AUTHOR=Hendrickx David , Varela Martínez Carmen , Contzen Matthias , Wagner-Wiening Christiane , Janke Karl-Heinz , Hernando Jiménez Pablo , Massing Susanne , Pichler Jeanette , Tichaczek-Dischinger Petra , Burckhardt Florian , Stark Klaus , Katz Katharina , Jurke Annette , Thole Sebastian , Carbó Rosa , del Pobil Ferré Mariam Pascual , Nieto Milagros , Zamora María Jesús , Sisó Ana , Pallares García Pilar , Valdezate Sylvia , Schaade Lars , Worbs Sylvia , Dorner Brigitte Gertrud , Frank Christina , Dorner Martin Bernhard 

TITLE=First cross-border outbreak of foodborne botulism in the European Union associated with the consumption of commercial dried roach (Rutilus rutilus)

JOURNAL=Frontiers in Public Health

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1039770

DOI=10.3389/fpubh.2022.1039770

ISSN=2296-2565

ABSTRACT=<p>Botulism outbreaks due to commercial products are extremely rare in the European Union. Here we report on the first international outbreak of foodborne botulism caused by commercial salt-cured, dried roach (<italic>Rutilus rutilus</italic>). Between November and December 2016, an outbreak of six foodborne botulism type E cases from five unrelated households was documented in Germany and Spain. The outbreak involved persons of Russian and Kazakh backgrounds, all consumed unheated salt-cured, dried roach—a snack particularly favored in Easter-European countries. The implicated food batches had been distributed by an international wholesaler and were recalled from Europe-wide outlets of a supermarket chain and other independent retailers. Of interest, and very unlike to other foodborne disease outbreaks which usually involves a single strain or virus variant, different <italic>Clostridium botulinum</italic> strains and toxin variants could be identified even from a single patient's sample. Foodborne botulism is a rare but potentially life-threatening disease and almost exclusively involves home-made or artisan products and thus, outbreaks are limited to individual or few cases. As a consequence, international outbreaks are the absolute exception and this is the first one within the European Union. Additional cases were likely prevented by a broad product recall, underscoring the importance of timely public health action. Challenges and difficulties on the diagnostic and epidemiological level encountered in the outbreak are highlighted.</p>