Botulism outbreak investigation associated with tofu (soybean cheese) in the city of São Paulo, SP – December 2005

Abstract

 Foodborne botulism, a potentially lethal neuroparalytic disease, is caused by the ingestion of food containing    preformed Clostridium botulinun neurotoxin. In Brazil, reported cases of botulism have been usually caused by    type A toxin, associated with canned vegetables, fruits or meat, generally homemade products. On December    22, 2005, the Epidemiologic Surveillance Groups from the city of Taboão da Serra, Metropolitan Area of São    Paulo, and Regional Health branch in the city of Osasco – DIR V, notified to the Center for Epidemiologic    Surveillance four suspected botulism cases, one death, residents in the city of São Paulo. Heat sensitive toxin         was detected in gastric fluid from one patient and type A toxin was identified in the suspected food. This report    summarizes the findings of the outbreak investigation, which linked disease to the ingestion of food prepared    with tofu (soybean cheese). Based on clinical features, therapeutic antitoxin was promptly administrated to the    survivor patients. Educational and sanitary measures were developed to prevent new cases.