title: Outbreak of type A foodborne botulism at a boarding school, Uganda, 2008.
abstract: Botulism has rarely been reported in Africa. In October 2008, botulism was reported in three Ugandan boarding-school students. All were hospitalized and one died. A cohort study was performed to assess food exposures among students, and clinical specimens and available food samples were tested for botulinum toxin. Three case-patients were identified; a homemade, oil-based condiment was eaten by all three. In the cohort study, no foods were significantly associated with illness. Botulinum toxin type A was confirmed in clinical samples. This is the first confirmed outbreak of foodborne botulism in Uganda. A homemade, oil-based condiment was the probable source. Consumption of homemade oil-based condiments is widespread in Ugandan schools, putting children at risk. Clinicians and public health authorities in Uganda should consider botulism when clusters of acute flaccid paralysis are seen. Additionally, schools should be warned of the hazard of homemade oil-based condiments, and take steps to prevent their use.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA,USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Viray
authors.affiliation: Uganda Ministry of Health, Kampala,Uganda.
authors.forename: J
authors.initials: J
authors.lastname: Wamala
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA,USA.
authors.forename: R
authors.initials: R
authors.lastname: Fagan
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA,USA.
authors.forename: C
authors.initials: C
authors.lastname: Luquez
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA,USA.
authors.forename: S
authors.initials: S
authors.lastname: Maslanka
authors.affiliation: Centers for Disease Control and Prevention, Entebbe,Uganda.
authors.forename: R
authors.initials: R
authors.lastname: Downing
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA,USA.
authors.forename: M
authors.initials: M
authors.lastname: Biggerstaff
authors.affiliation: Uganda Ministry of Health, Kampala,Uganda.
authors.forename: M
authors.initials: M
authors.lastname: Malimbo
authors.affiliation: Mulago Hospital, Kampala,Uganda.
authors.forename: J B
authors.initials: JB
authors.lastname: Kirenga
authors.affiliation: Mulago Hospital, Kampala,Uganda.
authors.forename: J
authors.initials: J
authors.lastname: Nakibuuka
authors.affiliation: Mulago Hospital, Kampala,Uganda.
authors.forename: E
authors.initials: E
authors.lastname: Ddumba
authors.affiliation: World Health Organization, Kampala,Uganda.
authors.forename: W
authors.initials: W
authors.lastname: Mbabazi
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA,USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Swerdlow
mesh_terms: D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000378:metabolism*; D001906:Botulism / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D047013:Clostridium botulinum type A / Q000302:isolation & purification*; D015331:Cohort Studies; D003906:Developing Countries; D004196:Disease Outbreaks; D005260:Female; D005506:Food Contamination; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012572:School Health Services; D013334:Students; D015996:Survival Rate; D014454:Uganda / Q000453:epidemiology
chemical_list: D019274:Botulinum Toxins, Type A