Botulism in Spain: Epidemiology and Outcomes of Antitoxin Treatment, 1997–2019

Peñuelas, Marina; Guerrero-Vadillo, María; Valdezate, Sylvia; Zamora, María Jesús; Leon-Gomez, Inmaculada; Flores-Cuéllar, Ángeles; Carrasco, Gema; Díaz-García, Oliva; Varela, Carmen

doi:10.3390/toxins15010002

Cited by 4 publications

(3 citation statements)

References 44 publications

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“…Treatment is mainly supportive, with the addition of specific medications such as antitoxins [17,18]. When administered early (within 24-48 h from the onset of symptoms), botulinum antitoxin could stop the progression of paralysis and prevent respiratory failure [19].…”

Section: Discussionmentioning

confidence: 99%

Food-borne botulism outbreak during the Rugby World Cup linked to marinated sardines in Bordeaux, France, September 2023

Courtot-Melciolle,

Jauvain,

Siefridt

et al. 2023

Eurosurveillance

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In September 2023, a botulism outbreak affecting 15 individuals occurred in Bordeaux, France, during the Rugby World Cup. We report on eight individuals from four different countries on two continents admitted to the intensive care unit at our hospital, where six required invasive mechanical ventilation. Cases reported consuming locally produced canned sardines at a restaurant. This report highlights the importance of rapid, worldwide alerts from health authorities to prevent severe consequences of such outbreaks, particularly during events attracting international visitors.

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Section: Discussionmentioning

confidence: 99%

Food-borne botulism outbreak during the Rugby World Cup linked to marinated sardines in Bordeaux, France, September 2023

Courtot-Melciolle,

Jauvain,

Siefridt

et al. 2023

Eurosurveillance

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show abstract

“…In the European Union, botulism case numbers have remained stable at ≈100 cases/year with an overall notification rate of 0.02 cases/100,000 inhabitants (as occurs in Spain) ( 1 , 24 ), although the botulism form (food-borne or infant) and incidence vary according to the reporting countries. The highest incidences have been recorded in Italy and Romania.…”

Section: Discussionmentioning

confidence: 99%

Exploring the genetic background of the botulism neurotoxin BoNT/B2 in Spain

Valdezate,

Carrasco,

Medina

et al. 2023

Microbiol Spectr

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To determine whether the neurotoxin BoNT/B2 causing botulism in Spain is clonal, the genetic diversity and phylogenetic relationships of Clostridium botulinum from food-borne episodes and infant cases of the condition were explored. The botulinum toxin gene ( bont ) subtype, the variable region of the flagellin gene ( fla VR), and a seven-gene multi-locus sequence type were examined by sequencing 37 BoNT-positive cultures obtained over the period 2010 to 2022. Out of 37 botulism events, 16 food-borne episodes and 16 infant cases were associated with bont/b 2. Eight bont/b 2 alleles were detected [nucleotide distance range 0.0259–0.415%, Hunter and Gaston discrimination index (HGDI) 0.71]. The most common bont/b 2 allele corresponded to that of strain Prevot 25 NCASE and its single and double locus variations (87.5%). Four known fla VR types were identified (HGDI 0.79), along with one previously unknown ( fla VR-15). Sixteen sequence types (STs) (HGDI 0.89) were recorded including seven new STs (ST164–ST170; 10 new alleles) and five new STs (ST171–ST175; with new allele combinations) were also noted. Correlations among some STs and fla VR types were seen. Overall, the present results show that the combined analysis of bont/b 2- fla VR-ST at the nucleotide level could be used to track botulism events in Spain. The neurotoxin BoNT/B2 has largely been responsible for human botulism in Spain. The polymorphism analysis of bont/b2 , fla VR typing, and sequence type determinations, revealed a wide variety of clones to be responsible for human botulism, ruling out a common source of acquisition. IMPORTANCE Botulism, a potentially fatal disease, is classically characterized by a symmetrical descending flaccid paralysis, which if left untreated can lead to respiratory failure and death. Botulinum neurotoxin (BoNT), produced by certain species of Clostridium, is the most potent biological toxin known, and the direct cause of botulism. This study characterizes the acquisition in Spain of two forms of botulism, i.e., food-borne and infant botulism, which are largely caused by the main neurotoxin BoNT/B2. Polymorphism analysis of the bont/b2 gene, typing of the flagellin variable region sequence (flaVR), and multilocus sequence typing, were used to explore the genetic background of Clostridium botulinum group I. To our knowledge, this is the first phylogenetic and typing study of botulism undertaken in Spain.

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“…Botulism outbreaks in fish are most common in warm, stagnant waters with high organic loads. It can affect both wild and farmed fish populations (Peñuelas et al 2022). Fish with botulism may exhibit a variety of symptoms, including lethargy, loss of appetite, swimming in circles, and difficulty breathing.…”

Section: Botulismmentioning

confidence: 99%

Incidence, Transmission Mechanisms and Pathologic Implications of Bacterial Zoonotic Diseases of Fish

2023

IJAB

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Fish harbor a variety of bacterial pathogens, some of which can cause disease in humans. Zoonotic bacteria that may be present in asymptomatic fish hosts pose a public health risk when transmitted to humans through handling or consuming infected fish. Mycobacteriosis, caused by species in the Mycobacterium marinum group, is perhaps the most notorious zoonotic infection associated with fish and can produce serious skin infections in humans. Streptococcosis and staphylococcosis also occur with some frequency in fish and can result in human cases of septicemia, endocarditis or pneumonia if injured skin comes into contact with infected fish tissues and bacteria access wounds. Additionally, some Vibrio and Clostridium species found among fish may cause wound infections or gastrointestinal illness in humans, usually subsequent to exposure through handling or ingesting raw seafood. Clinical signs of bacterial zoonosis are variable and diagnosis in human cases can prove complicated by the vast diversity of potential pathogens involved. Preventative measures center on educating aquarists and fish handlers to avoid direct contact with ulcerated areas, lesions or feces from diseased fish. For consumer safety, good aquaculture practices that reduce bacterial loads in farmed fish stock are recommended. Moreover, thoroughly cooking fish to an internal temperature over 140°F destroys pathogens that may be present. Additional research priorities include better characterization of bacterial diversity among wild and farmed fish, investigating genetic and immunological aspects of disease resistance, developing improved diagnostics through genomic analysis, assessing efficacy of existing antibacterial treatments in clearing pathogens prior to human consumption and formulating integrated control strategies to mitigate risks. This book chapter examines the incidence, transmission mechanisms and pathologic implications of common bacterial zoonosis originating from fish hosts.

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Botulism in Spain: Epidemiology and Outcomes of Antitoxin Treatment, 1997–2019

Cited by 4 publications

References 44 publications

Food-borne botulism outbreak during the Rugby World Cup linked to marinated sardines in Bordeaux, France, September 2023

Food-borne botulism outbreak during the Rugby World Cup linked to marinated sardines in Bordeaux, France, September 2023

Exploring the genetic background of the botulism neurotoxin BoNT/B2 in Spain

Incidence, Transmission Mechanisms and Pathologic Implications of Bacterial Zoonotic Diseases of Fish

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