{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T19:02:51Z","timestamp":1783450971272,"version":"3.55.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,6,7]],"date-time":"2019-06-07T00:00:00Z","timestamp":1559865600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Botulism is a rare and potentially fatal paralytic disease caused by botulinum neurotoxin (BoNT). In April 2017, 4 California residents from 2 adjacent counties were hospitalized with suspected foodborne botulism, precipitating an investigation by state and local public health departments in California.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We interviewed suspected botulism patients and their families, inspected the suspect establishment, and collected suspect food. We tested patient sera, stool, and gastric aspirates using mouse bioassay for BoNT and\/or culture for Clostridium botulinum. We tested suspect food and environmental samples for BoNT and confirmed presumptive positives using direct mouse bioassay and culture. We performed whole-genome sequencing on food and clinical isolates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From April 2017 through May 2017, 10 patients in the Sacramento area were hospitalized with laboratory-confirmed botulism; 7 required mechanical ventilation, and 1 died. Of 9 patients with information, all had visited Gas Station X before illness onset, where 8 reported consuming a commercial cheese sauce. BoNT\/A and\/or BoNT\/A-producing C. botulinum were detected from each patient and from leftover cheese sauce. Clostridium botulinum isolates from 4 patients were closely related to cheese sauce isolates by whole-genome high-quality single-nucleotide polymorphism analysis. No other botulism cases associated with this cheese sauce were reported elsewhere in the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This large foodborne botulism outbreak in California was caused by consumption of commercial cheese sauce dispensed at a gas station market. The epidemiologic and laboratory evidence confirmed the cheese sauce as the outbreak source. The cheese sauce was likely locally contaminated, although the mechanism is unclear.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz479","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T11:10:55Z","timestamp":1559819455000},"page":"1695-1700","source":"Crossref","is-referenced-by-count":18,"title":["Foodborne Botulism Outbreak Associated With Commercial Nacho Cheese Sauce From a Gas Station Market"],"prefix":"10.1093","volume":"70","author":[{"given":"Hilary E","family":"Rosen","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko C","family":"Kimura","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Crandall","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Poe","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June","family":"Nash","sequence":"first","affiliation":[{"name":"Sacramento County Department Public Health, Mather"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Boetzer","sequence":"first","affiliation":[{"name":"Sacramento County Environmental Management Department, Mather"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selam","family":"Tecle","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rituparna","family":"Mukhopadhyay","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Mcauley","sequence":"first","affiliation":[{"name":"Sacramento County Department Public Health, Mather"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Kasirye","sequence":"first","affiliation":[{"name":"Sacramento County Department Public Health, Mather"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Garza","sequence":"first","affiliation":[{"name":"San Joaquin County Department of Health Care Services, Stockton"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahtab","family":"Shahkarami","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishnu","family":"Chaturvedi","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kiang","sequence":"first","affiliation":[{"name":"Division of Food, Drug, and Cannabis Safety, California Department of Public Health, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Vidanes","sequence":"first","affiliation":[{"name":"Division of Food, Drug, and Cannabis Safety, California Department of Public Health, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Mccoy","sequence":"first","affiliation":[{"name":"Sacramento County Environmental Management Department, Mather"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Barcellos","sequence":"first","affiliation":[{"name":"Sacramento County Environmental Management Department, Mather"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy","family":"Derby","sequence":"first","affiliation":[{"name":"Sacramento County Environmental Management Department, Mather"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Jain","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duc J","family":"Vugia","sequence":"first","affiliation":[{"name":"Division of Communicable Disease Control, California Department of Public Health, Los Angeles, Richmond and Sacramento"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,6,7]]},"reference":[{"key":"2020041000554989500_CIT0001","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1086\/444507","article-title":"Botulism","volume":"41","author":"Sobel","year":"2005","journal-title":"Clin Infect Dis"},{"key":"2020041000554989500_CIT0002","doi-asserted-by":"crossref","first-page":"221","DOI":"10.7326\/0003-4819-129-3-199808010-00011","article-title":"Botulism in the United States: a clinical and epidemiologic review","volume":"129","author":"Shapiro","year":"1998","journal-title":"Ann Intern Med"},{"key":"2020041000554989500_CIT0003","volume-title":"Centers for Disease Control and Prevention. Botulism in the United States, 1899\u20131996","year":"1998"},{"key":"2020041000554989500_CIT0004","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/cid\/cix816","article-title":"Safety and improved clinical outcomes in patients treated with new equine-derived heptavalent botulinum antitoxin","volume":"66","author":"Yu","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2020041000554989500_CIT0005","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1093\/cid\/cis901","article-title":"National outbreak of type a foodborne botulism associated with a widely distributed commercially canned hot dog chili sauce","volume":"56","author":"Juliao","year":"2013","journal-title":"Clin Infect Dis"},{"key":"2020041000554989500_CIT0006","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1086\/379326","article-title":"An outbreak of foodborne botulism associated with food sold at a salvage store in Texas","volume":"37","author":"Kalluri","year":"2003","journal-title":"Clin Infect Dis"},{"key":"2020041000554989500_CIT0007","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1086\/592574","article-title":"International outbreak of severe botulism with prolonged toxemia caused by commercial carrot juice","volume":"47","author":"Sheth","year":"2008","journal-title":"Clin Infect Dis"},{"key":"2020041000554989500_CIT0008"},{"key":"2020041000554989500_CIT0009"},{"key":"2020041000554989500_CIT0010","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1093\/jaoac\/86.2.314","article-title":"Detection of botulinal neurotoxins A, B, E, and F by amplified enzyme-linked immunosorbent assay: collaborative study","volume":"86","author":"Ferreira","year":"2003","journal-title":"J AOAC Int"},{"key":"2020041000554989500_CIT0011","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1128\/AEM.72.2.1231-1238.2006","article-title":"Detection of type A, B, E, and F Clostridium botulinum neurotoxins in foods by using an amplified enzyme-linked immunosorbent assay with digoxigenin-labeled antibodies","volume":"72","author":"Sharma","year":"2006","journal-title":"Appl Environ Microbiol"},{"key":"2020041000554989500_CIT0012","doi-asserted-by":"crossref","first-page":"2502","DOI":"10.1128\/JCM.00361-17","article-title":"Validation and implementation of Clinical Laboratory Improvements Act-compliant whole-genome sequencing in the public health microbiology laboratory","volume":"55","author":"Kozyreva","year":"2017","journal-title":"J Clin Microbiol"},{"key":"2020041000554989500_CIT0013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/cid\/cix829","article-title":"Making the best of the evidence: toward national clinical guidelines for botulism","volume":"66","author":"Sobel","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2020041000554989500_CIT0014"},{"key":"2020041000554989500_CIT0015","author":"Glass"},{"key":"2020041000554989500_CIT0016","doi-asserted-by":"crossref","first-page":"558","DOI":"10.7326\/0003-4819-125-7-199610010-00004","article-title":"An outbreak of type A botulism associated with a commercial cheese sauce","volume":"125","author":"Townes","year":"1996","journal-title":"Ann Intern Med"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciz479\/28992856\/ciz479.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/70\/8\/1695\/33031754\/ciz479.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/70\/8\/1695\/33031754\/ciz479.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,10]],"date-time":"2020-04-10T05:10:25Z","timestamp":1586495425000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/70\/8\/1695\/5524350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,7]]},"references-count":16,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2019,6,7]]},"published-print":{"date-parts":[[2020,4,10]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciz479","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,4,15]]},"published":{"date-parts":[[2019,6,7]]}}}