Why You Should Never Drink Toilet-Made Wine: It May Contain Deadly Neurotoxins

Let’s talk about “pruno,” microbiology, and food safety.

Not a place where you want to make anything to eat or drink. (Photo by Giorgio Trovato on Unsplash)

While I was working at the Maryland Department of Health, an interesting botulism outbreak occurred. The first case was identified at a local emergency room when a physician diagnosed a patient with possible botulism. When the hospital staff entered the diagnosis into the electronic health record, a supercomputer received the report and flagged the case.

(This was the era before modern artificial intelligence systems, so all we got was a flag based on a term entered into the diagnosis along with a diagnosis code.)

One of our surveillance epidemiologists contacted the hospital to obtain additional information. They learned that the patient was incarcerated at a nearby prison. The patient was on a ventilator, so they were unavailable to be interviewed about possible exposures. We decided to wait until they were better before following up. A few hours later, a second case came in.

And then a third case the next day.

As it turns out, several incarcerated men ended up at the hospital, all sick with botulism. The culprit? Well, it wasn’t clear from the beginning what happened, but then we got a big clue when the fourth case…