Global & Disaster Medicine

Botulism in Italy, 1986 to 2015

Eurosurveillance

Eurosurveillance, Volume 22, Issue 24, 15 June 2017

Surveillance and outbreak report                                                                                                                                                                               Anniballi, Auricchio, Fiore, Lonati, Locatelli, Lista, Fillo, Mandarino, and De Medici:                                                                                 Botulism in Italy, 1986 to 2015

“…..From 1986 to 2015, 466 confirmed cases of botulism were recorded in Italy (of 1,257 suspected cases). Of these, 421 were food-borne (the most frequently seen form of botulism due to the consumption of improperly home-canned foods), 36 were infant botulism, which accounts for ca 50% of all these types of cases registered in Europe, six were wound-related and three were due to adult intestinal colonisation. ……”
Clinical signs and symptoms reported by patients with food-borne botulism, Italy, 1986–2015 (n=421)
Clinical sign/symptom Number of cases % of cases
Headache 28 6.6
Double vision 298 70.6
Drooping upper eyelid 43 10.2
Dilation of the pupil 88 20.9
Difficulty in swallowing 304 72.0
Dry mouth 278 65.9
Facial palsy 28 6.6
Respiratory failure 75 17.8
Constipation 209 49.5
Nausea 145 34.4
Vomiting 157 37.2
Abdominal pain 6 1.4
Diarrhoea 40 9.5
Urinary retention 20 4.7
Coma 9 2.1
Death 17 4.0
* Usually, patients presented mild symptomatology, with a clinical picture including diplopia (double vision), dysphagia (difficulty in swallowing), and dry mouth in ca 50% of the cases.
* Respiratory failure was reported in 17.8% (75/421) of patients.
* 16 deaths were recorded, giving a case-fatality rate of 3.8% (16/421), with four of the deaths occurring in elderly patients aged over 80 years who lived alone.

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