But at that hour botulism, the toxin produced by Clostridium botulinum bacteria, was only a suspect in all the cases, and we had no proof incriminating the whitefish chubs in any. The epidemiological part of the investigation was left to me and a colleague in the service, Dr. Dan B. Jones, who regularly worked in Nashville at the Tennessee health department and who now is chairman of ophthalmology at Baylor College of Medicine in Houston. We met in Knoxville late that afternoon and went directly to the hospital to begin working with doctors caring for the three surviving patients. The main tasks were to ascertain that the cases were botulism and to learn how many other people were sick with it. Botulinus toxin leaves the mind clear but paralyzes the cranial nerves, which control facial expressions, eye and tongue movements, swallowing and breathing, among other functions.
Doctors identify botulism from the pattern of paralysis and symptoms.
Our patients complained of constantly dry mouths despite drinking copious amounts of fluids. Their upper eyelids drooped. Their vision was clear, but their pupils were wide and did not narrow when a light was flashed. They saw double because their weakened or paralyzed eye muscles prevented coordinated eye movements. Some needed breathing tubes and respirators.