Portal de Periódicos da CAPES

Outbreak of Suspected Clostridium butyricum Botulism in India

1998; Centers for Disease Control and Prevention; Volume: 4; Issue: 3 Linguagem: Inglês

10.3201/eid0403.980347

1080-6059

Rama Chaudhry, Benu Dhawan, Dinesh Kumar, Rajesh Bhatia, Jaimini Gandhi, RK Patel, Bhavik Purohit,

Parkinson's Disease Mechanisms and Treatments

Outbreak of Suspected Clostridium butyricum Botulism in IndiaTo the Editor: Foodborne botulism, particularly associated with Clostridium butyricum, is rare; no cases had been reported in India before this outbreak.A reported case of foodborne botulism represents a public health emergency because of the potential severity of the disease and the possibility of mass exposure to the contaminated product.In September 1996, the anaerobic section of the All India Institute of Medical Sciences received serum and food samples from the National Institute of Communicable Diseases, Delhi, India, for investigating a possible outbreak of foodborne botulism.In the early hours of September 18, 1996, 34 of 310 students of a residential school in rural Gujrat complained of abdominal pain, nausea, chest pain, and difficulty in breathing.One of the students, aged 14, died before he could be treated; two others, aged 13, died on their way to the hospital.The remaining 31 students were admitted to a rural hospital; eight were discharged 1 day later after being given symptomatic treatment, while the other 23 were transported by ambulance to an urban emergency department in Ahemdabad, Gujrat.Findings on examination included ptosis, pupillary mydriasis, extraocular palsies, and impairment of conciousness.All students were given symptomatic treatment in the form of stomach lavage and intravenous administration of antibiotics and steroids.Over the subsequent 24 hours, 21 improved clinically and were discharged; however, two (aged 14 and 17 years) had respiratory distress and required mechanical ventilation.Differential diagnosis included botulinum food poisoning, and both patients were administered trivalent (A,B,E) botulinum antitoxin.They responded well to the treatment and were discharged from the hospital 1 month later.Patients reported that 24 hours before onset of symptoms, they had eaten ladoo (a local sweet), curd, buttermilk, sevu (crisp made of gram flour), and pickle.Food samples were assayed for botulinum toxin and were cultured anaerobically (1).Anaerobic culture of leftover sevu yielded an organism in pure culture whose cultural and biochemical properties were consistent with those of C. butyricum; i.e., it was lipase-negative, fermentative, and did not liquefy gelatin (2).