Botulism Outbreak Review

Botulism Outbreak Review

What is it? Clostridium botulinum is a spore-forming bacteria commonly found in soil, that survives in low oxygen environments, and lays dormant until exposed to conditions that support its growth. Once ingested, spores release a nerve toxin that blocks nerve function and can lead to respiratory and muscular paralysis. The most common symptoms are as follows: double vision, blurred vision, slurred speech, droopy eyelids, dry mouth, muscle weakness and/or difficulty swallowing. Botulism is not contagious.

What happened at FMC? Elizabeth Walz, M.D. diagnosed the first patient at Fairfield Medical Center with botulism the morning of April 21 and quickly discovered the association with a potluck at a local church. FMC activated a Code Green: External Disaster on April 21 at noon. It was discontinued on the morning of April 23.

FMC has seen a total of 53 patients in the Emergency Room with botulism exposure. Many patients were transferred to Columbus hospitals and/or discharged home. Three patients remain at FMC with anticipated lengthy recoveries. A total of nine doses of the anti-toxin were administered to
patients at FMC.

To date, the total number of cases is as follows: 22 confirmed Toxin A botulism cases (including one death); nine suspected cases; and eight patients still hospitalized.

What caused it? The Ohio Department of Health Lab confirmed the presence of Toxin A in six food samples. The presence of Toxin A in the six food samples was believed to be a result of cross contamination. Interviews, including food histories, were completed with a total of 77 potential exposed persons. Based on the lab results and interviews, the contaminated food source was communicated to the public as the homemade potato salad with improperly home canned potatoes.

What to do for your patients? FMC continues to get many questions regarding the aftercare of patients with botulism. A patient oriented handout that describes the expected course of botulism has been created and is available by contacting FMC Infection Control
practitioners or online at clicking here.

One of the questions is whether neurology and/or infectious disease involvement is necessary after successful diagnosis and treatment of the patient with botulism. It seems that there would be limited benefi t to these consults or follow-up. More important would be follow-up for physical therapy, occupational therapy, speech therapy, counseling and even physical medicine for rehabilitation on an outpatient basis. Some patients may have difficulty with breathing or shortness of breath. In those cases, a referral to the pulmonary specialist may be helpful. If the patient is still very weak and ill, rehabilitation in a rehabilitation facility and/or a specialty hospital may be required

As patients are being transitioned to home, it's become apparent that there may be questions regarding the proper treatment for these patients after recovery begins. The Infection Control Team is available to assist you.

Contact information:

Andrew R Murry, M.D., C.W.S., F.A.C.P.
Assistant Medical Director – Infection Control
740-687-8805 ext. 1
dramurry@fmchealth.org

Ann Preble, B.S., M.T., (A.S.C.P.)
Infection Control Practitioner
740-687-8625
annp@fmchealth.org

Jodie Hildenbrand, M.S.N., R.N., C.N.L.
Infection Control Practitioner
740-687-8493
jodieh@fmchealth.org

Recovery from botulism may take time. There are resources to aid in your and/or your loved one’s recovery.

For financial needs or questions, please call our financial representative at (740)687-8371.

Home Health Nursing and/or Home Health Therapy Services and/or short term rehabilitation may be arranged by calling our Case Managers at 740-687-8040 or 740-687-8060.

Outpatient Physical, Occupational, and/or Speech Therapy may be arranged by calling 740-687-8602. Outpatient Therapy offices are located at 1143 E. Main St., Lancaster, Ohio 43130. Please note: Speech therapy is also indicated for persons suffering from swallowing difficulties. These therapies may also assist in questions related to work i.e. restrictions, disability, and/or functional job capacity.

Mental Health support and/or counseling may be arranged by the following steps:

You may begin the process of selecting a therapist by contacting the Mental Health Provider Information Service. To find out who is “in network”. The phone number will be listed on your insurance card. If no mental health phone number is listed on your card, then call the customer service number on the card and tell them you would like a list of mental health providers “in network”. Then select one of those providers from this list and call to schedule an appointment.

In addition, a great resource may be found on-line at http://www.nami.org/

Click here to download a list of local counseling services available.

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