Three botulism cases tied to carrot juice

Sep 18, 2006 (CIDRAP News) – Three people in Georgia recently contracted botulism after drinking contaminated carrot juice, prompting health officials to warn that carrot juice must be kept refrigerated.

The three patients fell ill a day after sharing a Sep 7 meal that included two bottles of carrot juice, the Centers for Disease Control and Prevention (CDC) reported in a Sep 16 notice. Botulinum toxin type A was found in leftover juice from one of the two bottles (the other bottle had been rinsed with water) and in the serum and stool of all three patients, the CDC said.

The bottle labels said the juice came from Bolthouse Farms, Bakersfield, Calif., the CDC reported. But in a Sep 15 news release, Georgia health officials said investigators found that other people had bought and drunk the same product from the same store in the previous 3 weeks without getting sick, which suggested that the toxin was not in the product before it was sold.

The Food and Drug Administration (FDA), in a Sep 17 news release, said the carrot juice was pasteurized and that the cases "may have been due to the product not being properly refrigerated." Botulism spores can survive pasteurization, according to the CDC.

"Because botulism is such a potentially serious illness, we want to remind consumers that it is critical to refrigerate carrot juice for safety," said Dr. Robert Brackett, director of the FDA's Center for Food Safety and Applied Nutrition. The agency said inadequate refrigeration allows botulism organisms to multiply enough to cause illness.

The Georgia news release said the three patients were from Washington County and were being treated in hospitals, but officials gave no other information about them.

Botulinum toxin is a nerve poison produced by Clostridium botulinum, a bacterium commonly found in soil. Botulism symptoms include double or blurred vision, droopy eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness, according to the CDC. If the illness is not treated, it can progress to paralysis of the limbs, trunk, and breathing muscles.

The FDA said about 24 cases of foodborne botulism are reported in the United States each year, on average. Botulism can also result from infected wounds. Infants are more susceptible to botulism than adults and older children are and can contract it from spores found in honey and other sources.

See also:

Sep 17 FDA news release
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2006/ucm108734.htm

CIDRAP overview of botulism

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