Jailhouse wine is not as delicious as it sounds, could be deadly

December 13, 2013

WASHINGTON -- In a case series seemingly tailor-made for cinematic tragedy or farce, emergency physicians report severe botulism poisoning from a batch of potato-based "wine" (also known as pruno) cooked up in a Utah prison. The study was published online Tuesday in Annals of Emergency Medicine ("Emergency Department Identification and Critical Care Management of a Utah Prison Botulism Outbreak") .

"Evidently the incorporation of an old baked potato in the pruno recipe allowed botulism to develop," said Megan Fix, MD, of the Division of Emergency Medicine at the University of Utah in Salt Lake City. "The patient who cooked the wine had cooked this recipe approximately 20 times previously without a potato, but his decision to experiment sickened him and seven other inmates. The patients' initial reluctance to confess their consumption of pruno could have been deadly since botulism requires fast intervention."

Eight patients came to the emergency department from a Utah prison with trouble swallowing, double vision, difficulty speaking and weakness approximately 54 hours after ingestion of the potato-based pruno. The amount of pruno prisoners consumed varied greatly, with some patients reportedly ingesting over two gallons. The three most severely affected patients had respiratory failure and were intubated.

Because botulism anti-toxin is held in stockpiles around the country by the Centers for Disease Control and Prevention (CDC) in case of bioterrorism attack, the process of obtaining the anti-toxin takes some time. In this case it took about 9 hours from suspicion of diagnosis to administration of the anti-toxin. All patients received botulism anti-toxin within 12 hours from being admitted to the ED.

Foodborne botulism poisoning is extremely rare, with a typical incidence of about 20 cases per year in the United States.

"The CDC is the only source for botulism anti-toxin," said Dr. Fix. "However, there are a number of steps involved in obtaining it. The CDC recommends that emergency physicians treat patients first, if botulism is suspected, rather than waiting for a positive test. Therefore it's important to contact the CDC to obtain the anti-toxin based on clinical suspicion as we can't treat the disease without having the anti-toxin in hand!"
-end-
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, visit http://www.acep.org.

Contact:

Julie Lloyd
jlloyd@acep.org
202-370-9292
newsroom.acep.org
annemergmed.com
Twitter @emergencydocs

American College of Emergency Physicians

Related Emergency Department Articles from Brightsurf:

Deep learning in the emergency department
Harnessing the power of deep learning leads to better predictions of patient admissions and flow in emergency departments

Checklist for emergency department team's COVID-19 surge
After reviewing the literature on COVID-19 scientific publications the authors developed a checklist to guide emergency departments.

Why is appendicitis not always diagnosed in the emergency department?
A new study examines the factors associated with a potentially missed diagnosis of appendicitis in children and adults in the emergency department.

Providing contraceptive care in the pediatric emergency department
A new study found that two-thirds of female adolescents ages 16-21 seen in a pediatric Emergency Department (ED) were interested in discussing contraception, despite having a high rate of recent visits to a primary care provider.

Low back pain accounts for a third of new emergency department imaging in the US
The use of imaging for the initial evaluation of patients with low back pain in the emergency department (ED) continues to occur at a high rate -- one in three new emergency visits for low back pain in the United States -- according to the American Journal of Roentgenology (AJR).

Emergency department admissions of children for sexual abuse
This study analyzed emergency department admissions of children for sexual abuse between 2010 and 2016 using a nationwide database of emergency visits and US Census Bureau data.

30-day death rates after emergency department visits
Researchers used Medicare data from 2009 to 2016 to see how 30-day death rates associated with emergency department visits have changed.

Preventing smoking -- evidence from urban emergency department patients
A new study from the Prevention Research Center of the Pacific Institute for Research and Evaluation offers a more in-depth understanding of smoking among patients in an urban emergency department.

When a freestanding emergency department comes to town, costs go up
Rather than functioning as substitutes for hospital-based emergency departments, freestanding emergency departments have increased local market spending on emergency care in three of four states' markets where they have entered, according to a new paper by experts at Rice University.

Emoji buttons gauge emergency department sentiments in real time
Simple button terminals stationed around emergency departments featuring 'emoji' reflecting a range of emotions are effective in monitoring doctor and patient sentiments in real time.

Read More: Emergency Department News and Emergency Department Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.