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Foodborne Botulism in Canada, 1985–2005 - Vol. 19 No. 6 - June 2013 - Emerging Infectious Disease journal - CDC
CME Articles
Volume 19, Number 6–June 2013
Volume 19, Number 6—June 2013
CME ACTIVITY
Foodborne Botulism in Canada, 1985–2005
Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.
Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at www.medscape.org/journal/eid
; (4) view/print certificate.
Release date: May 22, 2013; Expiration date: May 22, 2014
Learning Objectives
Upon completion of this activity, participants will be able to:
• Describe the incidence of laboratory-confirmed outbreaks of foodborne botulism occurring between 1985 and 2005 in Canada, based on a study of laboratory databases.
• Describe the implicated pathogens and sources of laboratory-confirmed outbreaks of foodborne botulism occurring between 1985 and 2005 in Canada, based on a study of laboratory databases.
• Describe the outcomes of laboratory-confirmed outbreaks of foodborne botulism occurring between 1985 and 2005 in Canada, based on a study of laboratory databases.
CME Editor
Shannon O’Connor, ELS, Technical Writer/Editor, Emerging Infectious Diseases. Disclosure: Shannon O’Connor has disclosed no relevant financial relationships.
CME Author
Laurie Barclay, MD, freelance writer and reviewer, Medscape, LLC. Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.
Authors
Disclosures: Daniel Leclair, PhD,; Joe Fung, MSc, MPH; Judith L. Isaac-Renton, MD; Jean-Francois Proulx, MD; Jennifer May-Hadford, MPH; Andrea Ellis; Edie Ashton; Sadjia Bekal, PhD; Jeffrey M. Farber, PhD; Burke Blanchfield; and John W. Austin, PhD, have disclosed no relevant financial relationships.
CME Articles
Volume 19, Number 6–June 2013
Volume 19, Number 6—June 2013
CME ACTIVITY
Foodborne Botulism in Canada, 1985–2005
Article Contents
Medscape CME Activity
Materials and Methods
Results
Discussion
Acknowledgment
References
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Figure 2
Table 1
Table 2
Table 3
Table 4
Table 5
Suggested Citation
Daniel Leclair, Joe Fung, Judith L. Isaac-Renton, Jean-Francois Proulx, Jennifer May-Hadford, Andrea Ellis, Edie Ashton, Sadjia Bekal, Jeffrey M. Farber, Burke Blanchfield, and John W. Austin
Author affiliations: Health Canada, Ottawa, Ontario, Canada (D. Leclair, J.W. Austin, J.M. Farber, B. Blanchfield); British Columbia Provincial Health Services Authority, Vancouver, British Columbia, Canada (J.L. Isaac-Renton, J. Fung); Nunavik Regional Board of Health and Social Services, Kuujjuaq, Quebec, Canada (J.-F. Proulx); Public Health Agency of Canada, Guelph, Ontario (J. May-Hadford); Laboratoire de santé publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada (S. Bekal); ProvLab, Edmonton, Alberta, Canada (E. Ashton); Canadian Food Inspection Agency, Ottawa (A. Ellis)
Suggested citation for this article
During 1985–2005, a total of 91 laboratory-confirmed outbreaks of foodborne botulism occurred in Canada; these outbreaks involved 205 cases and 11 deaths. Of the outbreaks, 75 (86.2%) were caused by Clostridium botulinum type E, followed by types A (7, 8.1%) and B (5, 5.7%). Approximately 85% of the outbreaks occurred in Alaska Native communities, particularly the Inuit of Nunavik in northern Quebec and the First Nations population of the Pacific coast of British Columbia. These populations were predominantly exposed to type E botulinum toxin through the consumption of traditionally prepared marine mammal and fish products. Two botulism outbreaks were attributed to commercial ready-to-eat meat products and 3 to foods served in restaurants; several cases were attributed to non-Native home-prepared foods. Three affected pregnant women delivered healthy infants. Improvements in botulism case identification and early treatment have resulted in a reduction in the case-fatality rate in Canada.
Foodborne botulism, a notifiable disease in Canada, results from the ingestion of foods contaminated with preformed botulinum neurotoxin types A, B, E, or F, produced by Clostridium botulinum groups I and II (1). More rarely, outbreaks of foodborne botulism in the United States, India, and China have been caused by neurotoxigenic C. butyricum type E (2,3) and C. baratii type F (4). In Canada, C. botulinum type E has been the most common serotype since the first type E outbreak in 1944 in Nanaimo, British Columbia (reported in 1947) (5–7).
Six forms of botulism have been described in the literature (8), but only foodborne and infant botulism and rare cases of adult colonization have been reported in Canada (1,9). Regardless of the form or serotypes involved, however, human botulism is a medical emergency that requires rapid intervention. Because prompt administration of antitoxin can reduce the severity of the disease (10), the decision for treatment is based on clinical diagnosis and epidemiologic information, without laboratory confirmation.
Investigation of foodborne botulism incidents provides useful information regarding implicated foods and conditions resulting in toxin formation. The last epidemiologic review on foodborne botulism in Canada was done for the 1971–1984 period (7). Since then, annual summaries of botulism cases were inconsistently published through disease surveillance reports (e.g., 11,12). Here, we summarize reports of all laboratory-confirmed cases of foodborne botulism in Canada during 1985–2005.
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Foodborne Botulism in Canada, 1985–2005 - Vol. 19 No. 6 - June 2013 - Emerging Infectious Disease journal - CDC