TY - JOUR AU - Sheppard, Yolanda AU - Middleton, Dean AU - Whitfield, Yvonne AU - Tyndel, Felix AU - Haider, Shariq AU - Spiegelman, Jamie AU - Swartz, Richard AU - Nelder, Mark AU - Baker, Stacey AU - Landry, Lisa AU - MacEachern, Ross AU - Deamond, Sherri AU - Ross, Lorrie AU - Peters, Garth AU - Baird, Michelle AU - Rose, David AU - Sanders, Greg AU - Austin, John T1 - Intestinal Toxemia Botulism in 3 Adults, Ontario, Canada, 2006–2008 T2 - Emerging Infectious Disease journal PY - 2012 VL - 18 IS - 1 SP - 1 SN - 1080-6059 AB - Five cases of intestinal toxemia botulism in adults were identified within an 18-month period in or near Toronto, Ontario, Canada. We describe findings for 3 of the 5 case-patients. Clinical samples contained Clostridium botulinum spores and botulinum neurotoxins (types A and B) for extended periods (range 41–61 days), indicative of intestinal toxemia botulism. Patients’ clinical signs improved with supportive care and administration of botulinum antitoxin. Peanut butter from the residence of 1 case-patient yielded C. botulinum type A, which corresponded with type A spores found in the patient’s feces. The food and clinical isolates from this case-patient could not be distinguished by pulsed-field gel electrophoresis. Two of the case-patients had Crohn disease and had undergone previous bowel surgery, which may have contributed to infection with C. botulinum. These cases reinforce the view that an underlying gastrointestinal condition is a risk factor for adult intestinal toxemia botulism. KW - intestinal botulism KW - Crohn disease KW - Clostridium botulinum KW - bacteria KW - adult intestinal toxemia botulism KW - Canada DO - 10.3201/eid1801.110533 UR - https://wwwnc.cdc.gov/eid/article/18/1/11-0533_article ER - End of Reference