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News From the Centers for Disease Control and Prevention
August 28, 2013

Tofu: An Unlikely Cause of Botulism

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Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2013;310(8):788. doi:10.1001/jama.2013.194564

Botulism’s symptoms and causes may not be as straightforward as many clinicians might think.

The paralytic illness usually is associated with home-canned foods with low acid levels—asparagus, green beans, and corn, for example—and some fermented, salted, or smoked foods. However, for only the second time in the United States, public health professionals last year traced botulism to fermented tofu.

One confirmed case and another suspected case were reported to the New York City Department of Health and Mental Hygiene in March 2012. The first patient, a 39-year-old Chinese man, was hospitalized after several days of vomiting followed by dysphagia, diplopia, dysarthria, dyspnea, and trouble walking. The second patient, a 36-year-old Chinese woman, was admitted to the same hospital with similar symptoms. Both lived in the same neighborhood and recently had emigrated from the same region in Jiangxi Province, China, but didn’t know each other.

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