National surveillance of food-borne botulism in Iran during 2011–2015

ISSN Food-borne botulism, a potentially lethal neuroparalytic disease, is also a health challenge with a variable prevalence rate in Iran. This work presents the results of a 5-year surveillance of botulism in Iran, with the distribution of the cases by regions and by vehicle of transmission. This descriptive-retrospective study was done on food-borne botulism poisoning cases reported to the Iran’s Ministry of Health during 2011–2015. Data was collected by interview, examination and questionnaires. All the relevant and confirmed botulism outbreaks that occurred in the period under consideration are described. During these 5 years, 1743 cases of suspected botulism were reported from different clinical sources. A total of 99 (5.6%) cases confirmed as food-borne botulism of which the most occurred in West Azarbaijan, Guilan and Golestan provinces, respectively. The main causes of the food-borne botulism were consumption of nonpasteurized dairy products, spawn (a kind of caviar) and smoked fish. Twenty-six (26.2%) laboratory-confirmed incidents were caused by toxin type A, 21 (21.2%) by toxin type B and 15 (15.1%) by toxin type E. Among all confirmed patients, a total of 32 (32.3%) deaths were reported and the case-fatality rate ranged from 4% (in 2014) to 12% (in 2011). Though a relatively rare disease, botulism can be a serious problem of public health, particularly when connected with the consumption of traditional food products; moreover, in the last years, the shortage of specific antitoxin has caused some concern in the Public Health Authorities. Copyright 2019 Wolters Kluwer Health, Inc. All rights reserved.