Event highlights
The WHO Country Office in Bulgaria supported the Bulgarian Ministry of Health’s National Centre of Infectious and Parasitic Diseases (NCIPD) in their efforts to identify and prevent botulism, a rare neurotoxin-mediated, life-threatening disease, through the facilitation of a webinar on 22 May 2025. The webinar, attended by 36 regional and district level health specialists from 10 different regions, focused on the identification, prevention and treatment of foodborne botulism resulting from the consumption of improperly canned or preserved foods containing preformed toxins. This issue is particularly critical for refugee and migrant populations, as homemade canned, preserved or fermented foodstuffs are more prevalent among these mobile groups. While Bulgaria had no cases detected between 2018–2022, there is a strong need for understanding prevention, identification and treatment methods for botulism given the increase in migrants from Ukraine due to the ongoing conflict, as well as from Afghanistan, north Africa and the Syrian Arab Republic. These populations are at risk not only because home-canning foods preserve cultural traditions and maintain food security while living on the go, but also due to potential delayed disease recognition and limited access to a general practitioner – a commonly reported barrier among refugee populations, which may further delay identification and treatment.
However, in 2023, “The European Union One Health 2023 Zoonoses report”, published by the European Food Safety Authority of the European Centre for Disease Prevention and Control, found that Clostridium botulinum toxins were responsible for 5 foodborne outbreaks (FBOs) reported by 4 Member States, including Bulgaria, Italy, Romania and Spain; and 3 FBOs in the 2 non-Member States of Norway and Serbia.
Botulism cases have been reported across Europe over the past 10 years in Poland and Lithuania, and wound botulism in intravenous drug users has been reported in the United Kingdom of Great Britain and Northern Ireland and Ireland. Additionally, there has been an increase in botulism reported in Ukraine compared to before the war, with 39 cases reported between the beginning of 2024 until mid-July. In the Middle East, there was recently an outbreak in Saudi Arabia linked to contaminated mayonnaise.
The technical presentation included a summary of the WHO “Laboratory biosafety manual, fourth edition”, published on 21 December 2020, which was presented by a WHO/Europe laboratory specialist. The presentation focused on both refugee and migrant populations as well as the overall risk of botulism across Europe. Held as part of WHO/Europe’s “Better Labs for Better Health” initiative, this essential webinar strengthened Bulgarian medical professionals’ understanding of the importance of early detection, treatment and prevention of botulism among refugee populations who often rely on home-preserved foods.
The event was supported with generous funding from the Asia-Europe Foundation.
Event notice
The WHO Country Office in Bulgaria will host a webinar on botulism in partnership with the Bulgarian Ministry of Health’s National Centre of Infectious and Parasitic Diseases (NCIPD), funded through the Asia-Europe Foundation’s Phase III contributions. Botulism is a rare, neurotoxin-mediated, life-threatening disease that requires rapid detection to prevent additional cases. As refugees are migrant populations, they are exposed to challenges with food preservation and storage, and thus often reliant on fermented foods, which can contribute to foodborne illnesses, including botulism.
This webinar, organized in partnership with NCIPD, will be held on 22 May 2025, in Sofia, Bulgaria, through an online portal, facilitated by the WHO Country Office in Bulgaria. It forms part of WHO/Europe’s Better Labs for Better Health initiative, aimed at strengthening laboratory services through policy and planning, training and mentoring, as well as selected upgrading of crucial support services for laboratories.