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Foodborne botulism is rare in the United States, and almost all cases are caused by improperly prepared home-processed foods. During one week in July 2007, however, four cases of suspected botulism in Texas and Indiana were reported to the CDC. The subsequent investigation identified four additional cases, for a total of eight confirmed outbreak-associated cases in three states.
All patients were hospitalized, and seven required mechanical ventilation; none died. Epidemiologic investigation revealed botulinum toxin in leftover hot dog chili sauce mixtures at the homes of two patients and in 20 of 23 unopened, swollen cans of the sauce at the implicated manufacturing plant in Georgia. Multiple violations of the federal guidelines, including f…