Two clusters of botulism, affecting a total of eight people, in southern and northern France have been associated with eating tapenade, a food product based on ground olives.
French authorities have recalled additional artisan products due to this outbreak. Products from the implicated producer are sold under three brand names: Terre de Mistral, Le Secret D'Anais and Les Delices de Marie Claire and were available for online purchase from the following two websites: www.chocolatprovence.com and http://www.epicerie-terroirprovence.com. A full list of products produced by the implicated producer is available on the Food Safety Authority of Ireland website.
Botulism is caused by a botulinum toxin, which is a poison produced by the bacterium Clostridium botulinum. The bacterium is commonly found in the soil in the form of spores. Botulism produces a neurological condition affecting the nerves of the body. Symptoms often begin with blurred vision and difficulty in swallowing and speaking, but sometimes diarrhoea and vomiting can occur. The disease can lead to problems with vision, and paralysis. Most cases make a recovery, but the recovery period can be many months. The disease can be fatal in 5-10% of cases. Botulism is a notifiable disease in Ireland.
More information on botulism is available on the HPSC website here.
Botulism Outbreak in France
Two clusters of botulism, affecting a total of eight people, in southern and northern France have been associated with eating tapenade, a food product based on ground olives.
All cases had consumed tapenade produced in the Vaucluse district of southern France under the brand name "Les Délices de Marie-Claire", batch number 112005. This product is distributed in four districts in southern France (i.e. Bouches-du-Rhône, Drome, Var and Vaucluse), and was available in food delicatessen stores since 31 May 2011 with a best before date of 16 December 2012. French authorities have issued a national recall of all products produced by the implicated producer, and have informed the public health authorities of all European Member States.
Tourists who may have purchased this product while staying in France, are advised not to consume it.
Botulism is caused by a botulinum toxin, which is a poison produced by the bacterium Clostridium botulinum. The bacterium is commonly found in the soil in the form of spores. Botulism produces a neurological condition affecting the nerves of the body. Symptoms often begin with blurred vision and difficulty in swallowing and speaking, but sometimes diarrhoea and vomiting can occur. The disease can lead to problems with vision, and paralysis. Most cases make a recovery, but the recovery period can be many months. The disease can be fatal in 5-10% of cases. Botulism is a notifiable disease in Ireland.
More information on botulism is available on the HPSC website here.
More information (in French) about this event is available on the French official websites:
Botulism outbreak among injection drug users in Dublin
The Health Protection Surveillance Centre has been notified of six cases of botulism occurring in injection drug users in the Dublin region since the end of November. Additionally, one death associated with disease has been reported in an injection drug user (10th December 2008).
The incident is being managed by an outbreak control team from the Department of Public Health (East) and alerts have been issued to drug services and relevant clinical staff in emergency departments and other locations.
HPSC urges all clinicians and other health professionals to be on the lookout for botulism in injecting drug users. Injection drug users who may unknowingly be exposed to drugs that may be contaminated with the bug that causes botulism are urged to seek immediate medical attention if they develop any of the signs or symptoms of the disease.
Disease may develop between 4-14 days after use of contaminated drug. Symptoms typically begin with a dry mouth, blurred or double vision, drooping eyelids, difficulty swallowing, difficulty speaking and may progress to breathing problems, weakness of arms and legs and more severe paralysis. Any injection drug user who experiences these symptoms should seek medical attention immediately. Most people with botulism will recover with treatment, but it can take months. Even in countries with treatment the disease is fatal in 5-10% of cases.
Botulism outbreaks have previously been reported among injection drug users, most recently in 2002 when 3 cases were reported. Using contaminated heroin is a risk factor for botulism, particularly among drug users who inject the drug either into the muscle or under the skin (skin popping).
Health professionals urged to lookout for botulism after four suspected cases in drug users
HPSC and the HSE East Public Health Department have been informed of four presumptive cases of wound botulism – all affecting injecting drug users - which are under investigation in the HSE Eastern Region.
Wound botulism is a rare condition and further test results are awaited to confirm these cases. Wound botulism is caused by a toxin that is commonly found as spores in soil. The illness can be caused if a wound is contaminated by soil or gravel. In recent years this type of botulism has been most commonly reported among chronic drug users. It occurs mainly in skin abscesses from injecting heroin but can also be caused by snorting cocaine.
Symptoms usually develop about 12-36 hours after exposure to the toxin and typically begin with blurred vision, difficulty swallowing, difficulty speaking and occasionally breathing problems. Diarrhoea and vomiting can also occur and the disease can progress to paralysis. Anyone who experiences these symptoms should seek medical attention immediately. Most people with botulism will recover with treatment, but it can take months. The disease is fatal in 5-10% of cases.
Botulism has previously been reported in drug users but few cases are seen in Ireland. The last cases of botulism in drug users occurred in 2002 when three injecting drug users developed botulism.
Case of Foodborne Botulism in Ireland
HPSC has been made aware of a case of botulism in a non-national individual resident in Ireland. The case has been fully investigated and there are no implications as regards food on sale in Ireland.
Foodborne Botulism Cases of foodborne botulism are very rare in Ireland. This is the first case reported to HPSC since botulism was made a notifiable disease in 2004.
Botulism is a neurological condition produced by ingestion of a toxin produced by a bacterium Clostridium botulinum. Illness usually occurs when the bacteria have reproduced in an environment outside the body and produced toxin - this environment is usually a foodstuff. The individual then consumes the toxin itself when they eat the food, and this makes them ill with weakness and paralysis. Clostridium botulinum is an "anaerobic bacterium" which means it can only grow in the absence of oxygen, so botulism in adults tends to occur when the spores have somehow got into an airtight environment such as tins or jars, particularly home-preserved foods which have been preserved in oil. The toxin is destroyed by normal cooking processes.
The National Disease Surveillance Centre has been notified of a case of botulism, which has been identified in the Eastern Regional Health Authority. This case is under investigation by the ERHA. It has arisen in an injecting drug user. In February 2002 three cases of botulism were reported in injecting drug users in the UK.
The NDSC and the Department of Health and Children have asked public health doctors and other health professionals to be alert to possible cases of botulism.
Botulism is a rare condition that is caused by botulinum toxin, a poison produced by the bacterium Clostridium botulinum. The bacterium is common in the soil in the form of spores. It usually takes about 12-36 hours to start to develop symptoms once you have been exposed to the toxin. More than 90% of cases are treated successfully but some prove fatal.
Persons with botulism may complain of symptoms such as blurred vision, difficulty swallowing, difficulty in speaking, paralysis and breathing problems. Treatment is with a special botulism antitoxin antidote and antibiotics.
It is possible that this case may be associated with injecting drug use. The advice to those who inject drugs is:
Never, ever share needles, syringes, cookers/spoons or other 'works' with other users.
Smoking heroin is less harmful than injecting
If you must inject, do not inject into muscle or under the skin: make sure you hit the vein - blood kills bugs better than muscle.
Use as little citric acid as possible to dissolve the heroin. Too much damages skin and muscle and gives bugs a better chance to grow and cause infection.
If you inject more than one type of drug, don't inject them all in the same place. This is important because some drugs, like cocaine could give any bacteria in heroin a better chance to grow.
