deceased (5.3%). Median annual incidence rate of FBB was 0.37 cases per 100,000 population in this study.

Conclusion: Comparing other part of the world, FBB has a medium incidence rate in our province. Unpasteurized dairy products are the main causative foods and BoNT/A is the most commonly recognized toxin type. Promoting correct preservation and appropriate cooking are recommended for preventing FBB.

Full-Text [PDF 121 kb]   (717 Downloads)    
Type of Study: Research | Subject: Special

1. Shahcheraghi F, Nobari S, Masoumi-Asl H, Aslani MM. Identification of botulinum toxin type in clinical samples and foods in Iran. Arch Iran Med 2013;16(11):642-6.
2. Sobel J, Tucker N, Sulka A, McLaughlin J, Maslanka S. Foodborne botulism in the United States, 1990-2000. Emerg Infect Dis 2004;10(9):1606-11. [DOI:10.3201/eid1009.030745]
3. Barash JR, Arnon SS. A novel strain of Clostridium botulinum that produces type B and type H botulinum toxins. J Infect Dis 2014;209(2):183-91. [DOI:10.1093/infdis/jit449]
4. Cherington M. Clinical spectrum of botulism. Muscle Nerve 1998;21(6):701-10. https://doi.org/10.1002/(SICI)1097-4598(199806)21:6<701::AID-MUS1>3.0.CO;2-B [DOI:10.1002/(SICI)1097-4598(199806)21:63.0.CO;2-B]
5. Zhang S, Wang Y, Qiu S, Dong Y, Xu Y, Jiang D, et al. Multilocus Outbreak of Foodborne Botulism Linked to Contaminated Sausage in Hebei Province, China. Clin Infect Dis 2010;51(3):322-5. [DOI:10.1086/653945]
6. Varma JK, Katsitadze G, Moiscrafishvili M, Zardiashvili T, Chikheli M, Tarkashvili N, et al. Foodborne botulism in the Republic of Georgia. Emerg Infect Dis 2004;10(9):1601-5. [DOI:10.3201/eid1009.030806]
7. Neghina AM, Marincu I, Moldovan R, Iacobiciu I, Neghina R. Foodborne botulism in southwest Romania during the post-communism period 1990-2007. Int J Infect Dis 2010;14(2):e96-e101. [DOI:10.1016/j.ijid.2009.03.022]
8. Loutfy MR, Austin JW, Blanchfield B, Fong IW. An outbreak of foodborne botulism in Ontario. Can J Infect Dis 2003;14(4):206-9. [DOI:10.1155/2003/601525]
9. Tavakoli HR, Meshgi MA, Jafari NJ, Izadi M, Ranjbar R, Fooladi AA. A survey of traditional Iranian food products for contamination with toxigenic Clostridium botulinum. J Infect Public Health 2009;2(2):91-5. [DOI:10.1016/j.jiph.2009.03.001]
10. Sobel J. Botulism. Clin Infect Dis 2005;41(8):1167-73. [DOI:10.1086/444507]
11. Aminzadeh Z, Vahdani P, Mirzaei J. A survey on 80 cases of botulism and its clinical presentations as a public health concern. Arch Clin Infect Dis 2007;2(2):77-81.
12. Dover N, Barash JR, Hill KK, Xie G, Arnon SS. Molecular characterization of a novel botulinum neurotoxin type H gene. J Infect Dis 2014;209(2):192-202. [DOI:10.1093/infdis/jit450]
13. Kalb SR, Baudys J, Raphael BH, Dykes JK, Luquez C, Maslanka SE, et al. Functional characterization of botulinum neurotoxin serotype H as a hybrid of known serotypes F and A (BoNT F/A). Anal Chem 2015;87(7):3911-7. [DOI:10.1021/ac504716v]
14. Hashemi SH, Mamani M, Torkaman-Asadi F, Fayyazi A. A Family Outbreak of Foodborne Botulism Following Consumption of Home-Canned Doogh in Hamadan, West of Iran. Avicenna J Clin Microb Infec 2015;2(1):e23476. [DOI:10.17795/ajcmi-23476]
15. Barari M, Kalantar E. An outbreak of type A and B botulism associated with traditional vegetable pickle in Sanandaj. Iran J Clin Infect Dis 2010;5(2):111-2.
16. Momose Y, Asakura H, Kitamura M, Okada Y, Ueda Y, Hanabara Y, et al. Food-borne botulism in Japan in March 2012. Int J Infect Dis 2014;24:20-2. [DOI:10.1016/j.ijid.2014.01.014]
17. Leclair D, Fung J, Isaac-Renton JL, Proulx JF, May-Hadford J, Ellis A, et al. Foodborne botulism in Canada, 1985-2005. Emerg Infect Dis 2013;19(6):961-8. [DOI:10.3201/eid1906.120873]
18. RahbarTaromsari M, Badsar A R, Akhoundzade N, Oojaghi F, Fallah Karkan M. A Survey on the Clinical Presentations in Food-borne Botulism for Patients Refering to Razi Hospital During 2001-2006. Iran J Toxicol 2012;5(15):554-7.
19. Roblot P, Roblot F, Fauchere JL, Devilleger A, Marechaud R, Breux JP, et al. Retrospective study of 108 cases of botulism in Poitiers, France. J Med Microbiol 1994;40(6):379-84. [DOI:10.1099/00222615-40-6-379]
20. Fagan RP, McLaughlin JB, Castrodale LJ, Gessner BD, Jenkerson SA, Funk EA, et al. Endemic foodborne botulism among Alaska Native persons--Alaska, 1947-2007. Clin Infect Dis 2011;52(5):585-92. [DOI:10.1093/cid/ciq240]
21. Anniballi F, Chironna E, Astegiano S, Fiore A, Auricchio B, Buonincontro G, et al. Foodborne botulism associated with home-preserved turnip tops in Italy. Ann Ist Super Sanita 2015;51(1):60-1.
22. Pourshafie MR, Saifie M, Shafiee A, Vahdani P, Aslani M, Salemian J. An outbreak of food-borne botulism associated with contaminated locally made cheese in Iran. Scand J Infect Dis 1998;30(1):92-4. [DOI:10.1080/003655498750002385]
23. Tavakoli HR, Zeynali M. Epidemiological survey of food-borne botulism in Iran during 2004-2008. Epidemiology 2009;20(6):S113. [DOI:10.1097/01.ede.0000362394.97915.47]
24. Disorders of the neuromuscular junction. In: Davis LE, King MK, Schultz JL, editors. Fundamentals of neurologic disease: an introductory text. New York: Demos Medical Publishing; 2005. p. 49-56.
25. Tavakoli HR, Zeynali M, Mehrabi-Tavana A. Scrutiny of food-borne botulism intoxication in iran during 2003-2007 with the food hygiene view point. Hakim Health Sys Res 2009;11(4):38-46.
26. Afshari R, Habibiyan Nejad Z, Shafiei S, Sayyahnejezhad M, Dadras-Moghaddam D, Balali-Mood M. A Botulism outbreak following a wedding in a suburban area of Mashhad, 2006. J Birjand Univ Med Sci 2010;17:59-65.
27. Czerwinski M, Czarkowski MP, Kondej B. Foodborne botulism in Poland in 2012. Przegl Epidemiol 2014;68(2):249-52.
28. Czerwinski M, Czarkowski MP, Kondej B. Foodborne botulism in Poland in 2013. Przegl Epidemiol 2015;69(2):243-5.
29. Hutchinson DN. Foodborne botulism. BMJ 1992;305(6848):264-5. [DOI:10.1136/bmj.305.6848.264]
30. Shahcheraghi F, Nobari S, Vahdani P, Majdian J, Aslani MM. Type A Botulism in Members of a Family Following the Consumption of Locally Made Cheese. J Mazandaran Univ Med Sci 2013;22(96):124-9.
31. Botulinum Antitoxin [package insert]. Masoondarou Biopharmaceutical Company, Inc, Alborz, Iran 2014.
32. Afshani MT, Zahraee SM, Aghili N. National Guideline for Botulism. Tehran, Iran: Centers for Disease Control and Prevention, Ministry of Health and Medical Education; 2007.

Add your comments about this article : Your username or Email:

Send email to the article author

© 2019 All Rights Reserved | Iranian Journal of Toxicology

Designed & Developed by : Yektaweb