outbreak of botulism associated with fermented beaver – alaska, 2001 louisa castrodale, dvm, mph...
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Outbreak of Botulism Associated with
Fermented Beaver – Alaska, 2001
Louisa Castrodale, DVM, MPHSection of EpidemiologyAlaska Division of Public
Health
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Outbreak
Southwestern Alaska village14 Alaska NativesBeaver paw and tailLunchtime on January 17Following morning, symptoms
compatible with botulism
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Botulism
Ingestion of toxin produced by Clostridium botulinum
Blocks Ach release at neuromuscular junctions
Symmetrical descending paralysisIncubation 12-36 hrs (range 6-240)Case fatality rate 5-10%
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Symptoms
GI, neurologic, respiratoryDiagnostic Pentad
Nausea or vomitingDysphagiaDiplopiaDilated, fixed pupilsDry throat
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Botulism in Alaska
First outbreak in 1940sHighest rate in United StatesCase-patients all Alaska NativesConsuming traditional foodsRecent decline coincident with
prevention efforts by AIP-CDC
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Methods
Interviews of exposed persons–Symptoms and onset–Food history
Details of food preparationSpecimens collected–Serum, stool, gastric aspirate–Beaver
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Persons Exposed
Person Pentad Level Antitoxin # (n/5) of care (A/B & E)
1 4 tertiary* Y2 3 tertiary* Y3 3 tertiary Y4-14 < 1 observed N
each for >48 hrs
*placed on ventilator
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Beaver Paws Tested for BotulinumToxin at CDC, Atlanta, GA
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Results
Toxin type E–Serum from Persons 1 and 2–Stool from Person 3–Beaver paws–Cultures pending
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Fermentation Process
Beavers hunted Nov ‘00 - Jan ‘01Cut up and placed in heavy paper
sack; left to ferment in entryway
C. botulinum spores ubiquitous; toxin production facilitated by–Anerobic conditions–Warm environment
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Summary
Outbreak associated with consumption of fermented beaver
Three cases of botulism confirmed
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Recommendations
Still a need to evaluate educational messages and prevention strategies that emphasize safe fermentation and consumption practices
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Acknowledgments
Coauthor: Michael Beller
Andrea Horn, RS, BBAHCSusan Maslanka, CDC/Bot LabArctic Investigations ProgramAK State Public Health
Laboratory