Outbreak of foodborne botulism in Alexandria, Egypt: modulating indications for administration of heptavalent botulinum antitoxin

Abstract

Background: In October 2019, 94 patients were admitted into Alexandria Poison Center (APC) with a history of ingestion of Feseekh (salted sh). As a trial to allocate the resources, not all patients were given Heptavalent botulinum antitoxin (HBAT) immediately.The current study aimed to portray the clinical characteristics of the cases, explore the possible relation between these characteristics and necessity of HBAT administration, explore the reliability of MLT, and to establish a clinical guide for management with preservation of resources.Subject and Method: the current prospective study included 94 patients who were admitted to Alexandria Poison Center (APC) in the period from 29 th September to 27 th October 2019. The patients' data was recorded using a checklist that includes: personal data, past medical history, clinical assessment, investigations, treatment and the outcome. The checklist was carried out to assess and follow up each patient. Hospitalized patients were categorized according to symptoms consistent with botulism. The equine HBAT, made by Emergent BioSolutions Canada Inc. (formerly Can gene Corporation) was used in the treatment.Results: HBAT was given to (36.2%) patients only out of the total admission. However, 87.2% of patients were completely cured, whereas 10.6% of patients were discharged with mild neurological sequelea and death occurred only in two cases (2.2%). Conclusion: 63.8% of cases with suspected foodborne botulism toxicity could be managed by supportive treatment only with no need for HBAT.

Integrating climate change, food safety, nutrition, and health outcomes in food systems policies and programs in Africa

“…Similarly, Bacha et al (2021) documented a rare case of clostridium botulism in Ethiopia due to homemade and fermented foods. Numerous scholars, including Smith et al (1979) and Knightingale and Ayim (1980) in Kenya, Weber et al (1993) and Ghitani et al (2021) in Egypt, and Frean et al (2004) in South Africa, have reported similar cases. Viray et al (2014) also documented a comparable incident in Uganda.…”