In November of 2012, eight inmates of an Arizona state prison complex fell ill with botulism that was thought to be acquired from homemade alcohol brewed in prison cells. Now, a report from the federal Centers for Disease Control and Prevention sheds light on what caused this outbreak and what is being done to prevent future epidemics of this nature. Prisoners at the Eyman Correctional Facility in Norman, Arizona fell ill between November 24 and November 27 of 2012. All were hospitalized after experiencing symptoms of botulism –  a disease that affects the nervous system –  including blurred vision, weakness and difficulty swallowing. Health officials eventually discovered that the inmates lived in adjoining pods and had all drunk pruno, an illegally brewed alcoholic drink. Just three months earlier, in August of 2012, four other inmates of the same hospital were hospitalized with botulism after drinking pruno. All victims of both outbreaks were hospitalized. Of these victims, nine were intubated, meaning that a tube was placed in their throat to facilitate breathing and consumption of drugs. These two outbreaks marked a spike in pruno-related botulism outbreaks in 2012. Before last year, only 13 cases of botulism-related pruno were reported to state health departments, compared to the 12 reported in 2012 alone. The November 2012 outbreak was later linked to pruno that had been made using fermented baked potatoes. Potatoes tested positive for botulinum toxin type A, the same type asociated with the outbreak, report the authors of the paper.   “For this batch, they put a baked potato in sealed, warm bottles and fermented it for several days- the perfect environment for producing botulism toxin,” said Will Humble, director of Arizona’s Department of Health Services in a December 14, 2012 post on his blog, . “This prison brew (called pruno) is foul smelling and doesn’t look much better either,” noted Humble. “It has been a source of botulism in past outbreaks, especially when potatoes are used. The CDC paper also notes that two instances of botulism in  California (one tied to four victims and the other a singular case), and one botulism outbreak in a Utah prison sickened 13 in total between 2004 and 2011. Is this spike in reported pruno-related botulism cases due to more prisoners making pruno, or to pruno being made in a more unsafe way? “We have no information on the magnitude of pruno production in prisons over past years,” said Seema Yasmin, Epidemic Intelligence Service Officer for CDC and employee of the Arizona Department of Health Services in an emailed statement to Food Safety News. “Botulism can be difficult to diagnose on the basis of clinical symptoms alone and some cases might not be recognized,” said Yasmin, who was also an author of the study.   The authors note that the Arizona Department of Health Services has been working with the CDC to come up with measure to prevent such outbreaks from occurring in the future. One such measure is the removal of baked potatoes from cafeteria menus, according to the report. “Arizona Department of Health Services and Pinal County Health Services are providing education for prison staff and inmates in the form of lectures and leaflets,” said Yasmin.