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Botulism in Canada

A recent episode involving contaminated jelly belies the fact that current botulism rates in Canada are only half those reported in the United States [see graph]

The following background data on botulism in Canada are abstracted from the Gideon e-book series. [1,2] Primary references are available on request.

Historical background:
The first outbreak of botulism in Canada was recorded in 1919.
– A total of 100 outbreaks involving over 230 cases had been reported to 2005.
– Botulism is primarily encountered among the First Nations and Inuit people.
– Rates of 30 per 100,000 per year are reported among the Inuit.
– Most cases in recent years have been caused by fermented salmon roe (‘stink eggs’ or ‘gink’) in British Columbia; and fermented sea mammal meat among the Inuit.
– 14 outbreaks (63 cases, 35 fatal) were reported during 1919 to 1954.
– 61 outbreaks (122 cases, 21 fatal) were reported during 1971 to 1984 – Inuit people accounted for 92.6% of the patients, and 59% of the cases caused by raw, parboiled or “fermented” meats from marine mammals. Fermented salmon eggs or fish accounted for 23% of the outbreaks.

Canada’s first case of infant botulism was reported in 1971.
– 27 cases of infant botulism were reported during 1979 to 2006 – including 22 type A and 5 type B.
– As of 2008, infant botulism had been reported in 26 countries – with highest numbers in United States – followed by Argentina, Australia, Canada, Italy, and Japan.

Food recalls:
2006 – Lots of imported Italian olives, American carrot juice, chili sauce and pasteurized canned crab were recalled due to contamination with botulism toxin.
2007 – A recall was issued for clams and cod liver sold in mason jars.
2010 – A recall was issued for peperoni products sold in British Columbia.
2011 – A case of botulism on Vancouver Island let to the recall of watermellon jelly.

Notable outbreaks:
1974 – Outbreaks (10 cases in 4 outbreaks, 4 fatal) of type E botulism were reported among indigenous peoples. Walrus, Arctic char, seal and fermented salmon eggs were implicated.
1977 (publication year) – Outbreaks (12 cases in 2 outbreaks) of type A and B botulism were reported among Inuit peoples.
1985 – An outbreak (36 cases) in the United States and Canada was associated with chopped garlic in soybean oil served in a restaurant in Vancouver, Canada.
1991 – An outbreak of type A botulism was reported in Ottawa.
1995 – Outbreaks (16 cases in 7 outbreaks, 0 fatal) and one case of infant botulism were reported – implicated foods included muktuk, micerak (fermented fat of marine mammals), seal, walrus and marinated/smoked fish.
1996 – Outbreaks (10 cases in 5 outbreaks, 0 fatal) of foodborne botulism were reported – implicated foods included seal, fermented fish, beluga whale and micerak.
1997 – Outbreaks (18 cases in 7 outbreaks, 1 fatal) were reported – including 9 cases in Quebec acquired from seal igunaq and 4 cases in the Northwest Territories acquired from beluga whale and caribou fat.
1999 – An outbreak (3 cases) of type B botulism in Ontario was ascribed to home-canned tomatoes.
2001 – Outbreaks (4 cases in 2 outbreaks, 1 fatal) in British Columbia were ascribed to fermented salmon roe.
2006 – An outbreak (4 cases) in the United States was associated with commercially-canned carrot juice. Three additional cases in Toronto were associated with the same product.
2009 – An outbreak (3 cases) of type E botulism in France was related to vacuum packed hot-smoked Canadian whitefish purchased in Finland.

References:
1. Berger SA. Infectious Diseases of Canada, 2011. 475 pp. Gideon e-book series, http://www.gideononline.com/ebooks/country/infectious-diseases-of-canada/
2. Berger SA. Botulism: Global Status, 2011. 80 pp. Gideon e-book series, http://www.gideononline.com/ebooks/disease/botulism-global-status/

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