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January 5, 1976

Botulism in Alaska, 1947 Through 1974Early Detection of Cases and Investigation of Outbreaks as a Means of Reducing Mortality

Author Affiliations

From the Division of Public Health, Section of Communicable Disease Control, Alaska Department of Health and Social Services (Dr Eisenberg), and the Bureau of Epidemiology, Center for Disease Control, Public Health Service, US Department of Health, Education, and Welfare, Anchorage.

JAMA. 1976;235(1):35-38. doi:10.1001/jama.1976.03260270021019

Since 1947, there have been 21 outbreaks of botulism in Alaska, involving 46 people with 13 deaths (28% fatality). In the last six months of 1974, there were four outbreaks. With one exception to date, type E toxin was involved in all outbreaks for which laboratory confirmation has been obtained, and in all instances, Eskimo and Indian foods were the source. Clinical signs and symptoms of nausea and vomiting, dysphagia, diplopia, dilated pupils, and dry throat occurred with great frequency, forming a diagnostic pentad. We recommend that treatment include close medical supervision, supportive care, and the use of antitoxin, cathartics, and, possibly, penicillin. The source of an outbreak must be determined to prevent further cases. Only prompt recognition, therapy, and epidemiologic investigation can reduce the death toll from botulism.

(JAMA 235:35-38, 1976)