First cross-border outbreak of foodborne botulism in the European Union associated with the consumption of commercial dried roach (Rutilus rutilus)

Abstract

Botulism outbreaks due to commercial products are extremely rare in the European Union. Here we report on the first international outbreak of foodborne botulism caused by commercial salt-cured, dried roach (Rutilus rutilus). Between November and December 2016, an outbreak of six foodborne botulism type E cases from five unrelated households was documented in Germany and Spain. The outbreak involved persons of Russian and Kazakh backgrounds, all consumed unheated salt-cured, dried roach—a snack particularly favored in Easter-European countries. The implicated food batches had been distributed by an international wholesaler and were recalled from Europe-wide outlets of a supermarket chain and other independent retailers. Of interest, and very unlike to other foodborne disease outbreaks which usually involves a single strain or virus variant, different Clostridium botulinum strains and toxin variants could be identified even from a single patient's sample. Foodborne botulism is a rare but potentially life-threatening disease and almost exclusively involves home-made or artisan products and thus, outbreaks are limited to individual or few cases. As a consequence, international outbreaks are the absolute exception and this is the first one within the European Union. Additional cases were likely prevented by a broad product recall, underscoring the importance of timely public health action. Challenges and difficulties on the diagnostic and epidemiological level encountered in the outbreak are highlighted.

Exploring the genetic background of the botulism neurotoxin BoNT/B2 in Spain

“…The highest incidences have been recorded in Italy and Romania. Food-borne botulism outbreaks are, however, reported worldwide, and depend notably on dietary habits and culinary traditions ( 1 , 25 ). An unusually high prevalence of infant botulism is reported in the United States (100 cases per year), especially northern California, eastern Pennsylvania, southern New Jersey, and northern Delaware.…”

Botulism in fish: a review

“…Human cases of type E foodborne botulism are most commonly seen in association with consumption of fermented or pickled fish, and based on this, it is thought that the fermentation and pickling process allows the development of anaerobic conditions that promote germination of spores and toxin formation. 24 Sporadic reports of botulism in fish are documented in the scientific literature. In commercial fish production, several large-scale mortality events in salmonid hatcheries have been attributed to type E botulism.…”

“…Although C. botulinum type E has been associated frequently with fish and fish-eating birds, several cases of human disease have also been reported. 24 The number of type E outbreaks in humans depends on the country and on dietary habits. 22 Type E outbreaks were also detected in poultry on farms in France in the late 1990s 33 ; the source of contamination was not identified, but this outbreak shows that type E botulism outbreaks can occur in species other than fish, piscivorous birds, and humans.…”

“…Human cases of type E foodborne botulism are most commonly seen in association with consumption of fermented or pickled fish, and based on this, it is thought that the fermentation and pickling process allows the development of anaerobic conditions that promote germination of spores and toxin formation. 24…”

Navigating the Complexities Involving the Identification of Botulinum Neurotoxins (BoNTs) and the Taxonomy of BoNT-Producing Clostridia

“…Epidemiology studies related to human or animal botulism are designed to trace the source of intoxications and prevent further spread of botulism when associated with foodborne outbreaks [ 81 , 82 ]. They may also be used to determine source batches of contaminated heroin related to wound botulism cases [ 83 , 84 ], and they have been employed in infant botulism cases as well [ 85 , 86 ].…”