Published Date: 2006-10-06 00:00:00
Subject: PRO/EDR> Botulism, fish - Ukraine (Donetsk)
Archive Number: 20061006.2864
BOTULISM, FISH - UKRAINE (DONETSK)
A ProMED-mail post
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International Society for Infectious Diseases
Date: Fri, 28 Sep 2006
From: ProMED-mail <email@example.com>
Source: Komsomolskaya pravda, Kiev [trans. Mod.NP; edited]
Three cases of nonfatal botulism were reported in Mariupol in September
. All these cases are connected with domestically prepared fish,
according to Larissa Guseva, the deputy of the main state health office in
the Donetsk region of Ukraine.
Most likely, all requirements for the preparation and storage of the fish
were not observed. According to Larissa Guseva, since the beginning of
2006, the regional sanitary epidemiological station has reported only 9
cases of botulism. The same number of cases was registered for all of 2005.
[Smoked and dried fish prepared in the home without appropriate procedures
and precautions, is the most common cause of botulism in the steppe zones
of Russia and Ukraine, on the coasts of the Azov and Black Seas and near
large rivers, where fish processing is widely developed. Botulism connected
with the consumption of fish prepared industrially is practically
nonexistent. Exceptions may occur when workers (without permission) remove
from a processing plant fish that did not undergo a full processing cycle.
The Donetsk region is located in southeast Ukraine. Mariupol is on the
northern coast of the Sea of Azov, south of the Donetsk region - Mod.NP]
[A map of Ukraine showing the location of Mariupol in the Donetsk region
(in the extreme southeastern part of the country):
The method of diagnosis of botulism is not stated here. Individual cases of
paralysis can be confused with other diseases, but a cluster of such cases
is certainly likely to be botulism. Type E botulism is the type frequently
associated with fish products (1).
Classically, botulism is a foodborne disease caused by the ingestion of
preformed toxin, although there also exists wound botulism (in which _C.
botulinum_ spores germinate in a wound), and infant botulism (in which the
spores germinate in the intestinal tract).
Types A, B, and E of human botulism are the commonest types. Although each
type has a similar symptom complex, Hughes and colleagues report that type
E is much more likely to produce an initial lethargic mental status and
more autonomic dysfunction (2).
1. Weber JT, Hibbs RG, Darwish A, et al. A massive outbreak of type E
botulism associated with traditional salted fish in Cairo. J Infect Dis
2. Hughes JM, Hatheway CL, Ostroff SM. Botulism. In: Scheld WM, Whitley RJ,
Durack DT, editors. Infections of the central nervous system. 2nd edition.
Philadelphia: Lippincott-Raven, 1997, pp. 615-28. - Mod.LL]