Comprehensive field investigation of a large botulism outbreak, Saudi Arabia, 2024

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-02-12 DOI:10.1016/j.jiph.2025.102702

Saad Nasser Al Zuayr , Shady Abdelrahman Kamel , Abdulaziz Saad Almutairi , Yahya Abdullah AlAsseri , Musa alfaifi , Bader Alyahya , Mohammad Al Deeb , Hussein Ayaed Albogami , Hamoud Marzouq Alrougi , Rayyan Mohammad Saqah , Abdulmohsen Mohammed Alahmad , Abd Elelah Hamoud Almutairi , Eman Elsayed Abd-Ellatif

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引用次数: 0

Abstract

Background

Botulism is an uncommon and possibly lethal disease caused by botulinum neurotoxins, produced by Clostridium botulinum, Clostridium butyricum, and Clostridium baratii. Food-borne botulism typically results from consuming homemade canned, preserved, or fermented food. This paper presents the first documented occurrence of a commercially prepared food-borne botulism outbreak in Saudi Arabia.

Methods

We used information from medical charts to describe the outbreak by time, place and affected persons. Individuals who consumed food from a specific restaurant chain in Riyadh within one week of its closure and experienced symptoms compatible with botulism were included. One hundred and two cases were interviewed. All clinical data, laboratory investigations, and information regarding antitoxin administration were obtained. We reviewed the results of samples collected from food handlers and the environment. The public health actions and the outbreak source investigations were detailed.

Results

A total of 50 cases have met the criteria for clinically confirmed botulism. Laboratory testing verified 10 (20 %) of the confirmed cases. Half of the cases were males with a mean age of 25.08 ( ± 6.42) and the other half were females with a mean age of 25.28 ( ± 9.38). Saudi nationals represented 90 % of cases. All cases reported eating from different branches of the same restaurant in Riyadh. The mean incubation period ranged from 4 to 101 h. Prevalent symptoms were dysphagia (80 %), dysarthria (78 %), peripheral muscle weakness (78 %), and diplopia (62 %). 96 % of cases received Antitoxin. Consumed food items included meat burgers (58 %), chicken burgers (22 %), fries (52 %), fries with meat (10 %), and sauces (100 %). BoNT types A and B were detected in one sample from a mayonnaise jar.

Conclusion

The study outlined an outbreak of food-borne botulism associated with commercially processed items. The early administration of antitoxins, high index of suspicion, and effective source control considerably reduced morbidity and mortality. It is uncommon for mayonnaise to cause botulism, so further testing is necessary to confirm this relationship. We recommend higher measures of monitoring and improving the food sector's preservation, storage, and quality control.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.