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© 1989 Oxford University Press

research-article

Foodborne Botulism: An International Outbreak

PAUL E SLATER*, DAVID G ADDISS**, ALIZA COHEN{dagger}, ALEX LEVENTHAL{ddagger}, GIDEON CHASSIS§, HANNA ZEHAVI{ddagger}, ANITA BASHARI{ddagger} and CORINA COSTIN*

* Department of Epidemiology, Ministry of Health Jerusalem, Israel
** Enteric Diseases Branch, Centers for Disease Control Atlanta, Georgia, USA
{dagger} National Botulism Reference Laboratory, Kimron Veterinary Institute Beit Daggan, Israel
{ddagger} Jerusalem District Health Office Jerusalem, Israel
§ Department of Veterinary Services, Ministry of Health Jaffa, Israel

Slater P E (Department of Epidemiology, Box 1176, Ministry of Health, Jerusalem 91010, Israel), Addiss D G, Cohen A, Leventhal A, Chassis G, Zehav H, Bashari A and Costin C. Foodborne botulism: an international outbreak. International Journal of Epidemiology1989, 18: 693–696.

We report an outbreak of fishborne botulism caused by type E Clostridium botulinum. The eight cases, six in Israel and two in New York City, resulted from the consumption of ribbetz or kapchunka, a freshwater whitefish soaked in brine and air-dried, that was processed commercially in New York. Half the cases were males; the age range was 9 to 77 years. Five of the victims were hospitalized; the oldest died, and two others required ventilatory assistance. Laboratory confirmation of botulism was obtained in three cases. Prolonged lack of refrigeration during transatlantic flight and packaging contributing to an anaerobic environment were felt to be contributing environmental factors in the Israeli cases. Rapid communication and full cooperation between Israeli and US health authorities limited the extent of the outbreak. Despite adequate understanding of how foodborne botulism may be avoided, outbreaks still occur, particularly among people consuming certain high-risk or ethnic foods.


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