Preventing Botulism from Traditional Alaska Native Foods

Botulism is caused by a toxin made by Clostridium botulinum and related bacteria. The bacteria are found naturally in many places and rarely make people sick, but under certain conditions their spores (protective coatings) grow and produce botulinum toxin. Those conditions can arise when traditional Alaska Native foods are not prepared safely, and in Alaska most cases of botulism have come from eating such foods, including:

• fermented fish heads ("stinky heads")
• fermented fish eggs ("stinky eggs")
• fermented beaver tail
• fermented seal or walrus flipper
• fermented whale
• seal oil
• dried, unsalted fish

Eating home-fermented foods carries some risk, but these five tips help protect families.

1. Wash hands, containers and food

Wash your hands well with soap and water, clean the containers and surfaces the food will touch, and wash the food before preparing it. Washing reduces germs on food but does not remove all of them.

2. Use traditional preparation methods

A botulism survivor featured by CDC urges following the traditional ways of preparing food, without shortcuts to make it ready faster, and without plastic containers.

Traditional preparation methods can reduce the risk of botulism. Image from CDC's page.

• Ferment food the traditional way, in a grass-lined hole in the ground.
• Use methods that let fresh air circulate. Do not use plastic or glass containers: without air circulating, bacteria in the food can grow and make toxin, even if the container has no lid.
• Salt fish when drying it. Salt is a natural preservative and lowers the chance of botulism or other illness.

3. Ferment food cold

Keep food cold by fermenting it in the ground, away from the sun, ideally below 37°F at all times. Fermenting takes longer in the cold, but it is safer.

4. Boil fermented food before eating it

High heat destroys botulinum toxin. Boiling may change the familiar taste, but it can protect your family. Boil in a saucepan any home-fermented food or dish containing it, and any fermented food stored in plastic or glass. Below 1,000 feet of altitude, boil for 10 minutes, adding 1 minute for each additional 1,000 feet.

5. When in doubt, throw it out

The toxin cannot be seen, smelled or tasted, and even a small taste of contaminated food can be deadly. Never taste food to check whether it is safe. If you do not know whether food was prepared safely, throw it out: far better to lose the food than to get sick or lose a loved one.

Botulism is a medical emergency

Anyone with signs or symptoms of botulism should see a health care provider or go to an emergency room right away. Do not wait. Botulism is treated with antitoxin, which stops the toxin from doing further harm, though it cannot undo damage already done. It works best when given early.

CDC's video A Helping Hand: Keeping Your Family Safe from Botulism, in English and Yupik, features Alaska Native people who have lived through botulism and the doctors, nurses and health aides who treated them.

More information

• CDC Arctic Investigations Program, 4055 Tudor Centre Drive, Anchorage, AK 99508-5932; 907-729-3400; ncidaip@cdc.gov
• Alaska Department of Health and Social Services, Division of Public Health, 3601 C Street, Suite 540, Anchorage, AK 99503; 907-269-8000
• University of Alaska Cooperative Extension Service: food preservation and the Alaska Tribes Extension Program

Sources

• Centers for Disease Control and Prevention, "Alaska Native Foods" (Botulism prevention). https://www.cdc.gov/botulism/prevention/alaska-native-foods.html
• A Helping Hand video: https://www.youtube.com/watch?v=I_WlJzmb1Pk (Yupik: https://vimeo.com/105157046); CDC, "About Botulism": https://www.cdc.gov/botulism/about/index.html
• The survivor's remarks are paraphrased, and the survivor's portrait is not reproduced.
• Words on this page from people and organisations outside the federal government are paraphrased; rewritten in hubnx's own words.