Botulism Associated with Commercially Distributed Kapchunka --
New York City
On August 9, 1985, a Russian immigrant couple, aged 63 and 64
years, presented to a Queens, New York, hospital emergency room
complaining of nausea and vomiting of 5 days duration for the
husband
and 1 day duration for the wife. The wife was admitted and died
the
following day. The husband was admitted August 10, and died the
following day. Botulism was suspected, and serum from the husband
was
found to be neutralized by trivalent botulinum antitoxin in the
mouse
test for botulism toxin. An investigation of food items found in
the
couple's home detected type E botulinal toxin on August 20 in
kapchunka, an ungutted, dried, salted whitefish product that is not
cooked before eating.
The source of the incriminated kapchunka is thought to be
either
of two firms, Royal Baltic or Gold Star of Brooklyn, New York,
which
manufacture kapchunka and distribute it primarily to delicatessens.
Both firms have asked stores that sell their products to hold the
incriminated product pending the outcome of an investigation by the
U.S. Food and Drug Administration (FDA). In addition to local
sales
in New York City, kapchunka was shipped to retail stores in
California, Colorado, Florida, Georgia, Illinois, Maryland,
Massachusetts, Michigan, Minnesota, Missouri, Ohio, Pennsylvania,
and
Texas. The New York City Department of Health has contacted
hospitals
in the New York City area; FDA has contacted health departments in
the
other areas where the product was distributed; and the public has
been
warned about the potential danger of the product through news
releases.
Reported by E Bell, P Bennett, S Friedman, MD, Div of Preventable
Diseases, C Riceberg, Div of Environmental Health Svc, H Baskind, M
Beim, C McGiven, M Moynihan, Bureau of Technical Svc, S Shahidi,
PhD,
Bureau of Laboratories, D Sencer, MD, New York City Health
Department;
Food and Drug Administration; Enteric Diseases Br, Div of Bacterial
Diseases, Center for Infectious Diseases, CDC.
Editorial Note
Editorial Note: Kapchunka was previously implicated as a vehicle
for
botulism when a California man was affected in 1981 (1). No
further
cases have been reported in association with the current outbreak,
but
health personnel in the affected areas should be aware of the
potential problem, especially for people in ethnic groups who may
eat
this product. Requests for testing of serum and stool for
botulinal
toxin and for trivalent botulinum antitoxin for the treatment of
botulism should be made through state health departments.
Reference
California Department of Health Services. Botulism alert.
California Morbidity (November 6, 1981).
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