On January 19, 2021, Larry Wells purchased a two-container package of Kettle Cuisine brand clam chowder at the Sam’s Club located on New Circle Road in Lexington, Kentucky. As was his usual practice, he stored the two containers in his home pantry until he was ready to eat them. Larry would typically eat the entire contents of one container at a single meal. His wife, Estelle, detested clam chowder and never ate any.
In the days following the January 19 purchase of the chowder 2-pack, Larry consumed one container. Around 6 pm on January 30, 202, Larry heated the contents of the second container of chowder. As usual, Larry consumed the entire contents. He mentioned to Estelle that the chowder has a strange smell. Afterwards the empty container was discarded in the family trash bin.
The next day, Larry woke up feeling nauseated with a “weak and a droopy” left eyelid. He sought care at the University of Kentucky Chandler Medical Center Emergency Department. His condition worsened rapidly, and he was admitted to inpatient care. On February 3, 2021, Dr. Hanine El Haddad, infectious disease specialist at the hospital, notified the Kentucky Department for Public Health (KY DPH) that Larry Wells was hospitalized with symptoms of botulism and that his serum would be sent to the agency’s Division of Laboratory Services (DLS) for testing. Carrell Rush, Reportable Disease Section Supervisor, Division of Epidemiology and Health Planning, at the KY DPH notified agency staff, Lexington-Fayette County Health Department (LFCHD), and the Centers for Disease Control and Prevention (CDC) about her conversation with Dr. El Haddad.
Serum collected from Larry on February 3, 2021, was confirmed positive for Clostridium botulinum toxin type A on February 4. This result was reported to the CDC Public Health Officer, Laura Ford, who authorized released of Botulism Antitoxin Heptavalent. Antitoxin was administered the next day.
LFCHD epidemiologists, Mia Williams, and Hollie Sands, interviewed Estelle Wells about Larry’s symptoms and foods he consumed in the 2 days before symptom onset. Estelle told investigators about the clam chowder Larry had consumed on January 31 and noted that she had not eaten any. Estelle retrieved the original chowder container from the trash and gave it to LFCHD environmental health staff who delivered the container to the state DLS on February 4. Testing for Clostridium botulinum began the next day. DLS shared photos of the container and packaging with investigators. Photos showed the Lot Number (Lot #602563 3A2 01051) and Use By Date of (03/26/21). On February 9, 2021, DLS reported that laboratory testing confirmed the presence of C. botulinum toxin type A in the leftover clam chowder collected from Larry Wells’ home.
Local health agencies visited area Sam’s Clubs in search of Kettle Cuisine clam chowder, Lot #602563 3A2 01051. None was found. On February 9, the FDA Seattle District office located clam chowder of the same lot at the manufacturer, Fresh Foods of Washington in Everett, Washington. Samples were shipped to the FDA laboratory in Jefferson, Arkansas for testing. However, inclement weather delayed shipment and these samples could not be tested. On February 22, 2021, three more unopened 24-ounce containers of Members Mark New England Clam Chowder, Lot Number 602563 3A2 01051, were obtained from Fresh Foods and delivered to the FDA laboratory in Arkansas. Samples of all three containers were individually analyzed. Clostridium botulinum was recovered in Sub 2.