title: A large outbreak of botulism: the hazardous baked potato.
abstract: In April 1994, the largest outbreak of botulism in the United States since 1978 occurred in El Paso, Texas. Thirty persons were affected; 4 required mechanical ventilation. All ate food from a Greek restaurant. The attack rate among persons who ate a potato-based dip was 86% (19/22) compared with 6% (11/176) among persons who did not eat the dip (relative risk [RR] = 13.8; 95% confidence interval [CI], 7.6-25.1). The attack rate among persons who ate an eggplant-based dip was 67% (6/9) compared with 13% (241189) among persons who did not (RR = 5.2; 95% CI, 2.9-9.5). Botulism toxin type A was detected from patients and in both dips. Toxin formation resulted from holding aluminum foil-wrapped baked potatoes at room temperature, apparently for several days, before they were used in the dips. Consumers should be informed of the potential hazards caused by holding foil-wrapped potatoes at ambient temperatures after cooking.
authors.affiliation: Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. fja0@cdc.gov
authors.forename: F J
authors.initials: FJ
authors.lastname: Angulo
authors.forename: J
authors.initials: J
authors.lastname: Getz
authors.forename: J P
authors.initials: JP
authors.lastname: Taylor
authors.forename: K A
authors.initials: KA
authors.lastname: Hendricks
authors.forename: C L
authors.initials: CL
authors.lastname: Hatheway
authors.forename: S S
authors.initials: SS
authors.lastname: Barth
authors.forename: H M
authors.initials: HM
authors.lastname: Solomon
authors.forename: A E
authors.initials: AE
authors.lastname: Larson
authors.forename: E A
authors.initials: EA
authors.lastname: Johnson
authors.forename: L N
authors.initials: LN
authors.lastname: Nickey
authors.forename: A A
authors.initials: AA
authors.lastname: Ries
mesh_terms: D000818:Animals; D019274:Botulinum Toxins, Type A / Q000032:analysis; D001906:Botulism / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D003014:Clostridium botulinum / Q000254:growth & development / Q000302:isolation & purification / Q000378:metabolism; D004196:Disease Outbreaks; D004576:Electromyography; D005243:Feces / Q000382:microbiology; D005516:Food Microbiology; D006801:Humans; D051379:Mice; D011198:Solanum tuberosum / Q000382:microbiology*; D013781:Texas / Q000453:epidemiology
chemical_list: D019274:Botulinum Toxins, Type A