Botulism in Estonia, 1982-1998

 1 Published: 24.05.05 Updated: 24.05.2005 11:06:16
Juta Varjas, Kuulo Kutsar Health Protection Inspectorate, Estonia
In 1992 - 1998 was diagnosed 43 cases of botulism in Estonia with annual average 1 - 2 cases. Most cases were in age groups 20 - 29 and 40 - 49 years. Botulism was connected with consumption of home-made canned and dried food ( meat, fish, mushrooms, vegetable ). Infectious agents were predominantly Clostridium botulinum type B and rarely types A and E.

Botulism is a comparatively seldom occurring disease in Estonia. In the period 1982-1998 altogether 43 people became ill with botulism. Annual average is 1-2 ill people. Only the year 1992 was different: the number of people who became ill was considerably higher - 11 people had diagnosed botulism (incidence rate 0,7). Evidently it was connected with the food problems in Estonia in the beginning of 1990-s, which were accompanied by intensive spread of gastrointestinal infectious diseases at the same time. Out of diseased persons 18 were men and 25 women; by age groups they were: 0-9 years 1 person, 10-19 years 1 person, 20-29 years 11 persons, 30-39 years 3 persons, 40-49 years 14 persons, 50-59 years 5 and 60 years and older were 8 persons.

All the cases of botulism have been connected with consumption of food, and in the period of observation no infant or wound botulism cases were registered. People have fallen ill after eating home-canned and dried meat; canned mushrooms; marinated, smoked and cured dried fish and canned vegetables. Important information was obtained from investigation of infection foci. People fell ill simultaneously, together in small groups. So 43 cases become divided into 32 foci. On four occasions two persons simultaneously fell ill, on two occasions three persons and on one occasion four persons fell ill.

Diagnosis has been proven with the results of laboratory investigations in 44 % of cases. Most often botulism was caused by the Clostridium botulinum type B (14 cases). Four and two cases have been connected accordingly with type E and A. All Clostridium botulinum E cases occurred as a result of eating contaminated fish (salted trout, marinated herring, home made sprats in oil, smoked fish).

The majority of cases were of mild or middle severity. After specific treatment the patients recovered, except one patient (72 year old women, without specific treatment) who died.