Botulism

40-year-old man admitted into Hospital.

He has a splitting headache, his legs were unsteady, and his vision was
blurred.

During the examination, it was obvious that something was wrong wit his
throat.

The throat was not sore, but it felt stiff and tight, and it was almost
impossible for him to speak.

Over the next 7 days, 28 people with similar symptoms were admitted to
the hospital.

-12 of these patients required ventilatory support

-No deaths were reported.

-During the investigation it became apparent that the illness were due
to meals consumed between Oct. 14-16 at one restaurant.

-Detailed food histories were obtained from the patients.

-An additional case control study was conducted on well people who had
consumed food at the restaurant during the same 3-day period.

-The media helped identify 18 more people who had eaten virtually the
same foods at the restaurant.

-The meals consisted of:

Patty Melt- Frozen hamburger patties purchased from a restaurant distrb.
Patties were removed from the freezer and fried as ordered. Presliced
pasteurized American cheese purchased from a distributor was kept
refrigerated, and a slice was melted on each cooked hamburger patty.
Meat and cheese were served on a rye bread purchased from a local
bakery.

Sautйed Onion- Onions were purchased fresh from a farmer. Fresh whole
onions were sliced and then sautйed with margarine, paprika, garlic
salt, and a chicken-based powder. After the initial cooking, the onions
were held uncovered in a pan on a warm stove (<60oC) along with a large
volume of melted margarine; they were not reheated before serving.

French Fried potatoes- Pre-cut frozen potatoes were deep-fried in two or
three serving batches as needed.

Potato Salad- Potatoes were purchased from a farmer. They had been
stored in a root cellar and were transported loose in a pickup truck.
The potatoes were washed, peeled, diced, and boiled. Cooled, drained,
potato cubes were mixed with oil, vinegar, dry mustard, and garlic salt,
and kept refrigerated. Individual servings were removed from the
container as needed.

Lettuce and Tomato salad- Produce was delivered every other day, Lettuce
and tomatoes were cut in the morning, refrigerated, and mixed with oil
and vinegar for serving.