title: Outbreak of Botulism After Consumption of Illicit Prison-Brewed Alcohol in a Maximum Security Prison--Arizona, 2012.
abstract: The authors investigated the second botulism outbreak to occur in a maximum security prison in Arizona within a 4-month period. Botulism was confirmed in eight men aged 20 to 35 years who reported sharing a single batch of pruno made with potatoes. Initial symptoms included blurred vision, slurred speech, muscle weakness, ptosis, and dysphagia. All patients received heptavalent botulinum antitoxin, seven required mechanical ventilation, and all survived. The median incubation period was 29 hours. Sera from all patients and leftover pruno tested positive for botulinum toxin type A. Botulism should be considered among prisoners with cranial nerve palsies and descending, symmetric flaccid paralysis. Prison-brewed alcohol, particularly when made with potatoes, can be a vehicle for botulism and is associated with outbreaks of botulism in prisons.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA Arizona Department of Health Services, Phoenix, AZ, USA seemayasmin@gmail.com.
authors.forename: Seema
authors.initials: S
authors.lastname: Yasmin
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA Arizona Department of Health Services, Phoenix, AZ, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Adams
authors.affiliation: Pinal County Public Health Services, Florence, AZ, USA.
authors.forename: Graham
authors.initials: G
authors.lastname: Briggs
authors.affiliation: Arizona Department of Health Services, Phoenix, AZ, USA.
authors.forename: Joli
authors.initials: J
authors.lastname: Weiss
authors.affiliation: Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Kris
authors.initials: K
authors.lastname: Bisgard
authors.affiliation: Arizona Department of Health Services, Phoenix, AZ, USA Metro Public Health Department, Nashville, TN, USA Present address.
authors.forename: Shoana
authors.initials: S
authors.lastname: Anderson
authors.affiliation: Arizona Department of Health Services, Phoenix, AZ, USA.
authors.forename: Clarisse
authors.initials: C
authors.lastname: Tsang
authors.affiliation: Arizona Department of Health Services, Phoenix, AZ, USA 3M Food Safety, 3M Center, St. Paul, MN, 55144 Present address.
authors.forename: Evan
authors.initials: E
authors.lastname: Henke
authors.affiliation: Mountain Vista Medical Center, Mesa, AZ, USA.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Vasiq
authors.affiliation: Arizona Department of Health Services, Phoenix, AZ, USA.
authors.forename: Ken
authors.initials: K
authors.lastname: Komatsu
mesh_terms: D000328:Adult; D000434:Alcoholic Beverages / Q000633:toxicity*; D001130:Arizona; D001904:Botulinum Antitoxin / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000302:isolation & purification; D001906:Botulism / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D011330:Prisons; D012121:Respiration, Artificial; D011198:Solanum tuberosum
chemical_list: D001904:Botulinum Antitoxin; D019274:Botulinum Toxins, Type A
keywords: botulinum; botulism; outbreak; prison