1246. Prisons, Pruno, and Potatoes Botulism in an Arizona Correctional Facility, 2012
Session: Oral Abstract Session: Hot Topics in Public Health
Saturday, October 5, 2013: 11:00 AM
Room: The Moscone Center: 220-226
Background: Botulism, caused by botulinum toxin, can lead to respiratory paralysis and death. Foodborne botulism outbreaks have been associated with pruno, an illicit prison-brewed alcohol, when potatoes are an included ingredient. We investigated the second botulism outbreak in one correctional facility within a 4-month period to examine pruno as the potential cause and prevent additional cases.

Methods: A confirmed case was defined as botulism signs or symptoms in a correctional facility inmate, with laboratory confirmation of botulinum toxin during November 24–26. Clinical specimens and leftover pruno were tested for Clostridium botulinum and botulinum neurotoxin by using botulinum toxin gene real-time PCR, botulinum toxin enzyme-linked immunosorbent assay, mouse bioassay, and mass spectrometry. We interviewed inmates and correctional officers about brewing practices.

Results: Illness was confirmed in eight males aged 20–35 years. Initial symptoms included double or blurred vision, slurred speech, dysphagia, ptosis, and weakness. All patients received heptavalent botulinum antitoxin (HBAT); seven required mechanical ventilation, and all survived. All reported sharing a batch of pruno made primarily from potatoes; median incubation from pruno consumption to clinical signs was 29 (range: 16–64) hours. No other inmates reported consuming this pruno. Sera from all patients and leftover alcohol tested positive for botulinum toxin type A. C. botulinum type A was isolated from rectal swabs, stool, and pruno samples.

Conclusion: Prison-brewed alcohol made with potatoes was associated with the second botulism outbreak in one Arizona prison and the first U.S. outbreak in which pruno tested positive for botulinum toxin. Pruno ingredients and brewing practices likely facilitated botulinum toxin production. Access to potatoes was curtailed in the facility, and inmates were educated regarding the risk of botulism.

Laura Adams, DVM MPH1,2, Seema Yasmin, MD1, Graham Briggs, BS3, Shoana Anderson, MPH2, Jamae Morris, PhD1, Joli Weiss, PhD2, Clarisse Tsang, MPH2, Evan Henke, Ph D2, Muhammad Vasiq, MD4, Tara Anderson, DVM, PhD1, Agam Rao, MD5, Janet Dykes, MS5, Carolina Luquez, PhD5, Kristine Bisgard, DVM5 and Ken Komatsu, MPH2, (1)Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, (2)AZ Dept. of Health Services, Phoenix, AZ, (3)Pinal County Department of Public Health, Florence, AZ, (4)Mountain Vista Medical Center, Mesa, AZ, (5)Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

L. Adams, None

S. Yasmin, None

G. Briggs, None

S. Anderson, None

J. Morris, None

J. Weiss, None

C. Tsang, None

E. Henke, None

M. Vasiq, None

T. Anderson, None

A. Rao, None

J. Dykes, None

C. Luquez, None

K. Bisgard, None

K. Komatsu, None

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