International Outbreak of Severe Botulism with Prolonged Toxemia Caused by Commercial Carrot Juice

Sheth, Anandi N.; Wiersma, Petra; Atrubin, David; Dubey, Vinita; Zink, Donald L.; Skinner, Guy E.; Doerr, Fran; Juliao, Patricia; Gónzalez, Germán E.; Burnett, Cindy; Drenzek, Cherie; Shuler, Carrie M.; Austin, John W.; Ellis, Andrea; Maslanka, Susan E.; Sobel, Jeremy

doi:10.1086/592574

Cited by 107 publications

(61 citation statements)

References 9 publications

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“…BoNT/A, /B, /C, /D, /E, /F, and /G complexes were obtained from Metabiologics (Madison, WI). BoNT contaminated carrot juice obtained from bottles of carrot juice that were implicated in a botulism outbreak in 2006, 20 was provided by the U. S. Food and Drug Administration.…”

Section: Experimental Procedures Materialsmentioning

confidence: 99%

Subtyping Botulinum Neurotoxins by Sequential Multiple Endoproteases In-Gel Digestion Coupled with Mass Spectrometry

Wang¹,

Baudys²,

Rees³

et al. 2012

Anal. Chem.

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Botulinum neurotoxin (BoNT) is one of the most toxic substances known. BoNT is classified into seven distinct serotypes labeled A through G. Among individual serotypes, researchers have identified subtypes based on amino acid variability within a serotype and toxin variants with minor amino acid sequence differences within a subtype. BoNT subtype identification is valuable for tracing and tracking bacterial pathogens. A proteomics approach is useful for BoNT subtyping since botulism is caused by botulinum neurotoxin and does not require the presence of the bacteria or its DNA. Enzymatic digestion and peptide identification using tandem mass spectrometry determines toxin protein sequences. But with the conventional one-step digestion method, producing sufficient numbers of detectable peptides to cover the entire protein sequence is difficult and incomplete sequence coverage results in uncertainty in distinguishing BoNT subtypes and toxin variants because of high sequence similarity. We report here a method of multiple enzymes and sequential in-gel digestion (MESID) to characterize the BoNT protein sequence. Complementary peptide detection from toxin digestions has yielded near-complete sequence coverage for all seven BoNT serotypes. Application of the method to a BoNT-contaminated carrot juice sample resulted in the identification of 98.4% protein sequence which led to a confident determination of the toxin subtype.

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Section: Experimental Procedures Materialsmentioning

confidence: 99%

Subtyping Botulinum Neurotoxins by Sequential Multiple Endoproteases In-Gel Digestion Coupled with Mass Spectrometry

Wang¹,

Baudys²,

Rees³

et al. 2012

Anal. Chem.

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“…Home bottled mushrooms in England (Roberts et al, 1998) and home preserved asparagus in Italy (Zanon et al, 2006). Other FoNAO associated with botulism outside the EU have included include: canned, bottled, vacuum packed and preserved vegetables in the US Horwitz et al, 1975;Roberts et al, 1998;Zanon et al, 2006), vegetable products and juices in the US (CDC, 2006a;Sheth et al, 2008); dried and fermented bean curd in the US and Taiwan (CDC, 2007a;Lai et al, 2011), an alcoholic vegetable drink in the US (Vugia et al, 2009); vegetables in oil in the US and Canada (Lohse et al, 2003;Morse et al, 1990;St Louis et al, 1988); aluminium foil-wrapped baked potatoes in the US (Cawthorne et al, 2005;Pingeon et al, 2011); preserved olives in Finland and Turkey (Jalava et al, 2011;Swaan et al, 2010) and potato salad as well as potato soup in the US (Bhutani et al, 2005;CDC, 2011c;Seals et al, 1981). Consumption of corn syrup has been epidemiologically identified as a risk factor for infant botulism in the US (Olsen and Swerdlow, 2000;Spika et al, 1989).…”

Section: Clostridium Botulinummentioning

confidence: 99%

Scientific Opinion on the risk posed by pathogens in food of non-animal origin. Part 1 (outbreak data analysis and risk ranking of food/pathogen combinations)

Publication¹

2013

EFSA Journal

174

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European Food Safety Authority (EFSA), Parma, Italy ABSTRACTFood of non-animal origin (FoNAO) is consumed in a variety of forms, and a major component of almost all meals. These food types have the potential to be associated with large outbreaks as seen in 2011 associated with VTEC O104. A comparison of the incidence of human cases linked to consumption of FoNAO and of food of animal origin (FoAO) was carried out to provide an indication of the proportionality between these two groups of foods. It was concluded that outbreak data reported as part of EU Zoonoses Monitoring is currently the only option for EU-wide comparative estimates. Using this data from 2007 to 2011, FoNAO were associated with 10% of the outbreaks, 26% of the cases, 35% of the hospitalisations and 46% of the deaths. If the data from the 2011VTEC O104 outbreak is excluded, FoNAO was associated with 10% of the outbreaks, 18% of cases, but only 8% of the hospitalisations and 5% of the deaths. From 2008 to 2011 there was an increase in the numbers of reported outbreaks, cases, hospitalisations and deaths associated with food of non-animal origin. In order to identify and rank specific food/pathogen combinations most often linked to human cases originating from FoNAO in the EU, a model was developed using seven criteria: strength of associations between food and pathogen based on the foodborne outbreak data from EU Zoonoses Monitoring (2007-11), incidence of illness, burden of disease, dose-response relationship, consumption, prevalence of contamination and pathogen growth potential during shelf life. Shortcomings in the approach using outbreak data were discussed. The top ranking food/pathogen combination was Salmonella spp. and leafy greens eaten raw followed by (in equal rank) Salmonella spp. and bulb and stem vegetables, Salmonella spp. and tomatoes, Salmonella spp. and melons, and pathogenic Escherichia coli and fresh pods, legumes or grain.© European Food Safety Authority, 2013 KEY WORDSFood of non-animal origin, foodborne pathogens, foodborne outbreaks, food/pathogen combination, risk ranking SUMMARYThe European Commission asked EFSA"s BIOHAZ Panel to prepare a scientific Opinion on the public health risk posed by pathogens that may contaminate food of non-animal origin (FoNAO). In particular, this opinion addresses the first two terms of reference for the mandate, namely: (i) to compare the incidence of foodborne human cases linked to FoNAO and foodborne cases linked to food of animal origin (FoAO), and (ii) to identify and rank specific food/pathogen combinations most often linked to foodborne human cases originating from FoNAO in the EU.For the comparison of the incidence of foodborne human cases linked to FoNAO and foodborne cases linked to FoAO, the BIOHAZ Panel concluded that: the analysis of the outbreak data reported as part of EU Zoonoses Monitoring allows attribution of human cases to food of non-animal origin or food of animal origin, and is currently the only option for obtaining a EU-wide comparative estimate of the proportion ...

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“…The general circulation can be considered as a "holding compartment" from where small but sufficient amounts of toxin are delivered to target neuron endings [3]. Indeed, in food-borne botulism, most of the patients show the presence of toxin in the serum, and the toxemia can persist until 25 days after symptom onset [163]. However, in some cases of food-borne botulism (20-30 %) and in the majority of infant botulism, BoNT is not detectable in the serum.…”

Section: Bont Disseminationmentioning

confidence: 99%

Absorption and Transport of Botulinum Neurotoxins

Popoff

Connan

2014

Molecular Aspects of Botulinum Neurotoxin

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Botulinum neurotoxin (BoNT) is a potent toxin, which blocks the neurotransmitter release at neuromuscular junctions. BoNT can be acquired from the digestive tract (food-borne botulism, Clostridium botulinum intestinal colonization), respiratory tract (inhalational botulism), or wound (wound botulism). BoNT associates to nontoxic proteins (ANTPs), which have a main role in toxin protection against acidic pH and proteases, especially in the gastrointestinal tract. BoNT, which enters through the digestive or respiratory tract, has to first cross the epithelial barrier. This is achieved by a receptor-mediated transcytosis, which delivers the whole and active toxin at the basolateral side of epithelial cells. ANTPs containing hemagglutinins (HAs) may have an additional role in altering the intercellular junctions and facilitating toxin passage through the paracellular way. Then, BoNT disseminates locally and at distance via the blood/lymph circulation and possibly via a retrograde axonal transport to the target motor neuron endings, where the toxin uses an endocytic pathway permitting the release of the light (L)-chain into the cytosol and its subsequent proteolytic activity towards the soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) proteins involved in the neurotransmitter exocytosis.

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International Outbreak of Severe Botulism with Prolonged Toxemia Caused by Commercial Carrot Juice

Cited by 107 publications

References 9 publications

Subtyping Botulinum Neurotoxins by Sequential Multiple Endoproteases In-Gel Digestion Coupled with Mass Spectrometry

Subtyping Botulinum Neurotoxins by Sequential Multiple Endoproteases In-Gel Digestion Coupled with Mass Spectrometry

Scientific Opinion on the risk posed by pathogens in food of non-animal origin. Part 1 (outbreak data analysis and risk ranking of food/pathogen combinations)

Absorption and Transport of Botulinum Neurotoxins

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