How Pruno is brewing the spread of botulism in prisons


By Jim Wigmore, Special Contributor to CorrectionsOne

It is reported that the number of times that inmates were caught brewing alcohol behind bars rose in England and Wales from 172 in 2005 to 1,090 in 2014. Pruno is also known as prison wine, jailhouse hooch, juice or brew, is an illicit alcohol brew made in prisons from fruit, sugar and water potatoes and other ingredients. The mixture is typically warmed in a plastic bag where the wild yeasts in the air ferments the sugar into alcohol as follows:

It may seem innocuous but depending on how it is fermented, Pruno can be toxic.

Botulism from Pruno
Foodborne botulism is a rare paralytic disease cause by the ingestion of botulinum toxin formed by C. botulinum in an anaerobic (low oxygen)environment, such as occurs during fermentation. The bacteria is commonly found in soil and its spores have been found in raw potatoes. It is the toxin produced by the bacteria not the bacteria itself which causes this disease which is fatal in 5-10% of those affected.

The disease starts with weakness, trouble seeing, and speaking and feeling tired. and can lead to respiratory failure and death if the victim is not ventilated. Botulism antitoxin can stop progression of paralysis if administered early enough in the course of the illness. 

Botulism Outbreaks in California and Utah
There have been reports of botulism in inmates caused by the drinking of pruno in prisons in California and Utah. One of the largest outbreaks occurred in Utah where 8 inmates were hospitalized. The botulism was determined to be caused by the addition of raw potatoes (which contain the botulism bacteria) to the brew, which then formed the toxin in the low oxygen environment of fermentation.

Of the eight hospitalized inmates, three were placed on mechanical ventilation and all patients received the botulism antitoxin. All patients survived but most have continued to have various lingering symptoms such as weakness, loss of muscle mass and difficulty in sleeping. 

Conclusion
During the investigation, many types of plastic bags and jars were observed in cells. In addition to clinical morbidity, the outbreak results in considerable cost to Utah taxpayers. These included charges of nearly $5,000,000; secure emergency transport and correctional facility monitoring in hospital; and local, state and federal public health and correction facility resources for the investigation.

References
"Botulism From Drinking Prison-Made Illicit Alcohol- Utah 2011", MMWR, 61(39): 782-784, 2012.
Vugia, D.J., Mase, S.R., Cole, B., Stiles, J., Rosenberg, J., Velasquez, L., Radner, A., and Inami, G., "Botulism from Drinking Pruno", Emerging Infectious Diseases, 15(1): 69-71, 2009

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