ITALY – Italian researchers through the national surveillance system have reported 1,039 suspected cases of botulism from 2001 to 2020, with a predominance in the Southern part of the country.

One reason why Italy has one of the highest botulism rates in Europe is the nation’s long-standing habit of home canning.

406 cases of botulism involving 599 people were laboratory confirmed between 1986 and September 2022.

The study described the surveillance system and provided details on cases of botulism reported by regional health services and those from hospital discharge records between 2001 and 2020.

Of the 1,039 cases, 255 people ranged in age from 25 to 64, most of them being men. According to data, there were more cases in this age group from 2012 to 2020 than from 2001 to 2011.

412 of the 452 patients that were laboratory confirmed, had foodborne botulism, 36 had infant botulism, and four had wound botulism. 14 people died.

The year with the most suspected instances was 2013, with 137, but the year with the most confirmed cases was 2020, with 74.

An average of 50 reports of suspected cases are submitted to the national botulism surveillance system each year, with roughly half receiving lab confirmation.

An outbreak connected to pickled olives that occurred in the province of Campobasso in 2004 caused a rise in cases, with 28 cases reported but only three lab-verified.

A possible outbreak in Liguria in 2013 was connected to an industrially manufactured pesto, which the manufacturer pulled from the market.

In less than 24 hours, hospitals in Genoa received reports of more than 300 patients with possible symptoms, but none had lab confirmation.

According to the study, the largest outbreak since 1984 was recorded in 2020 at a construction site canteen in the province of Palermo.

An epidemiological investigation pointed to tuna in a multi-ingredient salad as the source. There were 42 suspected cases and 16 were lab-confirmed.

Botulism on the rise in the south

The south, particularly Basilicata and Molise, was reported to have the greatest occurrence rates.

According to scientists, traditional food preparation is common in rural regions, and the eating of inadequately home-canned foods is still an issue.

Most occurrences of botulism are associated with meat and fish, as well as vegetables preserved in oil, water, or brine.

From 2001 through 2020, 774 individuals were admitted to Italian hospitals, according to discharge paperwork. 671 patients, who were all discharged, received a confirmed diagnosis of botulism.

Although the 774 hospital admissions were less than the 1,039 suspected infections, the number of persons with botulism who had been diagnosed was much greater at 671 than the 452 cases that had been lab-confirmed.

Even though the national surveillance system is effective, experts indicated there is a need to enhance communication and clinical suspicion notification, as reported by Food Safety News.

Symptoms of Botulism

Toxins released by the Clostridium botulinum bacterium cause the uncommon but deadly illness known as botulism.

Typically, symptoms of foodborne botulism appear 18 to 36 hours after consuming a contaminated item. Nevertheless, they may begin as soon as six hours later or as late as ten days.

General weakness, disorientation, double vision, and difficulty speaking or swallowing are a few symptoms that can occur.

The majority of patients must be put on life support since it paralyzes the breathing muscles.

Additionally, possible symptoms include breathing difficulties, other muscular weakness, abdominal distention, and constipation.

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