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Biological Health Hazard (Botulism Outbreak) – Prepared food: Sacramento County, California



Published Date: 2017-05-12 15:53:42
Subject: PRO/EDR> Botulism – USA (07): (CA) gas station food, nacho cheese
Archive Number: 20170512.5031065

Date: Wed 10 May 2017 3:17 PM
Source: Sacramento (CA) Bee [edited]

Nacho cheese sauce is the likely culprit in a botulism outbreak that has sickened at least 5 people who visited a Walnut Grove gas station.

On [Wed 10 May 2017], Sacramento County Public Health officials pinpointed the source of the botulism outbreak as “prepared food, particularly nacho cheese sauce” from Valley Oak Food and Fuel gas station in the Delta. Five people are hospitalized in serious condition with botulism, a rare but serious paralytic illness caused by a nerve toxin, and an additional patient is suspected of having the illness.

People who ate prepared food, especially nacho cheese sauce, from the station between April 23 and May 5 [2017] and report symptoms should contact their medical provider immediately, the health department said.

The gas station, which sits on a busy stretch of River Road across from the Walnut Grove Bridge, stopped selling food and drink products on May 5 [2017] after the county Department of Environmental Management temporarily revoked its permit. Employees of the gas station refused to comment this week [week of 7 Sun 2017] on the suspected outbreak.


Read more …



Nacho cheese sauce suspected in California botulism outbreak
Food Safety News

Published Date: 2017-05-08 14:11:44
Subject: PRO/EDR> Botulism – USA (06): (CA) gas station food, RFI
Archive Number: 20170508.5021002

Date: Sun 7 May 2017 10:38 AM PDT
Source: The Sacramento (CA) Bee [edited]

Sacramento County Public Health officials are investigating a botulism outbreak after several people who ate prepared food from the Valley Oak Food and Fuel gas station in Walnut Creek contracted the possibly fatal form of food poisoning.

County Public Health Officer Dr Olivia Kasirye said 5 cases are under investigation and the affected people are in serious condition at local hospitals. 4 of the 5 confirmed they’d eaten prepared food from the gas station. Kasirye said the county wants to ensure that anyone who has eaten at the gas station since 23 Apr 2017 and is experiencing botulism symptoms receives immediate medical attention.

“The symptoms do vary a bit,” Kasirye said. “The most common ones a person might [initially] experience are stomach cramping and vomiting.” The more serious symptoms are blurry vision, slurred speech, droopy eyelids, and trouble breathing. Botulism is a rare and potentially fatal type of food poisoning caused by a bacterium called _Clostridium botulinum_, which produces a nerve toxin. If it affects the respiratory system, it can cause a person to stop breathing, Kasirye said.

Hospitals treat botulism with an antitoxin followed by intravenous liquids and [if needed] breathing support, she said.

Outbreaks of botulism are rare enough that Kasirye said she can’t remember the last time the county had one. Individual cases pop up occasionally, but it’s unusual to see 5 cases in 2 weeks. County officials learned of the cases because hospitals are required to report patients with botulism.

A county news release said the department is collaborating with the state Department of Public Health and the county Department of Environmental Management, which has the authority to stop the sale of prepared food at the gas station

[Byline: Ellen Garrison]

Communicated by:

[The state of California can be located on the HealthMap/ProMED-mail interactive map at Sacramento County can be seen on the map at – Sr.Tech.Ed.MJ

In foodborne botulism, particularly that involving toxin types B and E, the gastrointestinal symptoms nausea and vomiting may precede neurological symptoms as noted in the post. It is not clear if these symptoms are caused by direct action of botulinum toxin, other products of _C. botulinum_, or some other contaminant of food. Early gastrointestinal symptoms do not seem to occur in cases of wound botulism, nor have corresponding signs been observed in primate experiments in which pure toxin was administered intragastrically or intravenously (1). Of note, type E botulism has been reported with predominantly mild, mostly gastrointestinal symptoms (2).

1. Sobel J: Botulism. Clin Infect Dis. 2005; 41(8): 1167-1173; available at
2. Sobel J, Malavet M, John S: Outbreak of clinically mild botulism type E Illness from home-salted fish in patients presenting with predominantly gastrointestinal symptoms Clin Infect Dis. 2007; 45(2): e14-e16; available at

ProMED awaits more information regarding the food reservoir of this cluster of botulism. It is curious that 2 cases of botulism were reported in southern California last week (week of 1 May 2017), thought to be related to deer antler herbal tea, but it is not known if these clusters are related. The 1st cluster was in Orange county near Los Angeles whereas Sacramento county is almost 400 miles (about 644 km) north of the LA metropolitan area. – Mod.LL

The state of California can be located on the HealthMap/ProMED-mail interactive map at A county map can be seen at – Sr.Tech.Ed.MJ]

See Also

Botulism – USA (05): deer antler herbal tea, FDA recall 20170507.5018201
Botulism – USA (04): (CA) deer antler tea 20170429.5003486
Botulism – USA (03): (TX) wound, drug-related, 2005-2015 20170427.4999639
Botulism – USA (02): (CA) satay, risk, recall 20170420.4982801
Botulism – USA: (CA) wound, non-drug-related 20170402.4942916

Botulism – USA (11): (NM) wound, drug-related 20161004.4535918
Botulism – USA (10): soups, risk, recall 20160911.4480731
Botulism – USA (09): (NM) wound, drug-related 20160716.4350262
Botulism – USA (08): vacuum packed fish, risk, recall 20160623.4302950
Botulism – USA (07): (MS) prison brew 20160615.4288676
Botulism – USA (06): (NY,CA) dried salted uneviscerated fish, risk, recall 20160426.4184418
Botulism – USA (05): vegetable soup, risk, recall 20160421.4174551
Botulism – USA (04): (WA) fatal, conf 20160302.4062476
Botulism – USA (03): (OH,CA) jarred pesto, 2014 20160227.4052791
Botulism – USA (02): (WA) fatal, RFI 20160221.4037933
Botulism – USA: (MN) uneviscerated fish, recall 20160115.3935285

Botulism – USA (15): (MI) foods in jars, risk, recall 20151213.3858868
Botulism – USA (14): canned seafood, risk, recall 20151022.3736597
Botulism – USA (13): canned seafood, risk, recall 20151013.3712452
Botulism – USA (12): (OH) church dinner, home-canned potatoes, fatal 20150801.3548624
Botulism – USA (11): (OH, MD) jarred salsa, risk, recall 20150528.3391672
Botulism – USA (10): (AK, NC) fermented seal flipper, home canned carrots 20150515.3364683
Botulism – USA (09): (OH) church dinner, home-canned potatoes, fatal 20150427.3326627
Botulism – USA (04): (NY) uneviscerated fish, risk, recall 20150421.3312199
Botulism – USA (03): (NM) RFI 20150418.3306389
Botulism – USA (02): smoked fish ex Greece, risk, recall 20150215.3168432
Botulism – USA: uneviscerated fish, risk, recall 20150129.3130000
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


Botulism is a Category A Bioterrorism Agent. It is a neurotoxin and one of the deadliest toxins known. Created by the bacterium Clostridium botulinum, most strains produce one type of neurotoxin, but strains producing multiple toxins have been described.  C. botulinum producing B and F toxin types have been isolated from human botulism cases in New Mexico and California.

As a high-priority agent Botulinum toxins pose a risk to national security, they can be easily transmitted and disseminated, resulting in high mortality, Botulinum toxin (BTX) has a potential major public health impact, may cause public panic, or require special action for public health preparedness. Botulism causes death by respiratory failure and paralysis

Centers for Disease Control and Prevention – Botulism

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