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What sent nearly a dozen people to the hospital in Fresno County? A tainted cactus salad.

Fresno County Department of Public Health headquarters in downtown Fresno, Calif.
Kerry Klein
Fresno County Department of Public Health headquarters in downtown Fresno, Calif.

FRESNO, Calif. – A recent botulism outbreak that sent nearly a dozen people to the hospital in Fresno County has been confirmed to have originated from a nopal salad consumed at a family event.

Ten people were sickened in late June after attending two gatherings in Caruthers and Clovis, health officials told media on Tuesday. Patients showed up at emergency rooms with symptoms that included vertigo and blurred vision.

Doctors and health officials determined they had contracted botulism – a rare but serious illness that’s caused by a neurotoxin that attacks nerves and can weaken muscles and lead to respiratory problems or even death.

The only treatment for botulism is an antitoxin that health officials say had to be obtained from a state facility to treat the local patients. Since receiving the antitoxin, most of the patients have been discharged. Two sisters, however, remain in the intensive care unit.

Fresno County Interim Health Officer Dr. Rais Vohra said the antitoxin was delivered within hours in a manner straight out of a Hollywood movie.

“It's literally flown from the airport to our airport, where California Highway Patrol is waiting, and then they hand-deliver the package to the hospital where the pharmacy team is waiting to accept it,” he said.

Vohra said it was “just a phenomenally swift response.”

The toxin that causes botulism can be found in nature but also grows in foods prepared or stored under inadequate conditions. Norma Sanchez, a communicable disease specialist with the county, said that the culprit in this case – a salad that contained nopales, a kind of cactus – that had been canned at home by the chef.

Investigators came to this conclusion after interviewing attendees and sampling food scraps that had been picked out of the trash left behind after the gatherings.

“It was 100-and-some degrees out there, the food had been out there for a couple of days already, so I was just amazed at the results that came out of this food testing,” she said.

Sanchez said the chef had used a recipe for canning nopales that had been obtained from friends and family, but the salad appeared to have been kept in a shed that was too hot to be stored safely.

When canning foods at home, health officials say it’s important to follow proper guidelines for sterilization, acid content balanced by the proper amount of salt and sugar, and food storage conditions like temperature.

According to the Centers for Disease Control and Prevention, throughout the U.S., only a few dozen cases of foodborne botulism are reported each year.

The Fresno County patients are undergoing intensive care that Vohra says can hopefully lead to a full recovery.

“They require ventilation with machine support just because their muscles and nerves are affected so severely,” Vohra said.

Kerry Klein is an award-winning reporter whose coverage of public health, air pollution, drinking water access and wildfires in the San Joaquin Valley has been featured on NPR, KQED, Science Friday and Kaiser Health News. Her work has earned numerous regional Edward R. Murrow and Golden Mike Awards and has been recognized by the Association of Health Care Journalists and Society of Environmental Journalists. Her podcast Escape From Mammoth Pool was named a podcast “listeners couldn’t get enough of in 2021” by the radio aggregator NPR One.