METHODS: In December 2014, staff from the Alaska Division of Public Health (DPH) Sections of Epidemiology and Public Health Nursing, along with health care providers and community members, responded to a large foodborne botulism outbreak in Western Alaska. Activities included identifying suspected cases for medical evaluation and treatment, shipping botulinum antitoxin (BAT) to affected area hospitals, daily monitoring of individuals who ate the suspected food, implementing control measures, and community education.
RESULTS: The investigation identified 23 people in three communities who had eaten the suspected food—rendered seal oil with blubber bits that was made and distributed by a common supplier. Nine people were flown out of their villages for evaluation at a regional emergency department. Four symptomatic individuals were hospitalized and three received BAT that had been pre-positioned in the regional hospital’s pharmacy. The 19 asymptomatic persons who consumed the product were monitored with a daily phone call or home visit for 10 days after exposure. There were no deaths. Botulinum toxin type E was detected in pre-BAT serum in two of the hospitalized patients and in two samples of the seal oil.
CONCLUSIONS: This investigation highlights the challenges of responding to a large botulism outbreak in rural Alaska. Prompt reporting by health care providers triggered an immediate public health investigation. Collaboration with key stakeholders in the medical and affected communities likely prevented additional cases of botulism.