This is an official CDC HEALTH ADVISORY
Distributed via Health Alert Network
Saturday, September 16, 2006, 0:31 EDT (12:31 PM EDT)
CDCHAN-00250-2006-09-16-ADV-N
Outbreak of Botulinum toxin
Type A associated with bottled carrot juice
A commercial beverage has been confirmed as the cause of a
cluster of three botulism cases in Georgia. The three patients had onset
of symptoms on Friday, September 8th, after consuming a common meal that
included commercially produced carrot juice on Thursday, September 7th. Two
bottles of juice were consumed. All three patients drank from bottle #1;
whether all three patients drank from bottle #2 is unknown. Botulinum
toxin type A was identified in the serum and stool of all three patients by
mouse bioassay. Subsequently, botulinum toxin type A was identified from
carrot juice remaining in bottle #1 by mouse bioassay. Bottle #2 had been
rinsed with water, and the test for toxin was negative. The label on the
implicated bottle reads “Bolthouse Farms, Bakersfield,
California, 100% carrot juice.” The use by date is 09-18-06.
The investigation is ongoing. It is unknown whether
the contaminated juice was subjected to time or temperature abuse that might
have facilitated the growth of Clostridium botulinum spores, which can
survive pasteurization. CDC has not been notified of any cases of
suspected botulism since this cluster was reported on September 8. We encourage
state and local officials to inquire specifically about consumption of carrot
juice in the food history of suspect botulism cases.
CDC has dispatched a notice of this outbreak to public
health officials in all 50 states through the Foodborne Disease Listserve,
reminding them about the contact numbers for CDC’s Botulism
Clinical Consultation and Antitoxin Release Service. The Georgia
Department of Health issued an Epi-X alert, alerts to Georgia clinicians and
local health officials, and a press release about this outbreak and the
implicated food. We anticipate that the Food and Drug Administration
(FDA) will be issuing a press release about this outbreak and advising
consumers to properly refrigerate juices and follow other food safety
guidelines for illness prevention.
Any suspected botulism case reported by a clinician to a
state health department should be reported immediately by the state to CDC via
the 24/7 CDC Botulism Clinical Consultation and Antitoxin Release Service, by
calling the CDC Emergency Operations Center at (770) 488-7100 and asking for
the botulism officer on call.
For more information on botulism visit this CDC website: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/botulism_g.htm
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