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Original ArticleOpen Access
Foodborne Botulism Outbreaks Following Consumption of Home-Canned Bamboo Shoots in Northern Thailand
Swaddiwudhipong W 
,
Wong;mtcharapaiboon P
,
Wong;mtcharapaiboon P We report epidemiological investigations of 2 outbreaks of foodborne botulism following
consumption of home-canned bamboo shoots in northern Thailand. The first outbreak affecting
4 female and 2 male cases occurred in Mae Sot District, Tak Province, in December 1997. All 6
cases were hospitalized, 4 of whom required mechanical ventilation. All cases experienced
neurological features and 4 had gastrointestinal symptoms. One case died, giving a case-fatality
rate of 16.7 per cent. A case-control study revealed a significant association (p
<
0.0 I) between the
disease and consumption of home-canned bamboo shoots purchased from the same foodshop in
the village. The second outbreak of a similar clinical syndrome occurred in Thawangpha District,
Nan Province, in April 1998. A total of 13 cases were identified, 9 (69.2%) of whom were female.
Nine cases (69.2%) were hospitalized, 4 (30.8%) of whom required mechanical ventilation.
Two early hospitalized cases died due to ventilatory failure, giving a case-fatality rate of 15.4
per cent. A case-control study indicated that home-canned bamboo shoots prepared by a local
foodshop served as the vehicle for the disease transmission. One bamboo shoot specimen from one
affected house was positive for botulinum toxin type A by enzyme-linked immunosorbent assay
and mouse antitoxin bioassay. Improper home-canning procedures for bamboo shoot preservation
were similarly detected in both outbreaks although performed by different merchants. Prompt
recognition and treatment of the disease are essential in reducing the fatality rate. Safe home-canning
procedures should be widely distributed and instructed to persons who perfonn bamboo shoot
preservation for sale.
Key word
: Foodborne Botulism, Home-Canned Food
consumption of home-canned bamboo shoots in northern Thailand. The first outbreak affecting
4 female and 2 male cases occurred in Mae Sot District, Tak Province, in December 1997. All 6
cases were hospitalized, 4 of whom required mechanical ventilation. All cases experienced
neurological features and 4 had gastrointestinal symptoms. One case died, giving a case-fatality
rate of 16.7 per cent. A case-control study revealed a significant association (p
<
0.0 I) between the
disease and consumption of home-canned bamboo shoots purchased from the same foodshop in
the village. The second outbreak of a similar clinical syndrome occurred in Thawangpha District,
Nan Province, in April 1998. A total of 13 cases were identified, 9 (69.2%) of whom were female.
Nine cases (69.2%) were hospitalized, 4 (30.8%) of whom required mechanical ventilation.
Two early hospitalized cases died due to ventilatory failure, giving a case-fatality rate of 15.4
per cent. A case-control study indicated that home-canned bamboo shoots prepared by a local
foodshop served as the vehicle for the disease transmission. One bamboo shoot specimen from one
affected house was positive for botulinum toxin type A by enzyme-linked immunosorbent assay
and mouse antitoxin bioassay. Improper home-canning procedures for bamboo shoot preservation
were similarly detected in both outbreaks although performed by different merchants. Prompt
recognition and treatment of the disease are essential in reducing the fatality rate. Safe home-canning
procedures should be widely distributed and instructed to persons who perfonn bamboo shoot
preservation for sale.
Key word
: Foodborne Botulism, Home-Canned Food
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