Uitbraak van voedselgerelateerde botulisme op een minicruise

In the Netherlands, an outbreak of 7 documented cases of food borne botulism was observed among travelers, all adults, returning from a mini-cruise in the Mediterranean Sea. The spectrum of disease ranged from subtle bulbar paresis to deregulation of the autonomic nerve system, severe oculobulbar paralysis and generalized muscle weakness. The typical clinical presentation plus the information that the patients shared their daily meals, together with detection of Clostridium botulinum type B in the feces in 4 of them, confirmed the cause of the outbreak. The most severely affected patients were treated with antitoxin and supportive care. No patient needed mechanical ventilation. Although sporadic cases have been reported, outbreaks of foodborne botulism have not occurred in the Netherlands over the past decades. However, with increasing numbers of people travelling to areas with a higher prevalence, physicians should be able to recognize botulism and to treat it appropriately.