Canadian was first to get botulism poisoning from carrot juice

23.oct.06
CBC.ca News 

CBC News has learned, according to this story, that the initial warnings about botulism in carrot juice came from the U.S., but the original case happened in Toronto.
Six patients - four in the southeastern U.S. and two in Toronto - remain hospitalized and on ventilators after contracting botulism linked to the juice. Quebec health officials reported another case in Montreal on Friday, and Health Canada says test results expected Tuesday will confirm whether it is botulism.
The story says that the first person to drink contaminated carrot juice was one of the latest to actually be diagnosed with botulism. The patient is still at North York General Hospital in Toronto.
The timeline of events began on Aug. 24, when the patient came into the hospital with diarrhea, vomitting, blurred vision and a paralysis that began in the face and progressed downward.
Almost three weeks after the first patient was hospitalized, the patient's spouse also became ill with identical symptoms. The second patient was taken to a different hospital in West Toronto. Both members of the family were paralyzed and remain on ventilators.
Doctors at the two hospitals then realized the cases were connected. Guillain-Barre syndrome no longer made sense, and suspicion then fell on West Nest virus or some kind of encephalitis.
On Sept. 26, the hospitals called Toronto Public Health's environmental department for assistance. Doctors were thinking of heavy metal poisoning in the food, recalled Dr. Barbara Yaffe of Toronto Public Health. To the best of her recollection, botulism never came up in the conversation.
Perhaps if doctors in Toronto had known there were four people hospitalized with botulism poisoning in Florida and Georgia, or if they had known U.S. officials had zeroed in on carrot juice as the cause of the poisoning, they might have connected those cases to the patients in Toronto, said CBC-TV's Maureen Taylor.
In Ottawa, the Public Health Agency of Canada and the Canadian Food Inspection Agency saw the warnings and advisories from the U.S. on Sept. 16. Staff at the federal departments said it looked like an isolated incident, and they didn't pass on the information to public health officials or consumers until Sept. 30, the day California-based Bolthouse Farms issued a voluntary recall of its carrot juice. Then, someone in Toronto put the pieces together, although it's not clear who the person was.
Carrot juice from the Toronto patients' refrigerator tested postive for botulism toxin - six weeks after the first patient felt symptoms. By then, there was little point in giving the patient a drug to neutralize the botulism toxin because the damage had already been done.