A Family Outbreak of Foodborne Botulism Following Consumption of Home-Canned Doogh in Hamadan, West of Iran

Food-borne botulism is one of the potentially fatal forms of food poisoning, usually caused by ingestion of home-canned vegetables, fruits and fish products. The aim of this study was to report an outbreak of botulism due to homemade doogh in Hamadan, Iran. During an outbreak, 10 members of a family referred to the hospital because of food poisoning. All patients had a history of consumption of doogh, a traditional drink. After careful physical examination, all of them were hospitalized. Botulism was suspected in all patients except for the first patient. The first patient was a 76-year-old man who died after 12 hours of admission due to respiratory distress. Nine subsequent patients were diagnosed as botulism with the following symptoms: diplopia (90%), dizziness (70%), nausea and vomiting (80%), ptosis (60%), symmetric weakness of extremities (60%), dysarthria (30%), chest discomfort (30%), mydriasis (20%), dysphasia (20%) and dry mouth (20%). All of the nine patients received botulinum antitoxin and improved during 5-15 days of hospitalization. Immediate diagnosis based on careful history and physical examination are essential for management of botulism. People should be notified about proper food handling and preparation of traditional homemade foods.