Botulism type B: epidemiologic aspects of an extensive outbreak

Between March 31 and April 6, 1977, 59 individuals developed type B botulism. All ill persons had eaten at the same Mexican restaurant and all had consumed a hot sauce made with improperly home-canned jalapeno peppers, either by adding it to their food, or by eating a nacho that had had hot sauce used in its preparation. There was a highly significant association between illness and consumption of hot sauce when a comparison was made between ill persons and well controls: 4% of all restaurant patrons eating at the restaurant during the outbreak period became ill with botulism; however, approximately two-thirds of those actually exposed to the toxic hot sauce became ill. Disease severity was statistically correlated with incubation periods. No differences in disease severity were found between persons of different age groups. The full clinical spectrum (mild symptomatology with neurologic findings through life-threatening ventilatory paralysis) of type B botulism was documented.