Epidemiologic Notes and Reports Restaurant-Associated Botulism
from Mushrooms Bottled In-House -- Vancouver, British Columbia,
Canada
Eleven suspected cases of botulism were reported in Vancouver,
British Columbia, between February 18 and February 22, 1987. Five
of
the patients have been hospitalized; three of these are on
respirators. All of the persons involved ate in the Five Sails
Restaurant of the Pan Pacific Hotel on the Vancouver waterfront on
February 13, 14, or 16. A case-control study using 32 controls
demonstrated a highly significant correlation with eating
chantarelle
mushrooms bottled in-house (odds ratio (OR) infinite, p = 0.000057)
or
a lobster and red snapper meal that contained the mushrooms (OR =
31,
p = 0.0057). Toxin has not yet been identified in sera from the
patients; one specimen of liquid from the bottled mushrooms has
yielded Type A botulinal toxin. Three bottles of the mushrooms
were
estimated to have been used between February 13 and 16; restaurant
records revealed that 31 persons had been exposed to the mushrooms
between February 12 and 17. The restaurant was closed on February
18;
active case-finding is continuing in Vancouver and surrounding
regions.
Reported by HE McLean, MD, S Peck, MB, G Eng, BSC, City of
Vancouver
Health Dept, RG Mathias, MD, Dept of Health Care and Epidemiology,
University of British Columbia, WA Black, MD, British Columbia
Provincial Laboratories, GB Morgan, Health Protection Branch,
Health
and Welfare Canada, Vancouver, British Columbia, Canada; Enteric
Diseases Branch, Div of Bacterial Disease, Center for Infectious
Diseases, CDC.
Editorial Note
Editorial Note: Although restaurants are not frequently identified
as
the location of botulism outbreaks, they represent a risk of
widespread public exposure to contaminated foods. While foods
served
in restaurants were associated with 4% of botulism outbreaks in the
United States between 1976 and 1984, they resulted in 42% of the
cases
during that period (1). In addition, restaurant-associated
outbreaks
in major centers of transit such as Vancouver may result in
widely-distributed cases which may therefore not be recognized for
a
substantial period of time (2). Patients with neurologic illness
resembling botulism should be asked about recent travel to
Vancouver.
Clinicians in the United States can report any suspected associated
cases to their state epidemiologist. Cases outside Canada and the
United States can be reported to the Communicable Disease Division,
Bureau of Epidemiology, Laboratory Center for Disease Control,
Ottawa,
Canada.
References
MacDonald KL, Cohen ML, Blake PA. The changing epidemiology of
adult botulism in the United States. Am_J_Epidemiol
1986;124:794-9.
CDC. International outbreak of restaurant-associated botulism
--
Vancouver, British Columbia, Canada. MMWR 1985;34:643.
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