title: Outbreak of type A botulism caused by a commercial food product in Taiwan: clinical and epidemiological investigations.
abstract: In late September 1986, we found 7 patients from a printing factory in Chang-Hwa city who developed an endemic disease manifested by general malaise, ptosis, double vision, dysarthria, dysphagia, and proximal limb weakness. After clinical, epidemiological, microbiological, and toxicological investigations, an outbreak of botulism was confirmed 2 weeks later, Commercially canned peanuts made by an unlicensed cannery were identified as the vehicle of botulinum toxin transmission. Antitoxin was given to 2 patients who needed ventilator support. One of the 7 victims died from medical complications and the remaining 6 patients recovered. Several administrative problems exposed in this outbreak were the poor governmental supervision of canned food, the inadequate quantities of "orphan drugs" stored in this country, the inefficient system for recalling the problem products, and the delayed broadcasting of warnings to the public. Since commercially processed food is increasingly popular with modernization, the possibility of future botulism outbreaks should not be overlooked.
authors.affiliation: Department of Internal Medicine, Chung Shan Medical and Dental College, Taichung, R.O.C.
authors.forename: S J
authors.initials: SJ
authors.lastname: Tsai
authors.forename: Y C
authors.initials: YC
authors.lastname: Chang
authors.forename: J D
authors.initials: JD
authors.lastname: Wang
authors.forename: J H
authors.initials: JH
authors.lastname: Chou
mesh_terms: D000293:Adolescent; D000328:Adult; D010367:Arachis; D001906:Botulism / Q000453:epidemiology* / Q000209:etiology; D004196:Disease Outbreaks; D005260:Female; D005506:Food Contamination; D005519:Food Preservation; D006801:Humans; D008297:Male; D013624:Taiwan / Q000453:epidemiology