In a shocking incident in California, eight people were hospitalized after consuming a homemade salad contaminated with Clostridium botulinum, a potent neurotoxin that can lead to paralysis and even death. This alarming case, detailed in a recent report by the Centers for Disease Control and Prevention (CDC), sheds light on the dangers of improper food preservation and handling.
The events unfolded on June 21 and June 22, 2024, when approximately 31 attendees partook in two gatherings in Fresno County where a salad featuring uncooked nopales, or prickly pear cactus pads, was served. Shortly after consuming the salad, a 42-year-old woman began to experience severe symptoms including dizziness, blurry vision, a drooping eyelid, a sore throat, gastrointestinal issues, and difficulty swallowing. Initially dismissing her symptoms, medical professionals soon suspected botulism, a serious condition that attacks the nervous system.
By June 27, ten individuals who had attended the events sought medical attention at local hospitals in Fresno County, presenting symptoms consistent with botulism. Consequently, the CDC, along with the Fresno County Department of Public Health and the California Department of Public Health, initiated an investigation to trace the source of this widespread illness.
After extensive laboratory testing, officials identified that the uncooked nopales in the salad, which had been left unrefrigerated in 100-degree Fahrenheit heat, were contaminated with C botulinum. This incident represents one of the largest documented outbreaks of foodborne botulism in California's history. Notably, one patient who prepared the salad utilized fresh onions, tomatoes, and home-preserved nopales stored in reused commercial glass jars.
The individual responsible for preparing the salad had immersed empty jars in boiling water, added chopped uncooked nopales mixed with a small amount of salt, and sealed the jars with new metal lids. Unfortunately, she stored these jars for six weeks in an outdoor shed, unwittingly creating a perfect environment for C botulinum spores to thrive. This bacteria flourishes in low-oxygen, low-acid environments with moderate to high moisture and temperatures between 38°F and 113°F.
Health officials, including Norma Sanchez, a communicable disease specialist with the Fresno County Department of Public Health, confirmed the presence of the contaminated cactus after examining trash cans. The spores of C botulinum can often be found on fruits, vegetables, and seafood, and they proliferated on the surface of the uncooked and improperly canned nopales. All eight patients diagnosed with botulism exhibited symptoms such as double vision, hoarseness, dizziness, and swallowing difficulties.
All eight patients who were diagnosed with botulism were the only attendees who ingested the nopales salad. The 42-year-old woman, who displayed the most severe symptoms, consumed the salad at both events. Hospital stays for these patients ranged from two to 42 days, with six requiring admission to an intensive care unit and two needing invasive mechanical ventilation. Fortunately, the CDC later confirmed that all individuals diagnosed with botulism survived and recovered.
Botulism, while rare, is a serious infection caused by a bacterial toxin that affects the nervous system. According to the CDC, common symptoms of botulism include difficulty swallowing, muscle weakness, double vision, drooping eyelids, slurred speech, and breathing difficulties. In cases of foodborne botulism, symptoms typically manifest within 12 to 36 hours post-exposure to the toxin. Without treatment, the infection can lead to severe muscle weakness, paralysis, and even death.
The CDC estimates approximately 25 cases of foodborne botulism occur in the United States each year, highlighting its rarity. However, the stakes are high, with a mortality rate of about five percent among those who develop this condition. Many survivors face long-term disabilities and require extensive physical therapy. In light of this incident, the Fresno health department is urging the public to adhere to proper food storage and cooking guidelines to mitigate the risk of botulism. It is crucial to heat any food at risk of contamination to temperatures between 240°F and 250°F to ensure safety.
