Botulism in Taiwan, 2007-2009

Yu-Ling Chou, Ji-Jia Huang, Wei-Ju Su,Ding -Ping Liu

2010 Vol.26 NO.11

Correspondence Author: Yu-Ling Chou



Clostridium botulinum exists as spores in the environment. Intoxication caused by its toxin is called botulism. Botulinum toxin block the release of acetylcholine and hence nerve transduction, leading to partial or generalized paralysis and other neurological symptoms. However, consciousness remains clear. Without proper medical intervention, cases could develop paralysis of the respiratory muscles; without mechanical ventilation, patients may die. Botulism has been a reportable disease since infectious disease surveillance began in Taiwan. During 1991-2006, an average of 3 cases was reported each year. In 2007, the Department of Health promulgated botulism as a category IV communicable disease. The peak of case numbers appeared in 2008, followed by a decline in 2009. A retrospective analysis was conducted to understand risk factors of botulism. Twenty confirmed cases were identified during 2007–2009, and type A was identified as the major cause. Ingestion of soy products was identified as a possible risk factor (p value < 0.0001, Fisher exact test). However, many different kinds of food may lead to botulism. Hence, for the purpose of health education everyone should be taught about the risk to intoxication. In case investigation, public health professionals should know that, all foods and their process, storage, transportation and seasoning should be considered as possible source of intoxication, in addition to canned food, which traditionally thought to be the cause. Records should be obtained regarding storage of food and leftovers, to identify source of botulinum toxin.