BACKGROUND: On 7 and 11 July 2007, health officials in Texas and Indiana, 
respectively, reported 4 possible cases of type A foodborne botulism to the US 
Centers for Disease Control and Prevention. Foodborne botulism is a rare and 
sometimes fatal illness caused by consuming foods containing botulinum 
neurotoxin.
METHODS: Investigators reviewed patients' medical charts and food histories. 
Clinical specimens and food samples were tested for botulinum toxin and 
neurotoxin-producing Clostridium species. Investigators conducted inspections of 
the cannery that produced the implicated product.
RESULTS: Eight confirmed outbreak associated cases were identified from Indiana 
(n = 2), Texas (n = 3), and Ohio (n = 3). Botulinum toxin type A was identified 
in leftover chili sauce consumed by the Indiana patients and 1 of the Ohio 
patients. Cannery inspectors found violations of federal canned-food regulations 
that could have led to survival of Clostridium botulinum spores during 
sterilization. The company recalled 39 million cans of chili. Following the 
outbreak, the US Food and Drug Administration inspected other canneries with 
similar canning systems and issued warnings to the industry about the danger of 
C. botulinum and the importance of compliance with canned food manufacturing 
regulations.
CONCLUSIONS: Commercially produced hot dog chili sauce caused these cases of 
type A botulism. This is the first US foodborne botulism outbreak involving a 
commercial cannery in >30 years. Sharing of epidemiologic and laboratory 
findings allowed for the rapid identification of implicated food items and swift 
removal of potentially deadly products from the market by US food regulatory 
authorities.