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- Title
Botulism from chopped garlic: delayed recognition of a major outbreak.
- Authors
St Louis, M E; Peck, S H; Bowering, D; Morgan, G B; Blatherwick, J; Banerjee, S; Kettyls, G D; Black, W A; Milling, M E; Hauschild, A H
- Abstract
Diagnosis of botulism in two teenaged sisters in Montreal led to the identification of 36 previously unrecognized cases of type B botulism in persons who had eaten at a restaurant in Vancouver, British Columbia, during the preceding 6 weeks. A case-control study implicated a new vehicle for botulism, commercial chopped garlic in soybean oil (P less than 10(-4)). Relatively mild and slowly progressive illness, dispersion of patients over at least eight provinces and states in three countries, and a previously unsuspected vehicle had contributed to prolonged misdiagnoses, including myasthenia gravis (six patients), psychiatric disorders (four), stroke (three), and others. Ethnic background influenced severity of illness: 60% of Chinese patients but only 4% of others needed mechanical ventilation (P less than 10(-3]. Trypsinization of serum was needed to show toxemia in one patient. Electromyography results with high-frequency repetitive stimulation corroborated the diagnosis of botulism up to 2 months after onset. Although botulism is a life-threatening disease, misdiagnosis may be common and large outbreaks can escape recognition completely.
- Publication
Annals of internal medicine, 1988, Vol 108, Issue 3, p363
- ISSN
0003-4819
- Publication type
Journal Article
- DOI
10.7326/0003-4819-108-3-363