Botulism in Alaska, 1947 through 1974. Early detection of cases and investigation of outbreaks as a means of reducing mortality
M. S. Eisenberg and T. R. Bender
Since 1947, there have been 21 outbreaks of botulism in Alaska, involving
46 people with 13 deaths (28% fatality). In the last six months of 1974,
there were four outbreaks. With one exception to date, type E toxin was
involved in all outbreaks for which laboratory confirmation has been
obtained, and in all instances, Eskimo and Indian foods were the source.
Clinical signs and symptoms of nausea and vomiting, dysphagia, diplopia,
dilated pupils, and dry throat occurred with great frequency, forming a
diagnostic pentad. We recommend that treatment include close medical
supervision, supportive care, and the use of antitoxin, cathartics, and
possibly, penicillin. The source of an outbreak must be determined to
prevent further cases. Only prompt recognition, therapy and epidemiologic
investigation can reduce the death toll from botulism.
