Animals' role in the spread of botulism cases

Children pick termites in Teso village, Busia county in the evening on August 02, 2021. [Stafford Ondego, Standard] According to recent media reports, several people were hospitalised in Western Kenya after consuming alates (termites), or kumbekumbe, as they are known in Kiswahili. The victims complained of stomachaches, diarrhoea and general body aches. According to the reports, the termites were purchased at a local market. Termite alates, flying termites, or swarmers, are a delicacy in most parts of Kenya. They are either eaten raw or dry roasted. There is a strong connection between this delicacy and outbreaks of botulism, a zoonotic disease caused by the ingestion of contaminated food, feed, or water by humans and animals. Botulism is also strongly associated with animal carcasses, which are a major source of the disease. One of my former professors, the late Prof Samuel Arimi, who taught public health, liked to tell the story of a man who brought back termite alates to some of his relatives and neighbours in the city from his rural home. A short period after the evening meal, they all fell ill and had to be hospitalised. They blamed the termites' meal for their woes, although the man refuted the claims. It, however, did not take long before he joined them in the hospital, manifesting the same symptoms. It later emerged that the termites were possibly contaminated by either poultry waste or carcasses on the bus's roof rack, where his bag containing the alates was stored for the long journey. But contamination can also occur underground if the termite colony is near a buried carcass or upon emerging to the surface. Botulism is a bacterial disease of human beings, animals and birds. It is caused by Clostridium botulinum, hence the name botulism. This bacterium and its infective spores are found throughout the environment in soils and the stomachs and intestines of animals (domestic and wild) and fish. The bacterium can exist in the environment for long periods; the infective form develops under anaerobic conditions, and this explains how it ends up contaminating human food, especially that harvested from the ground, like vegetables or even termites. Upon ingestion, in the vegetative form, the bacteria grow in the guts and wounds, producing toxins that affect nerves and hence the disease. In livestock, botulism is common in animals lacking certain mineral elements and end up chewing bones containing botulism toxins. Carcasses of infected animals are a source of bacteria to the remaining animals and human beings through contamination. The disease is characterised by progressive paralysis, and the animal normally dies of respiratory failure caused by the paralysis of muscles used in breathing. Other clinical signs include drooling, stiff gait, and recumbency with the hind legs extended backwards (frog-legged position). Botulism in humans attacks the nervous system, and common clinical signs include muscle weakness and paralysis, resulting in difficulty walking, swallowing, and talking. Botulism can be fatal, especially when breathing muscles are affected, and it is noted on time and effectively treated. Symptoms may include drooping eyelids and other signs affecting the muscles of your face, eyes and throat. It can eventually affect muscles related to breathing. People are infected when they eat contaminated foods from improper storage. The toxin, in diluted forms, has found application in medicine; in some countries, it is used by licensed practitioners in the treatment of migraine headaches. In the beauty industry, the botulinum toxin has been used for cosmetic reasons to erase wrinkles that come with ageing. It does this by temporarily paralysing muscles, producing a deceptive youthful appearance. Reports of abuse have nonetheless been reported, resulting in iatrogenic botulism. [Dr Othieno is a veterinary surgeon and the head of communications at the Food and Agriculture Organisation (FAO), Kenya. The views expressed here are not necessarily those of FAO but his own]

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