A potential association between suspected botulism and the fried–egg–on–a–bottom–can activity: online media imitation, Satun Province, Thailand, 2020
Keywords:
botulism, bottom can, Satun, social mediaAbstract
Background: On 19 June 2020, a suspected case of botulism in Satun Province was notified. An investigation was conducted to verify the diagnosis, identify possible contamination and risk behaviors in the community, and provide recommendations.
Methods: A descriptive study was conducted. We reviewed medical records, interviewed involved people, performed an active case finding using national guideline definition, and identified potential risk behaviors by convenience sampling on the children in the community using a structured questionnaire.
Results: The index patient, a 9–year–old girl, was diagnosed with suspected foodborne botulism. Sixteen hours after consumed eggs cooked on the bottom of a can, which was collected from a garbage pile mixed with soil, she had stomachache, headache, and nausea, then ptosis, weakness, and dysphagia. Twenty–six hours later, she developed dyspnea and was intubated. She always had good consciousness. The electrodiagnosis was compatible with the presynaptic disease. The patient’s specimens and suspected equipment were tested for botulinum neurotoxin and Clostridium botulinum culture. However, no neurotoxin or Clostridium botulinum growth was detected. The patient recovered after receiving botulism antitoxin. The community survey showed 55 of 103 children had joined the fried– egg–on–a–can–bottom activity. Eighty percent of them started this activity due to being persuaded by their friends or relatives, while the rest mimicked this behavior from the internet. Fourteen of 43 adults thought that this activity was safe. The survey participants also suggested that the parents should pay more attention to their children, and retail stores should help monitor the children’s behavior. For control measures, we publicized the event and the dangers of the activity to the community.
Conclusion: This study reveals that fried–egg–on–a–can–bottom activity might cause botulism. This activity was widespread in the community and might have been publicized nationwide. Therefore, an educational campaign to raise awareness of the health threat from this activity should be exercised immediately. A more comprehensive environmental survey is suggested to confirm our findings.
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