{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T15:00:43Z","timestamp":1768489243905,"version":"3.49.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Epidemiol Glob Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Botulism has not been previously reported in the Kingdom of Saudi Arabia. This rare and sometimes fatal foodborne illness is caused by neurotoxins and primarily results from consuming home-canned fruits, vegetables, dairy, and seafood products &amp; it can lead to paralysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>The purpose of this study was to evaluate the clinical features of patients who developed botulism in Riyadh in 2024 after consuming mayonnaise from a well-known local chain of restaurants in Riyadh, Saudi Arabia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a retrospective analysis of medical records and interviewed patients or their attendants for all hospitalized cases of foodborne botulism at Riyadh First Health Cluster. For each patient, a standard case report form was completed, containing information on demographics, clinical aspects, botulinum test results, and type of exposure. Descriptive statistics were applied to assess the data. During the outbreak, nineteen patients with foodborne diseases were admitted to Riyadh First Health Cluster Hospitals. Following thorough physical examinations, botulism was suspected in each case.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Eight of the 19 suspected foodborne illness patients fully satisfied the botulism case definition requirements set forth by the Saudi Arabian Public Health Authority (Weqaya). Among these eight patients, 2 (25%) were male and 6 (75%) were female, with a mean age of 23.25\u2009\u00b1\u20099.29 years (range: 12\u201338 years). The incubation period for our patients was 36.25\u2009\u00b1\u200926.26\u00a0h. Notable symptoms included dysphagia in all eight patients (100%), dysarthria, generalized weakness, nausea and vomiting in seven patients (88%), diplopia in four patients (50%), and stomach discomfort in three patients (38%). Of the eight cases, six required intubation, one mimicked brain death, and two were stable. The presence of Clostridium botulinum spores as the cause of the outbreak was confirmed by detecting botulinum spores in contaminated food.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Diplopia and dysarthria were the most common early sign of botulism. Early manifestations may include respiratory symptoms without any musculoskeletal symptoms. or nausea, vomiting and disorientation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s44197-024-00255-z","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T09:02:05Z","timestamp":1717578125000},"page":"1071-1076","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The First Reported Foodborne Botulism Outbreak in Riyadh, Saudi Arabia: Lessons Learned"],"prefix":"10.1007","volume":"14","author":[{"given":"Nadeem","family":"Gul Dar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah H.","family":"Alfaraj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khulood Naser","family":"Alboqmy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazia","family":"Khanum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faleh","family":"Alshakrah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Abdallah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Hosni","family":"Badawi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ohoud Mohammed","family":"Alharbi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khadijh Ahmed","family":"Alshiekh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah M","family":"Alsallum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Hassan","family":"Shrahili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeidan A","family":"Zeidan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaki","family":"Abdallah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Ali","family":"Majrashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziad A.","family":"Memish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"issue":"1","key":"255_CR1","doi-asserted-by":"publisher","first-page":"2205251","DOI":"10.1080\/21505594.2023.2205251","volume":"14","author":"AM Rawson","year":"2023","unstructured":"Rawson AM, Dempster AW, Humphreys CM, Minton NP. Pathogenicity and virulence of Clostridium botulinum. Virulence. 2023;14(1):2205251. https:\/\/doi.org\/10.1080\/21505594.2023.2205251.","journal-title":"Virulence"},{"key":"255_CR2","unstructured":"Centers for Disease Control and Prevention (CDC). (2022, August 26). Botulism: Healthcare Professionals. https:\/\/www.cdc.gov\/botulism\/health-professional.html (02 May 2024,date last accessed)."},{"key":"255_CR3","doi-asserted-by":"crossref","unstructured":"Lund BM, Peck MW. Clostridium botulinum. In: Labb\u00e9 RG, Garc\u00eda S, editors. Guide to foodborne pathogens. 2nd ed. John Wiley & Sons, Ltd.; 2013. pp. 92\u2013111.","DOI":"10.1002\/9781118684856.ch6"},{"key":"255_CR4","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/S0065-2911(09)05503-9","volume":"55","author":"MW Peck","year":"2009","unstructured":"Peck MW. Biology and genomic analysis of Clostridium botulinum. Adv Microb Physiol. 2009;55:183\u2013265. https:\/\/doi.org\/10.1016\/S0065-2911(09)05503-9.","journal-title":"Adv Microb Physiol"},{"issue":"1","key":"255_CR5","doi-asserted-by":"publisher","first-page":"14130","DOI":"10.1038\/ncomms14130","volume":"8","author":"S Zhang","year":"2017","unstructured":"Zhang S, Masuyer G, Zhang J, Shen Y, Lundin D, Henriksson L, Miyashita SI, Mart\u00ednez-Carranza M, Dong M, Stenmark P. Identification and characterization of a novel botulinum neurotoxin. Nat Commun. 2017;8(1):14130. https:\/\/doi.org\/10.1038\/ncomms14130.","journal-title":"Nat Commun"},{"issue":"1","key":"255_CR6","doi-asserted-by":"publisher","first-page":"38","DOI":"10.3390\/toxins9010038","volume":"9","author":"MW Peck","year":"2017","unstructured":"Peck MW, Smith TJ, Anniballi F, Austin JW, Bano L, Bradshaw M, Cuervo P, Cheng LW, Derman Y, Dorner BG, Fisher A, Hill KK, Kalb SR, Korkeala H, Lindstr\u00f6m M, Lista F, L\u00faquez C, Mazuet C, Pirazzini M, Singh BR, Stringer SC. Historical perspectives and guidelines for botulinum neurotoxin subtype nomenclature. Toxins(Basel). 2017;9(1):38. https:\/\/doi.org\/10.3390\/toxins9010038. PMID: 28106761; PMCID: PMC5308270.","journal-title":"Toxins(Basel)"},{"issue":"8","key":"255_CR7","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1086\/444507","volume":"41","author":"J Sobel","year":"2005","unstructured":"Sobel J. Botulism. Clin Infect Dis. 2005;41(8):1167\u201373. https:\/\/doi.org\/10.1086\/444507.","journal-title":"Clin Infect Dis"},{"issue":"5","key":"255_CR8","doi-asserted-by":"publisher","first-page":"41","DOI":"10.3892\/br.2022.1524","volume":"16","author":"E Chaidoutis","year":"2022","unstructured":"Chaidoutis E, Keramydas D, Papalexis P, Migdanis A, Migdanis I, Lazaris AC, Kavantzas N. Foodborne botulism: a brief review of cases transmitted by cheese products (review). 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Strict confidentiality protocols were followed during data analysis to protect patient anonymity. The principal investigator was the only person with access to patient identifiers for research purposes.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"All coauthors consented to the publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"The corresponding author is the EIC otherwise no other competing interest has been declared.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}