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Foodborne Botulism, Canada, 2006-20211.

Richard A Harris, Christine Tchao, Natalie Prystajecky

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    Canada experienced 55 foodborne botulism outbreaks (67 cases) from 2006-2021. While incidence decreased in Indigenous communities, type E neurotoxin was most common, and misdiagnosis remains a concern.

    Keywords:
    CanadaClostridium botulinumantitoxinbacteriabotulinum toxinsbotulismfood safetyfoodborne botulismfoodborne illnessoutbreakserotype

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    Area of Science:

    • Foodborne illness epidemiology
    • Public health surveillance
    • Infectious disease outbreaks

    Background:

    • Foodborne botulism poses a significant public health risk, characterized by severe neuroparalytic illness.
    • Surveillance data is crucial for understanding disease trends and informing prevention strategies.

    Purpose of the Study:

    • To analyze the epidemiology of laboratory-confirmed foodborne botulism outbreaks in Canada between 2006 and 2021.
    • To identify trends in incidence, causative agents, and patient outcomes, with a focus on changes in Indigenous communities.

    Main Methods:

    • Retrospective analysis of laboratory-confirmed foodborne botulism outbreaks reported in Canada from 2006 to 2021.
    • Data collection on case numbers, geographic distribution, botulinum neurotoxin serotypes, implicated food products, and patient demographics.
    • Review of clinical data including hospitalization, intensive care unit admission, mechanical ventilation, and mortality.

    Main Results:

    • A total of 55 outbreaks and 67 cases were reported, with a mean annual incidence of 0.01 per 100,000 population.
    • Foodborne botulism in Indigenous communities decreased to 46% of cases, compared to 85% in 1990-2005.
    • Botulinum neurotoxin type E caused 52% of cases; type A was linked to longer hospital stays and intensive care. Four outbreaks involved commercial products, including carrot juice. Seven deaths were reported.

    Conclusions:

    • Despite a decrease in cases within Indigenous communities, foodborne botulism remains a concern in Canada.
    • Botulinum neurotoxin type A presents a greater clinical burden than types B or E.
    • Enhanced clinician awareness is vital for improving diagnosis, aiding investigations, and optimizing patient treatment.