The Role of a Poison Control Center in Identifying and Limiting an Outbreak of Foodborne Botulism Jennifer Brown, MD, Mark E. Sutter, MD, D. Adam Algren, MD, Jerry D. Thomas, MD, Sean Ragone, MD, Joshua G. Schier, MD, Robert J. Geller, MD Abstract: Many poison control centers partner with public health agencies to handle weekend and after-hours consultations and emergencies. This event describes the effective use of poison control center capabilities in identifying and limiting an outbreak of foodborne botulism. On September 8, 2006, the poison control center received a call regarding a man aged 77 years admitted to a hospital neurology service with dysarthria, dysphagia, and weakness. The poison control center was contacted regarding a concern for botulism. Further information revealed that the patient’s wife and a friend had similar symptoms and had eaten together on the previous night. All three sought treatment at different hospitals. The poison control center successfully located the other two patients and pro- vided information regarding the treatment of botulism. In addition, the poison control center notifıed the on-call local public health offıcial and the CDC for the release of botulinum antitoxin. Public health offıcials were informed of our concerns for a foodborne outbreak given the common meal. Their investigation determined that the source of botulism was carrot juice. (Am J Prev Med 2010;38(6):675– 678) Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine T his outbreak illustrates the important role that poison control centers can play in the public health. Although only one case was called into the poison control center, the other two cases were located, care was coordinated, and antitoxin release was initiated. By identifying a common encounter, a starting point for the epidemiologic investigation was identifıed. This re- port highlights the capabilities of poison control centers in public health and prevention. Increased collaboration and utilization of poison control center capabilities should be explored. Introduction Poison control centers are unique entities that have de- veloped their reputation around poison prevention, edu- cation, and providing a 24-hour telephone assistance line. Research 1,2 shows that poison control centers are effec- tive in limiting both medical expenses and healthcare resource utilization. For example, more than 70% of call- ers with exposures to poisons and who are in need of assistance are able to remain at home rather than seek medical attention in clinics and hospitals. 3 In addition, studies 1,2 have demonstrated that for every $1 spent on poison control centers, $7 is saved on long-term medical expenditures. Despite this evidence, fınancial support for poison control centers at the federal and state levels is often tenuous. Similar fınancial challenges are often faced by other public health agencies, such as local and state public health departments. With such limited fınancial support for public health measures, numerous agencies are asked to expand services. As a result, several states have devel- oped mutually benefıcial partnerships between poison control centers and other public health agencies. In these innovative alliances, some poison control centers now respond to after-hours and weekend emergency calls, addressing rabies inquiries and performing other state- specifıc duties. This report describes a successful collaboration between a poison control center and local, state, and federal public health agencies. To increase the awareness and effective uti- lization of a poison control center, this report highlights the poison control center’s capabilities in identifying, treating, and limiting an outbreak of foodborne botulism. In addition, this report illustrates the importance of developing stronger From the Georgia Poison Center, Education Department (Brown, Sutter, Algren, Thomas, Ragone, Schier, Geller); and the National Center for Environmental Health (Brown, Sutter, Algren, Thomas, Schier), CDC, Atlanta, Georgia Address correspondence to: Joshua G. Schier, MD, CDC/NCEH/ EHHE/HSB MS F-57, 4770 Buford Highway NE, Chamblee GA 30341. E-mail: jschier@cdc.gov. 0749-3797/00/$17.00 doi: 10.1016/j.amepre.2010.02.007 Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine Am J Prev Med 2010;38(6)675– 678 675