Retrospective study of 108 cases of botulism in Poitiers, France

Roblot, P.; Roblot, F.; Fauchère, J.L.; Devilleger, A.; Maréchaud, R.; Breux, J. P.; Grollier, G.; Becq‐Giraudon, B.

doi:10.1099/00222615-40-6-379

Cited by 36 publications

(18 citation statements)

References 28 publications

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“…Among the citations included in our report, 7 contained relevant information on allergic reactions (Table 2) [16][17][18][19][20][21][22] and 4 on ST (Table 3) [16,17,19,21], which were combined for analysis. The total number of patients in the combined review was 687; most were adults.…”

Section: Allergic Reactionsmentioning

confidence: 99%

Workgroup Report by the Joint Task Force Involving American Academy of Allergy, Asthma & Immunology (AAAAI); Food Allergy, Anaphylaxis, Dermatology and Drug Allergy (FADDA) (Adverse Reactions to Foods Committee and Adverse Reactions to Drugs, Biologicals, and Latex Committee); and the Centers for Disease Control and Prevention Botulism Clinical Treatment Guidelines Workgroup—Allergic Reactions to Botulinum Antitoxin: A Systematic Review

Schussler

Sobel

Hsu

et al. 2017

Clinical Infectious Diseases

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Background. Naturally occurring botulism is rare, but a large number of cases could result from unintentional or intentional contamination of a commercial food. Despeciated, equine-derived, heptavalent botulinum antitoxin (HBAT) is licensed in the United States. Timely treatment reduces morbidity and mortality, but concerns that botulinum antitoxin can induce anaphylaxis exist. We sought to quantify the allergy risk of botulinum antitoxin treatment and the usefulness of skin testing to assess this risk.Methods. We conducted a systematic review of (1) allergic reactions to botulinum antitoxin and (2) the predictive value of skin testing (ST) before botulinum antitoxin administration. We searched 5 scientific literature databases, reviewed articles' references, and obtained data from the HBAT manufacturer and from the Centers for Disease Control and Prevention. Anaphylaxis incidence was determined for HBAT and previously employed botulinum antitoxins. We calculated the positive predictive value (PPV) and negative predictive value (NPV) of ST for anaphylaxis related to HBAT and other botulinum antitoxins.Results. Seven articles were included. Anaphylaxis incidence was 1.64% (5/305 patients) for HBAT and 1.16% (8/687 patients) for all other botulinum antitoxins (relative risk, 1.41 [95% confidence interval, .47-4.27]; P = .5). Observed values for both PPV and NPV for HBAT-ST (33 patients) were 100%. Observed PPVs and NPVs of ST for other botulinum antitoxins (302 patients) were 0-56% and 50%-100%, respectively. There were no reports of fatal anaphylaxis.Conclusions. Considering the <2 % rate of anaphylaxis, fatal outcomes, modest predictive value of ST, resource requirements for ST, and the benefits of early treatment, data do not support delaying HBAT administration to perform ST in a mass botulinum toxin exposure. Anaphylactic reactions may occur among 1%-2% of botulinum antitoxin recipients and will require epinephrine and antihistamine treatment and, possibly, intensive care.

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Section: Allergic Reactionsmentioning

confidence: 99%

Workgroup Report by the Joint Task Force Involving American Academy of Allergy, Asthma & Immunology (AAAAI); Food Allergy, Anaphylaxis, Dermatology and Drug Allergy (FADDA) (Adverse Reactions to Foods Committee and Adverse Reactions to Drugs, Biologicals, and Latex Committee); and the Centers for Disease Control and Prevention Botulism Clinical Treatment Guidelines Workgroup—Allergic Reactions to Botulinum Antitoxin: A Systematic Review

Schussler

Sobel

Hsu

et al. 2017

Clinical Infectious Diseases

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“…Although group II C. botulinum counts are generally low (19), meat-related botulism cases reported, especially in Europe, indicate that group II C. botulinum should be regarded as a potential meatbome hazard (26,27,31). The growing international trend of consumers demand for fresh food with minimal heat processing and limited use of preservatives is posing new challenges for the food industry (24).…”

Section: Methodsmentioning

confidence: 98%

“…C. botulinum spores are commonly found in soil and in the intestinal tract of cattle and pigs; therefore, spores in dust, soil, or feces may contaminate meat during slaughter or meat processing (6,7,15,16). Modem botulism cases related to meat are mainly caused by home-prepared meats, and outbreaks traced to commercial meat products are rare (26,29,31).…”

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confidence: 99%

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Inhibition of Toxigenesis of Group II (Nonproteolytic) Clostridium botulinum Type B in Meat Products by Using a Reduced Level of Nitrite

Keto-Timonen

Lindström

Puolanne

et al. 2012

Journal of Food Protection

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The effect of three different concentrations of sodium nitrite (0, 75, and 120 mg/kg) on growth and toxigenesis of group II (nonproteolytic) Clostridium botulinum type B was studied in Finnish wiener-type sausage, bologna-type sausage, and cooked ham. A low level of inoculum (2.0 log CFU/g) was used for wiener-type sausage and bologna-type sausage, and both low (2.0 log CFU/g) and high (4.0 log CFU/g) levels were used for cooked ham. The products were formulated and processed under simulated commercial conditions and stored at 8°C for 5 weeks. C. botulinum counts were determined in five replicate samples of each nitrite concentration at 1, 3, and 5 weeks after thermal processing. All samples were positive for C. botulinum type B. The highest C. botulinum counts were detected in nitrite-free products. Toxigenesis was observed in nitrite-free products during storage, but products containing either 75 or 120 mg/kg nitrite remained nontoxic during the 5-week study period, suggesting that spores surviving the heat treatment were unable to germinate and develop into a toxic culture in the presence of nitrite. The results suggest that the safety of processed meat products with respect to group II C. botulinum type B can be maintained even with a reduced concentration (75 mg/kg) of sodium nitrite.

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“…Food-borne botulism, still a common form of the disease, is caused by the ingestion of the toxin in food. Different kinds of foods have been reported to cause food botulism, including sausage, ham, honey, salted fish, meat, fermented bean products, hazelnut yogurt, fruit juice and cheese sauce (2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

An Outbreak of Food-borne Botulism Associated with Contaminated Locally-made Cheese in Iran

Pourshafie

Saifie²,

Shafiee³

et al. 1998

Scandinavian Journal of Infectious Diseases

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Cases of botulism in the northern province of Iran were studied in March and April 1997. A total of 27 patients were affected; 1 patient died. The samples were sent to the Department of Bacteriology, Pasteur Institute of Iran, for investigation. To identify the food source, several patients were interviewed and a case control investigation was conducted among families of hospitalized patients. Clinical and food specimens were tested. Toxin testing was positive for 37% of serum and stool specimens. Type A botulinal toxin was detected in cheese and Clostridium botulinum type A was isolated from cultures of clinical specimens and the cheese. This is the first documented outbreak of botulism due to Clostridium botulinum type A following consumption of cheese in Iran.

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Retrospective study of 108 cases of botulism in Poitiers, France

Cited by 36 publications

References 28 publications

Inhibition of Toxigenesis of Group II (Nonproteolytic) Clostridium botulinum Type B in Meat Products by Using a Reduced Level of Nitrite

An Outbreak of Food-borne Botulism Associated with Contaminated Locally-made Cheese in Iran

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