County officials have closed down food and beverage sales at a gas station in California because of an outbreak of botulism poisoning and are urging anyone who has become sick after eating there in recent weeks to immediately seek medical attention.

Five people — four of whom ate food from Valley Oaks Food and Fuel in Walnut Gove, CA — are confirmed with botulism and are in serious condition in hospitals, said Sacramento County Public Health Officer and medical doctor Olivia Kasirye.

The county health department posted a notice Monday about the botulism outbreak. The Environmental Management Division of the department ordered the gas station to cease all food and beverage sales until further notice. Inspections by the division in February and October 2016 resulted in “passing” results, but inspection records online show the inspectors left most items on the “routine inspection” forms blank.

The inspection forms show Balvir Kaur as the permit holder for food sales for the gas station. A woman answering the phone at the business Monday said they were open but responded with “we have no comment” to all other questions.

County and state officials are investigating the specific source of the botulism poisoning, having collected samples of food from the gas station for testing.

“We are looking at foods usually found at gas stations like hot dogs, nacho cheese and condiments,” Kasirye said Monday. “We should begin getting test results by week’s end.

“The first case was reported to us April 24 and in the two weeks since then we’ve had four more. … Symptoms usually appear in two to three days after exposure. We worry about paralysis of the respiratory muscles which can cause people to go into respiratory failure.”

Symptoms include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth and muscle weakness, but Kasirye said symptoms are not consistent among all botulism victims.

“The symptoms do vary from person to person so we are asking that anyone who feels ill and who ate or drank anything from the Valley Oaks Food and Fuel gas station between April 23 and today to immediately seek medical attention,” the public health officer said Monday.

Tests on samples from the five victims are underway to determine if they are all were infected with the same strain of the bacterium Clostridium botulinum.

Inspection reports
The Sacramento County Health Department’s Environmental Management Division does not have any details posted with its closure notice for Valley Oaks Food and Fuel. A spokeswoman for the division said Monday afternoon that all establishments under its jurisdiction are inspected at least once a year, with the usual goal being three inspections every 12 months.

Inspectors noted in February and October 2016 that the ambient temperature in the walk-in cooler at the gas station was at 41 degrees, but most other checklist items were left blank on the forms, including sanitizer levels in dish washing water and cleaning cloths.

The February 2016 inspector noted “No violations observed during today’s routine inspection.”

In October 2016 a different county inspector cited a “major violation” regarding the temperature of water in hand-washing and dish-washing sinks. It was only 76 degrees instead of the 100 and 120 degrees, respectively, required by state law. The inspector noted that the problem was corrected during the inspection.

Botulism in the U.S.
Illnesses from the Clostridium botulinum bacterium in the United States are relatively rare and usually associated with homemade canned foods, according to the Centers for Disease Control and Prevention. The bacterium produces a toxin when it multiplies in food. The toxin is what makes people sick.

The bacterium is heat resistant so cooking contaminated foods does not kill it. about 5 percent to 10 percent of botulism cases are fatal, according to the World Health Organization. In 2014, which is the most recent year CDC has statistics for, there were 161 confirmed cases of botulism in the United States. Of those, 15 were foodborne, with most of the remainder being related to infants ingesting Clostridium botulinum spores before their digestive systems were developed.

California officials are also investigating botulism cases in Los Angeles County but Kasirye  said as far as officials know those cases are not related to the Sacramento County cases.

The Los Angeles botulism cases have been linked to deer antler tea. For additional details, please see: “California officials warn of botulism risk from herbal teas”