Two recent studies have highlighted the dangers of foodborne botulism caused by home-cooked foods.
First, a familial outbreak of botulism in China has been linked to consumption of homemade fermented eggs.
All victims experienced symptoms of botulism, including vomiting, limited eye movements, progressive muscle weakness of the limbs and other neurological signs.
According to a study published in the journal Frontiers in MedicineLaboratory tests confirmed the presence of Clostridium botulinum toxin type A.
Both patients received supportive care, with one requiring treatment during pregnancy. Antitoxin therapy was not administered due to late detection of the disease, but both patients recovered and were discharged without complications. The pregnant woman later gave birth to a healthy baby.
Food contaminated with Clostridium botulinum spores can become hazardous if stored under conditions that promote bacterial growth, such as low oxygen levels, low acidity (pH > 4.5), low salt and sugar content, and temperatures between 37 and 99 degrees Fahrenheit.
Pregnancy factor
The first patient, a 23-year-old pregnant woman, was hospitalized in August 2024. One week before hospitalization, she vomited after eating eggs. She was initially treated at a local hospital, but the cause was not determined and she was referred to another hospital.
Based on a review of her medical history, it was suspected that the cause was foodborne botulism resulting from the consumption of improperly preserved domestic eggs.
The second patient, a 47-year-old woman, presented with dizziness, blurred vision, and dysphagia that persisted for 10 days.
Egg samples were tested by the Centers for Disease Control and Prevention and were found to be positive for Clostridium botulinum type A. The patient developed symptoms 12 hours after ingestion.
“Outbreaks associated with egg consumption are rarely reported, and cases occurring during pregnancy are even rarer, posing unique diagnostic and therapeutic challenges,” the researchers said.
Botulism from dairy products
The second study describes botulism in three family members, including a pregnant woman, after consuming homemade dairy products.
All had neurological and respiratory symptoms of varying severity. Two required intubation and intensive care. Laboratory data confirmed the presence of neurotoxin type A in stool and stomach samples. Early administration of trivalent equine botulinum antitoxin and supportive care resulted in recovery.
Testing for botulinum neurotoxin was carried out at the National Reference Laboratory of Foodborne Diseases of the Pasteur Institute of Iran. The results were published in Journal of International Medical Case Reports.
Three members of the same family consumed cottage cheese and yogurt and were admitted to a public health center with symptoms consistent with botulism.
A 60-year-old woman was taken to the emergency department of Imam Reza Hospital Mashhad due to loss of consciousness and respiratory failure. She required immediate intubation for airway protection and mechanical ventilation.
The first patient's daughter, a 32-year-old pregnant woman, presented to the emergency department with fatigue, blurred vision, and shortness of breath. The antitoxin was administered on the second day. The delay was due to uncertainty of diagnosis upon admission. She was admitted to the intensive care unit (ICU) for close monitoring, including mechanical ventilation.
Four days after his mother and sister were hospitalized, a 28-year-old man presented to the emergency department. Given the clinical picture and family history, a single dose of trivalent botulinum antitoxin was urgently prescribed.
The mother and her pregnant daughter developed severe respiratory distress requiring intubation and admission to the intensive care unit, while the son had milder symptoms. The mother and sister recovered after seven days of intensive care.
“This study highlights the significant challenges in diagnosing and treating foodborne botulism in settings with limited health care resources. Public health education focusing on the risks associated with home-prepared foods, especially unpasteurized or improperly stored dairy products, is essential,” the scientists said.
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