The Importance of Package Labels

A case of botulism in Australia drives home the lesson: monitor those package labels carefully!

This blog has previously posted articles about the importance of checking package labels. Here is another example of why this is so important.

First, a disclaimer. Often there are missing details and it is often impossible to know what causes a particular illness. That is why foodborne illness is underreported. This article is posted to emphasize the importance of accurate product labels, nothing more.

The Food Safety News (6/26/24) has published an article about a 61 year old man in Australia who became ill with botulism. At first, his medical history and symptoms indicated other medical concerns but not botulism. Later it was discovered that he had consumed what was called ‘foul tasting’ almond milk, 12 to 36 hours before becoming ill. Botulism then became the primary suspect cause. Tests of a milk sample revealed botulism toxin type A (the most dangerous of six types of botulism toxin – there are seven in total). The man has since recovered. The implicated products have been recalled by the producer, primarily for the following reason.

One problem, the reason for this blog posting, was found during the investigation of this illness: the almond milk label did not carry a warning to keep the product refrigerated. It was not a shelf stable product and had to be kept refrigerated. If the product had been contaminated after treatment and before packaging, any bacteria would be able to grow. For this reason, the packaging or bottling process is extremely important.

Botulism is found everywhere in nature: soil, surface bodies of water, intestinal tracts of fish and mammals and even in the gills and internal organs of crabs and shellfish. Once it contaminates food, it attacks the human central nervous system; very little of the toxin is needed to produce illness. While the illness is rare, it can cause death.

Botulism grows well in improperly processed, canned, low acid or alkaline foods such as in vacuum packed or reduced oxygen, packed foods. For this reason, a variance and HACCP plan are usually required. The law requires obstacles (‘hurdles’) to botulism growth in these foods: heat or other treatments to kill the bacteria; additives to lower pH or water activity to discourage any further growth; and, once the food has been canned or sealed, refrigeration below 38F (41F is not adequate! Botulism, like Listeria and Salmonella, survive below 41F).

Botulism, like most food borne pathogens, does not leave any smell or off taste to indicate its presence. Why, then, was the almond milk in this case, ‘foul tasting’? Two possible reasons: first, botulism can cause a can to swell as it produces gas in the product. Second, there are other pathogenic (‘disease causing’) and spoilage bacteria which survive and grow in low oxygen environments. These microorganisms might also produce the off taste in the almond milk.

Food Safety News 6/26/24 ‘Challenging botulism case highlighted in Australia: country reports recall information’
The Medical Journal of Australia 6/17/24 ‘Botulism: a mimic for brainstem strokes and Miller
Fisher syndrome’ Kwan, Elias and Todd, et. al.
Bad Bug Book published by the United States Food and Drug Administration