April’s botulism outbreak in Ohio was the nation’s largest in 40 years, and one of the first patients to become ill died. But CDC’s Morbidity and Mortality Weekly Report (MMWR) is crediting early recognition and fast action with limiting the damage. The single fatality in the Ohio botulism outbreak blamed on a church potluck luncheon was the first since 1978 involving an outbreak with more than 10 cases, according to MMWR’s report. Potato salad prepared with home-canned potatoes was implicated as the source of the botulism outbreak associated with the potluck http://www.dreamstime.com/royalty-free-stock-photo-creamy-german-potato-salad-image14293025luncheon at the Cross Pointe Free Will Baptist Church in Lancaster, OH. MMWR for July 31, 2015, states that 29 cases of botulism were experienced by those participating in the potluck, and that one person died. The last time a death resulted from an outbreak of 10 or more cases of botulism in the United States was in 1978 when 34 county club diners in New Mexico eating bean and potato salad were stricken with botulism and one died. In the recent Ohio outbreak, the federal Centers for Disease Control and Prevention (CDC) publication stated that 77 took part in the potluck luncheon at the Lancaster church, 25 met the confirmed case definition, and four met the probable case definition. “The median age of patients was 64 years (range = 9-87 years); 17 (59 percent) were female. Among 26 (90 percent) patients who reported onset dates, illness began a median of two days after the potluck (range 1-6 days).” Twenty-seven of the 29 patients went initially to Fairfield Medical Center, and 22 (76 percent) were transferred from FMC to six hospitals in the Columbus metropolitan area, which is about 30 miles from Lancaster. “Botulism is a severe, potentially fatal neuroparalytic illness.” MMWR states. “A single case is a public health emergency, because it can signal an outbreak.” When the first cases began arriving at FMC on April 21, and later than afternoon, a patient arriving at the Emergency Room died of respiratory failure and the Ohio Department of Health was notified. Once it was determined that the source was likely something on the menu at the April 19 potluck luncheon, CDC’s Strategic National Stockpile sent 50 doses of botulinum antitoxin to Ohio. “FMC, the Fairfield Department of Health, ODH and CDC rapidly responded to confirm the diagnosis, identify and treat additional patients, and determine the source, “ according to the MMWR wrapup on the incident. Twenty-five doses of the antitoxin were used and 11 patients (38 percent) also required endotracheal intubation and mechanical ventilation. Within the week of arrival at the ER, 16 of the botulism patients were able to be discharged from the hospitals. “This outbreak response illustrates the benefits of coordination among responders during botulism outbreaks,” MMWR concluded. “Close adherence to established home-canning guidelines can prevent botulism and ensure safe sharing of home-canned produce.” CDC also found that the person who made the potato salad with home-canned potatoes reported using a boiling water canner, which does not kill C. botulinum spores, rather than a pressure canner, which does eliminate those spores. “In addition, the potatoes were not heated after removal from the can, a step that can inactivate botulinum toxin,” MMWR adds. “The combined evidence implicated potato salad prepared with improperly home-canned potatoes, a known vehicle for botulism.”