10-23-2019 When Should One Drink Pruno?

Toxicology Question of the week

October 23, 2019

When Should One Drink Pruno?

My recommendation is never. 

“Pruno”, “hooch”, or “prison wine” consumption is a common practice in correctional facilities and has caused outbreaks of botulism in prisons.  Pruno can be made by fermenting whole potatoes (bread or rice can be used but rumor has it that potatoes make stronger pruno) with food items containing processed sugar (sugar packets, candy, beverages).

Method: 1) Seal all items in a container (trash bag) 2) Mash the ingredients together 3) Store in holes in walls, bunks, or toilets, 4) Wait for fermentation (2-8 days).   The container swells and strong odors occur during the fermentation process. 5) Separate liquid from mash solids through a strainer (usually clothing).  6) Drink liquid portion.

Botulinum toxin production occurs in conditions of low salt, low sugar, low acid (pH>4.6), no oxygen and warm temperature. Foodborne botulism outbreaks are most frequently associated with home-canned vegetables. Botulism is caused by a potent neurotoxin produced from clostridium botulinum (primarily) which is an anaerobic, spore-forming bacteria.

Botulism is a neuroparalytic illness characterized by symmetric descending flaccid paralysis of motor and autonomic nerves, beginning with the cranial nerves.  Signs and symptoms include diplopia, blurred vision, ptosis, slurred speech, dysphagia, dry mouth, muscle weakness.  Infants demonstrate poor feeding, decreased suckling and crying, floppiness, and constipation. 

Initial diagnosis is by clinical symptoms with laboratory confirmation of toxin in serum, stool or food.  Treatment is botulinum antitoxin or Baby Big.  Antitoxin does not reverse paralysis but arrest its progression. 

In 2017, 182 laboratory-confirmed botulism cases were reported to the CDC—141 (77%) infant, 19 (10%) foodborne, 19 (10%) wound, and three (1%) “other” classified as: two (1%) iatrogenic, and one (1%) suspected adult intestinal colonization.

The following link informs you about botulism surveillance and provides some interesting facts.

(https://www.cdc.gov/ncezid/dfwed/PDFs/bot-overview_508c.pdf

Prepared by: Donna Seger, MD

I am interested in any questions you would like answered in the Question of the Week.  Please email me with any suggestion at donna.seger@vumc.org.

Donna Seger, MD

Executive Director

Tennessee Poison Center

www.tnpoisoncenter.org

Poison Help Hotline: 1-800-222-1222