Purpose: The aim of the study was to give an overview of the situation of human botulism in Belgium, over the past 29 years, and to elaborate on C. botulinum foodborne outbreaks.
Methods: The NRC collects clinical data on human botulism cases and food investigations. A confirmed case means that clinical (symptomatology) and laboratory criteria (detection of active botulinum toxin or BoNT-producing Clostridia in clinical samples) are in accordance. Mouse bioassays were performed for the detection of BoNT in (cultured) samples and realtime PCR assays for the detection of BoNT genes.
Results: Incidence of human botulism in Belgium is low; only 14 cases of human botulism and 1 case of infant botulism were confirmed between 1988 and 2013 (average: 1 case every 2 years). Between 2014 and 2016, four additional cases were confirmed. There is a clear preponderance of botulism type B cases (16 type B, 1 type E, 1 type A, and 2 unknown); all due to the ingestion of contaminated artisanal foods. During the last decade, no contamination of commercially produced foods, available on the market, were detected through monitoring surveillance, except for some honey samples.
Significance: Botulism is a rare but severe/fatal disease and the surveillance of cases is indispensable for identification and effective control of potential outbreaks. Appropriate actions must be carried out, promptly, in order to ensure such vital health protection activities. Furthermore, the risk posed by this organism is not negligible in relation to home preserved food, as well as in regard to modern food processing.