Public health officials in Amarillo, TX, are investigating a possible botulism outbreak after learning of four probable cases of the rare and potentially fatal foodborne illness on Friday, Dec. 6. As of Wednesday, Dec. 11, officials reportedly had not yet identified a common source and were checking into what the four adult patients had eaten in the hours and days leading up to their illnesses. Two of the patients had been treated with botulism anti-toxin, and all four were hospitalized. “All the patients are improving,” said Dr. Roger Smalligan, public health authority for Potter and Randall counties. “One patient required mechanical ventilation, but they’ve been taken off. Another is still on a ventilator, but is improving.” According to a story published Wednesday in the Amarillo Globe-News, officials were warning other health professionals and the general public that there might be other cases. “We don’t want to wait around and have other people affected,” Smalligan said. Common symptoms of infection by the botulism toxin include blurred vision, difficulty swallowing, slurred speech, and heavy or droopy eyelids. Because the bacteria attacks the body’s nerve endings, it can lead to paralysis. Symptoms usually appear 12 to 36 hours after being exposed to the toxin, but it may take up to eight days. The disease can only be spread by consuming a contaminated food source. Most of the botulism cases reported in the U.S. are associated with home-canned foods that have not been safely processed. Very occasionally, however, commercially processed foods are implicated as the source of botulism, including sausages, beef stew, canned vegetables and seafood products. Botulism cases are rare, with an average of 145 cases reported each year in the U.S.