January 11, 2017
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Prison ‘hooch’ caused largest US botulism outbreak since 1978

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Investigators reported that the largest botulism outbreak in the United States in almost 40 years came after dozens of federal inmates drank an illicit alcoholic beverage possibly made from fermented fruits and vegetables.

Thirty-one inmates from a medium-security federal prison in Mississippi were sickened last year and 24 were hospitalized after drinking a beverage known as “hooch” or “pruno,” according to CDC and state health investigators.

Fifteen patients were admitted to the ICU and nine required intubation and mechanical ventilation, the investigators wrote in MMWR. None of the patients died.

There were 19 confirmed cases, 10 probable cases and two suspected cases — the largest botulism outbreak in the U.S. since 1978 when 34 cases were linked to bean or potato salad from a country club in New Mexico.

Several of the patients in the Mississippi outbreak became sick after being sent to facilities in Texas and Oklahoma as part of routine inmate transfers, investigators said. Most of the affected inmates had never heard of botulism and did not know that drinking the illicit beverage could make them sick, according to the report.

Investigators said prison officials confiscated more than 20 gallons of the beverage, but details of the batch responsible for the botulism cases are unknown. However, one prisoner reported that a batch of the liquid was made by fermenting honey, potatoes, apples, and tomato paste from a bulging can at room temperature in a plastic bag for 3 to 5 days.

Tomato paste and potatoes are potential sources of Clostridium botulinum or toxin, and potatoes have been suspected as the source of other such outbreaks, investigators said.

According to the report, some of the drinking occurred during a farewell party for one inmate and the NBA Finals.

“Facility staff members should consider the potential for increased ‘hooch’ consumption during celebratory events,” the investigators said. “Educating correctional facility staff members and inmates about the risks of consuming ‘hooch’ and good communication channels between facility staff members and inmates can help to identify and treat persons with botulism quickly and prevent deaths.” – by Gerard Gallagher

Disclosures: The researchers report no relevant financial disclosures.