A case of foodborne botulism linked to eating fish is being investigated in Germany.

The Lower Saxony Ministry of Agriculture reported that the toxin was detected in the blood of a man from the district of Lippe in North Rhine-Westphalia and later in fish. Clostridium botulinum type E was found in the dried and salted fish from Turkey which was manufactured in the Netherlands.

Ozean Fischgroßhandel GmbH, based in Ostercappeln, Osnabrück in Lower Saxony, has recalled a variety of dried and salted fish, which were mainly sold in Russian shopping markets. The dried fish consumed by the patient came from a shopping market which received products from the company.

It has not yet been possible to determine what kind of fish the patient ate, so Ozean Fischgroßhandel has, as a precaution, warned against the consumption of all dried fish delivered to the market wher the patient bought the product.

Company officials said it would inform all markets that received the goods in question so remaining fish would not be resold.

Mass recall
The Lower Saxony Ministry of Agriculture advised consumers who had bought dried fish to destroy the product or ask at the point of sale to check if it was affected.

Recalled items are two types of roach with date Nov. 12, 2019, and Lot 180219 and date March 5, 2020, and Lot 180319. Crucian carp and perch both have best before dates May 27, 2020, and lot numbers 170519. Trout has a best before the date of March 9, 2020, and Lot 140619 while pike has a March 5, 2020 date and Lot 180319.

Botulism neurotoxin type E is not uncommon contamination in fish, which have been poorly eviscerated and/or self-salted at home. Contamination in commercial products has also been reported, according to the European Center for Disease Prevention and Control (ECDC).

Earlier this year, the Norwegian Institute of Public Health (Folkehelseinstituttet) reported rakfisk, a traditional Norwegian fish dish, from Torpet Fiskeoppdrettsanlegg AS was the suspected source for a case of foodborne botulism.

Meanwhile, a shipment of 204 vials of Canadian-produced anti-botulism serum was shipped to Ukraine earlier this year. It was procured by the United Nations Development Programme (UNDP) in Ukraine.

A total of 44 cases of botulism have been registered in Ukraine since the start of 2019, resulting in 50 illnesses. Most cases were recorded in Chernihiv, Zhytomyr, Vinnytsia, and Zaporizhzhia oblasts, and Kyiv city.

The medicine is a heptavalent antitoxin, which means it can treat infections by seven genotypes of botulinum toxin (types A, B, C, D, E, F, G), unlike its analogs, which can usually only treat one (type A) or three genotypes (types A, B, E).

Botulism is a rare but life-threatening condition caused by toxins produced by Clostridium botulinum bacteria. In foodborne botulism, symptoms generally begin 18 to 36 hours after eating contaminated food. However, they can start as soon as six hours after or up to 10 days later.

Botulism can cause symptoms including general weakness, dizziness, double vision, and trouble with speaking or swallowing. Difficulty in breathing, weakness of other muscles, abdominal distension and constipation may also occur. People experiencing these problems should seek immediate medical attention.

The symptoms result from muscle paralysis caused by the toxin. If untreated, the disease may progress and symptoms may worsen to cause paralysis of certain muscles, including those used in breathing and those in the arms, legs, and the body from the neck to the pelvic area.