The Taiwan Centers for Disease Control (Taiwan CDC) has recently confirmed a new case of botulism. The case is a 57-year-old male who resides in Lianjiang County. On July 4, 2015, he developed difficulty in swallowing. On the following day, when his symptom persisted, he sought medical attention. He was then transferred to a hospital in northern Taiwan and hospitalized for treatment. Subsequently, he developed difficulty in swallowing, eye muscle disorder, weakness in limbs and difficulty in breathing. As a result, he was reported to the health authority as a suspected botulism case by the hospital. On July 13, infection with botulinum toxin type A was confirmed in the case by Taiwan CDC. After the patient was given plasma exchange and botulism antitoxin, his condition has improved. At the time of writing, the case is still receiving treatment in the intensive care unit.

Prior to his disease onset, the case usually dines at home and restaurants at his company. According to the epidemiological investigation, the health authority found homemade preserved shellfish and spicy seafood sauce. A sample of the aforementioned foods has been submitted to the Food and Drug Administration for laboratory testing to determine the source of the case’s infection. Currently, none of 14 the family members residing in the same household and coworkers has developed any symptoms.

Clostridium botulinum is ubiquitous in the environment. The sporulation of the bacterium occurs in an anaerobic environment. Any food product can be contaminated with clostridium botulinum spores if the food product is not properly sterilized during the manufacturing and packaging processes. In a vacuum-packaged environment, food can be unsafe from clostridium botulinum growth. The toxin produced by clostridium botulinum is sensitive to heat and can be destroyed by heating it at 100°C for 10 minutes. Any homemade pickled products or vacuum-packaged food should be boiled for 10 minutes prior to consumption in order to ensure food safety. In addition, parents should avoid feeding children under one year of age any foods containing honey.

Botulism infection can be fatal if left untreated. Taiwan CDC urges all physicians to remain vigilant for suspected cases of botulism. Physicians may consider the diagnosis if a patient displays gastrointestinal symptoms or fatigue accompanied by neurological symptoms and signs related to botulism such as deterioration of sight, dilated pupils, drooping eyelids and/or weakness of the arms and legs. Physicians should report such cases to the health authority immediately to facilitate provision of antitoxin to treat the case and lower the risk of death.