August 15, 2007
Botulism can be dangerous in rural Alaska
by Kelsey Hustedt, Environmental Health Officer
Debbie and her family were enjoying a warm, sunny morning at fish camp when she remembered, “it’s been two weeks!”
She rushed over to the pit to find that the tep’a (fermented stink heads) in the bucket were ready. Just the thought of tep’a was making her mouth water.
Debbie and her daughter dug up the container and took it to the river to wash the tep’a. They took the tep’a back to camp where her family was anxiously awaiting the treat. Everyone sat down to a feast of tep’a and neq’errluk (dried fish).
The next evening Debbie started feeling strange. Her vision was blurry, she was slurring her speech and felt weak. Four other members of her family were having similar symptoms. They packed up their things and headed home. They were seen at the village health clinic and were referred to Bethel where they found out they had contracted Botulism.
Botulism is a rare but serious disease caused by toxin-producing bacterium called Clostridium botulinum. Botulism spores are found in soil throughout the United States, including Alaska.
There are three kinds of botulism. Foodborne botulism is caused by consuming food containing the toxin. Infant botulism is caused by ingestion of the spores where the toxin forms in the intestines of the infant. Wound botulism is caused by the toxin produced when the wound is infected with Clostridium botulinum. The most important type of botulism is foodborne, because many people can be poisoned from a single contaminated food source.
Symptoms of botulism generally show 18 to 36 hours after the toxin gets into your body. Common symptoms of botulism include: double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, vomiting, and muscle weakness. Muscle weakness may progress to paralysis of the respiratory muscles, which can be fatal.
Botulism is usually associated with home-canned and fermented foods. In Alaska, most cases are due to fermentation and drying foods. Botulism has been linked to a variety of native foods including: seal, seal oil, whale, salmon eggs, and fermented salmon heads. Botulism rates are higher in Alaska than any other state because of these native fermented foods.
The only way to diagnose this disease is to find the botulism toxin in the blood or stool. If caught early enough, the illness can be treated with an antitoxin to prevent the symptoms from worsening. Extreme cases usually require breathing machines and take several months to fully recover from the effects of the toxin.
Botulism can be prevented by cooking food properly. The toxin is destroyed by high heat. There is no way to prevent botulism when preparing fermented foods, but there are a few steps you can take to decrease your risk of getting the disease:
- Wash your hands, containers, and food before preparing or cooking the food.
- Ferment foods at a cooler temperature (usually less than 37°F) to inhibit growth of the botulinum toxin.
- Use proper methods of fermentation where air will reach the food. Do not use air-tight plastic, glass, or sealed plastic bags where the botulinum toxin will easily grow.
- Salt any dried fish to prevent growth of the toxin.
- If you don’t know how your food was handled or prepared, do not eat it.
If only Debbie had followed these simple steps or followed the traditional ways of fermentation this whole experience could have been avoided.