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Gul Dar N, Alfaraj SH, Alboqmy KN, Khanum N, Alshakrah F, Abdallah H, Badawi MH, Alharbi OM, Alshiekh KA, Alsallum AM, Shrahili AH, Zeidan ZA, Abdallah Z, Majrashi AA, Memish ZA. The First Reported Foodborne Botulism Outbreak in Riyadh, Saudi Arabia: Lessons Learned. J Epidemiol Glob Health 2024:10.1007/s44197-024-00255-z. [PMID: 38837035 DOI: 10.1007/s44197-024-00255-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Botulism has not been previously reported in the Kingdom of Saudi Arabia. This rare and sometimes fatal foodborne illness is caused by neurotoxins and primarily results from consuming home-canned fruits, vegetables, dairy, and seafood products & it can lead to paralysis. OBJECTIVE The purpose of this study was to evaluate the clinical features of patients who developed botulism in Riyadh in 2024 after consuming mayonnaise from a well-known local chain of restaurants in Riyadh, Saudi Arabia. METHODS We conducted a retrospective analysis of medical records and interviewed patients or their attendants for all hospitalized cases of foodborne botulism at Riyadh First Health Cluster. For each patient, a standard case report form was completed, containing information on demographics, clinical aspects, botulinum test results, and type of exposure. Descriptive statistics were applied to assess the data. During the outbreak, nineteen patients with foodborne diseases were admitted to Riyadh First Health Cluster Hospitals. Following thorough physical examinations, botulism was suspected in each case. RESULTS Eight of the 19 suspected foodborne illness patients fully satisfied the botulism case definition requirements set forth by the Saudi Arabian Public Health Authority (Weqaya). Among these eight patients, 2 (25%) were male and 6 (75%) were female, with a mean age of 23.25 ± 9.29 years (range: 12-38 years). The incubation period for our patients was 36.25 ± 26.26 h. Notable symptoms included dysphagia in all eight patients (100%), dysarthria, generalized weakness, nausea and vomiting in seven patients (88%), diplopia in four patients (50%), and stomach discomfort in three patients (38%). Of the eight cases, six required intubation, one mimicked brain death, and two were stable. The presence of Clostridium botulinum spores as the cause of the outbreak was confirmed by detecting botulinum spores in contaminated food. CONCLUSION Diplopia and dysarthria were the most common early sign of botulism. Early manifestations may include respiratory symptoms without any musculoskeletal symptoms. or nausea, vomiting and disorientation.
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Affiliation(s)
- Nadeem Gul Dar
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Sarah H Alfaraj
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Khulood Naser Alboqmy
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Nazia Khanum
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Faleh Alshakrah
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Hassan Abdallah
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Mohammad Hosni Badawi
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Ohoud Mohammed Alharbi
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Khadijh Ahmed Alshiekh
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Abdullah M Alsallum
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | - Ahmed Hassan Shrahili
- Prevention and Control of Infection Administration, King Saud Medical city, Riyadh, Saudi Arabia
| | | | - Zaki Abdallah
- Imam Abdulrahman Alfaisal Hospital, Riyadh, Saudi Arabia
| | | | - Ziad A Memish
- Research and Innovation Center, King Saud Medical City, Riyadh, Saudi Arabia.
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia.
- Hubert Department of Global Health, Rollins School of Public Health, Emory, University, Atlanta, USA.
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Cheong I, Imbelloni MI, Gómez RA, Álvarez Vilariño FM, Baiona GA, Tamagnone FM. Non-invasive diagnosis of diaphragmatic paralysis in botulism using ultrasound. Toxicon 2024; 239:107609. [PMID: 38216093 DOI: 10.1016/j.toxicon.2024.107609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/26/2023] [Accepted: 01/08/2024] [Indexed: 01/14/2024]
Abstract
This case study explores foodborne botulism, a severe illness caused by botulinum neurotoxin-contaminated food. It leads to bilateral descending paralysis, involving the diaphragm. We highlight diaphragmatic ultrasound as a non-invasive diagnostic tool. A 50-year-old obese male developed diplopia and weakness after consuming contaminated food, rapidly progressing to severe symptoms. Mechanical ventilation became necessary due to respiratory failure. Diaphragmatic ultrasound confirmed bilateral diaphragm paralysis despite early antitoxin treatment. The patient experienced complications, requiring tracheostomy and rehabilitation. After five months, he fully recovered diaphragmatic function. This study underscores botulism's life-threatening nature and the vital role of supportive care. Diaphragmatic ultrasound is a safe and effective method for assessing diaphragmatic function in such cases, obviating ionizing radiation exposure. We recommend its routine use for evaluating botulism-induced paralysis.
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Affiliation(s)
- Issac Cheong
- Department of Critical Care Medicine, Sanatorio de Los Arcos, Buenos Aires, Argentina; Argentinian Critical Care Ultrasonography Association (ASARUC), Argentina.
| | - Mariano Iván Imbelloni
- Department of Critical Care, Clínica de Internación Aguda en Rehabilitación y Cirugía (CIAREC), Buenos Aires, Argentina
| | - Raúl Alejandro Gómez
- Department of Critical Care Medicine, Sanatorio de Los Arcos, Buenos Aires, Argentina
| | | | - Gastón Adrián Baiona
- Department of Critical Care Medicine, Sanatorio de Los Arcos, Buenos Aires, Argentina; Department of Critical Care, Clínica de Internación Aguda en Rehabilitación y Cirugía (CIAREC), Buenos Aires, Argentina
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Castro C, Machado Morais J, Correia AL, Almeida R, Soares S. A Challenging Case: Botulism in a Toddler. Cureus 2023; 15:e49924. [PMID: 38174186 PMCID: PMC10763993 DOI: 10.7759/cureus.49924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 01/05/2024] Open
Abstract
Botulism is a life-threatening, rapidly progressive neuroparalytic disease caused by one of the most potent toxins known, botulinum toxin. It manifests as flaccid and symmetrical descending paralysis that can affect both cranial and peripheral nerves. The only specific treatment available is the administration of botulinum antitoxin. We present the case of a three-year-old boy who had gastrointestinal symptoms and had ingested garden soil/dust at a construction site before the onset of cranial nerve palsy, which manifested as dysphagia in swallowing liquid and solid food and bilateral progressive ptosis. Early suspicion of botulism and treatment with botulinum antitoxin resulted in complete neurologic recovery. This case highlights the importance of a careful history and neurologic examination to avoid misdiagnosis. Administration of botulinum antitoxin should not be delayed until the diagnosis is confirmed and clinicians should be aware that this approach can be life-saving.
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Affiliation(s)
| | | | | | - Rui Almeida
- Pediatrics, Hospital Pedro Hispano, Matosinhos, PRT
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Bezerra FWF, Silva JDME, Fontanari GG, de Oliveira JAR, Rai M, Chisté RC, Martins LHDS. Sustainable Applications of Nanopropolis to Combat Foodborne Illnesses. Molecules 2023; 28:6785. [PMID: 37836629 PMCID: PMC10574570 DOI: 10.3390/molecules28196785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 10/15/2023] Open
Abstract
Propolis has numerous biological properties and technological potential, but its low solubility in water makes its use quite difficult. With the advent of nanotechnology, better formulations with propolis, such as nanopropolis, can be achieved to improve its properties. Nanopropolis is a natural nanomaterial with several applications, including in the maintenance of food quality. Food safety is a global public health concern since food matrices are highly susceptible to contamination of various natures, leading to food loss and transmission of harmful foodborne illness. Due to their smaller size, propolis nanoparticles are more readily absorbed by the body and have higher antibacterial and antifungal activities than common propolis. This review aims to understand whether using propolis with nanotechnology can help preserve food and prevent foodborne illness. Nanotechnology applied to propolis formulations proved to be effective against pathogenic microorganisms of industrial interest, making it possible to solve problems of outbreaks that can occur through food.
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Affiliation(s)
- Fernanda Wariss Figueiredo Bezerra
- Graduate Program of Food Science and Technology (PPGCTA), Institute of Technology (ITEC), Federal University of Pará (UFPA), Belém 66075-110, Brazil; (J.d.M.e.S.); (R.C.C.); (L.H.d.S.M.)
| | - Jonilson de Melo e Silva
- Graduate Program of Food Science and Technology (PPGCTA), Institute of Technology (ITEC), Federal University of Pará (UFPA), Belém 66075-110, Brazil; (J.d.M.e.S.); (R.C.C.); (L.H.d.S.M.)
| | | | | | - Mahendra Rai
- Department of Biotechnology, SGB Amravati University, Amravati 444602, India;
| | - Renan Campos Chisté
- Graduate Program of Food Science and Technology (PPGCTA), Institute of Technology (ITEC), Federal University of Pará (UFPA), Belém 66075-110, Brazil; (J.d.M.e.S.); (R.C.C.); (L.H.d.S.M.)
| | - Luiza Helena da Silva Martins
- Graduate Program of Food Science and Technology (PPGCTA), Institute of Technology (ITEC), Federal University of Pará (UFPA), Belém 66075-110, Brazil; (J.d.M.e.S.); (R.C.C.); (L.H.d.S.M.)
- Instituto de Saúde e Produção Animal, Universidade Federal Rural da Amazônia, Belém 66077-530, Brazil;
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Delgado J, Álvarez M, Cebrián E, Martín I, Roncero E, Rodríguez M. Biocontrol of Pathogen Microorganisms in Ripened Foods of Animal Origin. Microorganisms 2023; 11:1578. [PMID: 37375080 DOI: 10.3390/microorganisms11061578] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Ripened foods of animal origin comprise meat products and dairy products, being transformed by the wild microbiota which populates the raw materials, generating highly appreciated products over the world. Together with this beneficial microbiota, both pathogenic and toxigenic microorganisms such as Listeria monocytogenes, Salmonella enterica, Staphylococcus aureus, Clostridium botulinum, Escherichia coli, Candida spp., Penicillium spp. and Aspergillus spp., can contaminate these products and pose a risk for the consumers. Thus, effective strategies to hamper these hazards are required. Additionally, consumer demand for clean label products is increasing. Therefore, the manufacturing sector is seeking new efficient, natural, low-environmental impact and easy to apply strategies to counteract these microorganisms. This review gathers different approaches to maximize food safety and discusses the possibility of their being applied or the necessity of new evidence, mainly for validation in the manufacturing product and its sensory impact, before being implemented as preventative measures in the Hazard Analysis and Critical Control Point programs.
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Affiliation(s)
- Josué Delgado
- Higiene y Seguridad Alimentaria, Instituto de Investigación de Carne y Productos Cárnicos (IProCar), Facultad de Veterinaria, Universidad de Extremadura, Avda. de las Ciencias s/n, 10003 Cáceres, Spain
| | - Micaela Álvarez
- Higiene y Seguridad Alimentaria, Instituto de Investigación de Carne y Productos Cárnicos (IProCar), Facultad de Veterinaria, Universidad de Extremadura, Avda. de las Ciencias s/n, 10003 Cáceres, Spain
| | - Eva Cebrián
- Higiene y Seguridad Alimentaria, Instituto de Investigación de Carne y Productos Cárnicos (IProCar), Facultad de Veterinaria, Universidad de Extremadura, Avda. de las Ciencias s/n, 10003 Cáceres, Spain
| | - Irene Martín
- Higiene y Seguridad Alimentaria, Instituto de Investigación de Carne y Productos Cárnicos (IProCar), Facultad de Veterinaria, Universidad de Extremadura, Avda. de las Ciencias s/n, 10003 Cáceres, Spain
| | - Elia Roncero
- Higiene y Seguridad Alimentaria, Instituto de Investigación de Carne y Productos Cárnicos (IProCar), Facultad de Veterinaria, Universidad de Extremadura, Avda. de las Ciencias s/n, 10003 Cáceres, Spain
| | - Mar Rodríguez
- Higiene y Seguridad Alimentaria, Instituto de Investigación de Carne y Productos Cárnicos (IProCar), Facultad de Veterinaria, Universidad de Extremadura, Avda. de las Ciencias s/n, 10003 Cáceres, Spain
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Ajose DJ, Abolarinwa TO, Oluwarinde BO, Montso PK, Fayemi OE, Aremu AO, Ateba CN. Application of Plant-Derived Nanoparticles (PDNP) in Food-Producing Animals as a Bio-Control Agent against Antimicrobial-Resistant Pathogens. Biomedicines 2022; 10:biomedicines10102426. [PMID: 36289688 PMCID: PMC9599314 DOI: 10.3390/biomedicines10102426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Antibiotics are regularly used in animal husbandry to treat diseases. This practice is beneficial to animals’ health and helps ensure food security. However, the misuse of antibiotics, especially in food-producing animals, has resulted in the advent of antimicrobial resistance (AMR) and its dissemination among foodborne pathogens. The occurrence of AMR in bacteria pathogens that cause infections in animals and those associated with food spoilage is now considered a global health concern affecting humans, animals and the environment. The search for alternative antimicrobial agents has kindled the interest of many researchers. Among the alternatives, using plant-derived nanoparticles (PDNPs) for treating microbial dysfunctions in food-producing animals has gained significant attention. In traditional medicine, plant extracts are considered as safe, efficient and natural antibacterial agents for various animal diseases. Given the complexity of the AMR and concerns about issues at the interface of human health, animal health and the environment, it is important to emphasize the role of a One Health approach in addressing this problem. This review examines the potential of PDNPs as bio-control agents in food-producing animals, intending to provide consumers with microbiologically safe food while ensuring food safety and security, better health for animals and humans and a safe environment.
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Affiliation(s)
- Daniel Jesuwenu Ajose
- Food Security and Safety Focus Area, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
- Antimicrobial Resistance and Phage Bio-Control Research Laboratory, Department of Microbiology, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Tesleem Olatunde Abolarinwa
- Food Security and Safety Focus Area, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
- Antimicrobial Resistance and Phage Bio-Control Research Laboratory, Department of Microbiology, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Bukola Opeyemi Oluwarinde
- Food Security and Safety Focus Area, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
- Antimicrobial Resistance and Phage Bio-Control Research Laboratory, Department of Microbiology, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Peter Kotsoana Montso
- Food Security and Safety Focus Area, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
- Antimicrobial Resistance and Phage Bio-Control Research Laboratory, Department of Microbiology, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Omolola Esther Fayemi
- Department of Chemistry, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Adeyemi Oladapo Aremu
- Food Security and Safety Focus Area, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
- Indigenous Knowledge Systems (IKS) Centre, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Collins Njie Ateba
- Food Security and Safety Focus Area, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
- Antimicrobial Resistance and Phage Bio-Control Research Laboratory, Department of Microbiology, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
- Correspondence: ; Tel.: +27-18-389-2247
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