Notes from the Field: Botulism!
Alert BIO230 correspondent Heather G. made sure that I saw this week’s Morbidity and Mortality Weekly Report from the CDC, and the Notes from the Field report. In November 2012, eight prisoners in a maximum security prison in Arizona were admitted to the prison infirmary with symptoms (vision problems, weakness, impaired gag reflex) resembling botulism. All patients reported drinking pruno, an alcoholic beverage that has been associated with prison botulism outbreaks in the past. All patients were hospitalized and received an antitoxin to reduce the effect of the botulism toxin. Disease in botulism is not due to the the action of the pathogen directly, but entirely due to the very potent neurotoxin produced by the bacterium. Consequently, antibiotic therapy is not effective to reverse the disease. Seven of the 8 patients required respiratory intubation as well as feeding tubes for up to 2 weeks before they began to recover.
Pruno is made by fermenting foodstuffs in plastic bags. Modern Drunkard magazine (Seriously! Follow the link, if you don’t believe me!) has a recipe for producing pruno, as well as a review of the final product. Any kind of fermentable materials will suffice (old fruit, potatoes, packets of ketchup,) which are combined in a plastic bag. If you are lucky, the mighty yeast Saccharomyces cerevisiae will take over, and convert sugars to ethanol. If you are unlucky, like the inmates in this case study, the anaerobic conditions in the plastic bag will foster the growth of strict anaerobes like Clostridium botulinum. The reviewer from above was apparently one of the lucky ones, however ended with this stellar quote:
Did it get me drunk? A pint of pruno earned me a mild buzz….I’ve never felt a great deal of sympathy for our nation’s prisoners, but I do now.
Prison authorities and the CDC are proposing two avenues to try and avoid future outbreaks. First, potatoes have apparently been banned from one prison in Arizona, and officials are looking to ban sugar and other ingredients from the menu as well. The CDC recommends a more balanced approach of education to ensure that prisoners understand the risks associated with producing and drinking pruno.