MacDonald K L, Spengler R F, Hatheway C L, Hargrett N T, Cohen M L
JAMA. 1985 Mar 1;253(9):1275-8.
Twenty-eight persons were hospitalized in Illinois with neurologic signs and symptoms compatible with botulism in October 1983. Twelve patients required ventilatory support, and 20 patients were treated with trivalent ABE antitoxin; one patient died while still in the hospital six months after onset of illness. Type A toxin and/or type A Clostridium botulinum were subsequently identified in specimens from 18 patients. Case-control studies implicated sauteed onions made from fresh raw onions and served on a patty-melt sandwich in a local restaurant as the vehicle of transmission. Although the original sauteed onions were not available for toxin testing, type A toxin was detected in washings from a wrapper in which a patty-melt sandwich was taken home by one of the ill persons. Also, type A C botulinum was cultured from five of 75 raw onions taken from the restaurant. This outbreak implicated an unusual vehicle for botulinal toxin that was initially not suspected and demonstrates the importance of considering all theoretically possible food items as potential vehicles for toxin until epidemiologic and laboratory data have been collected and analyzed.
1983年10月，伊利诺伊州有28人因出现与肉毒中毒相符的神经体征和症状而住院治疗。12名患者需要呼吸支持，20名患者接受了三价ABE抗毒素治疗；1名患者在发病6个月后仍住院期间死亡。随后在18名患者的标本中鉴定出A型毒素和/或A型肉毒杆菌。病例对照研究表明，当地一家餐馆夹在肉饼三明治中的用新鲜生洋葱炒制的洋葱是传播媒介。尽管最初的炒洋葱无法进行毒素检测，但在一名患病者带回家的肉饼三明治包装纸的洗涤液中检测到了A型毒素。此外，从该餐馆采集的75个生洋葱中，有5个培养出了A型肉毒杆菌。此次疫情涉及一种最初未被怀疑的肉毒毒素异常传播媒介，表明在收集和分析流行病学及实验室数据之前，将所有理论上可能的食物视为毒素潜在传播媒介的重要性。
