title: Foodborne botulism in southwest Romania during the post-communism period 1990-2007.
abstract: OBJECTIVE
  This study was a retrospective investigation of botulism cases over a period of 18 years following major political and economic changes, addressing the question of whether this disease is still an important health concern in southwest Romania.
  
  
  METHODS
  The medical records of botulism cases were used as the source of data. Patients from five southwest Romanian counties were hospitalized at Victor Babes Hospital of Infectious Diseases in Timisoara during the period 1990-2007.
  
  
  RESULTS
  The median annual incidence of botulism cases in southwest Romania decreased from 0.1 per 100 000 persons during 1990-1998, to 0.05 per 100 000 persons during 1999-2007. Most of the cases (18.6%) were diagnosed in 1990, immediately following the communism period. The median age of the patients was 38 years (range 16-73 years); 24 (55.8%) were male; the case fatality rate was 2.3%. A significantly higher incidence rate of 2.7 cases per 100 000 persons occurred in rural areas, even though most of the cases (53.5%) were inhabitants of urban areas. The clinical pattern included: difficulty swallowing (79.1%), double and/or blurred vision (69.8%), dry mouth (60.5%), drooping eyelids (51.2%), vomiting (39.5%), mydriasis (37.2%), constipation (27.9%), abdominal pain (23.3%), and slurred speech (18.6%). All cases were attributed to contaminated food sources, mainly home-prepared traditional pork products.
  
  
  CONCLUSIONS
  Although the botulism cases decreased over the study period in southwest Romania, this life-threatening disease continues to be an important concern. A strategy addressing individual behaviors in the home is needed to improve food safety.
authors.affiliation: Victor Babes University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania. adriana.neghina@gmail.com
authors.forename: Adriana Maria
authors.initials: AM
authors.lastname: Neghina
authors.forename: Iosif
authors.initials: I
authors.lastname: Marincu
authors.forename: Roxana
authors.initials: R
authors.lastname: Moldovan
authors.forename: Ioan
authors.initials: I
authors.lastname: Iacobiciu
authors.forename: Raul
authors.initials: R
authors.lastname: Neghina
mesh_terms: D000818:Animals; D001906:Botulism / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004196:Disease Outbreaks; D005506:Food Contamination; D005517:Foodborne Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008460:Meat / Q000382:microbiology; D008499:Medical Records; D011057:Politics; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology