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Health

Microbial Misadventures: Exploits in Botulism & Pruno In Our Prison Population

Body HorrorsBy Rebecca KrestonMay 23, 2013 9:59 PM

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Microbial Misadventures is a recurring series on Body Horrors looking at instances and incidents where human meets microbe in novel and unusual circumstances that challenge our assumptions about how infections are spread. 

I am partial to the odd tipple and, as a resident of the licentious, enabling city that is New Orleans, I'm fortunate to be adequately supported in my booze-seeking ways by the high number of bars and restaurants within stumbling distance of my front porch. But what to do for those of us prohibited from indulging in one of the world's greatest mood modulators, for those of us, say, incarcerated in America's prison-industrial complex? In that case, American ingenuity and tenacity wins, always: become a smalltime craft brewer and make your own.

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A Gram stain of Clostridium botulinum type A. The spore-forming, soil-dwelling bacterium produces a nerve toxin, causing the rare, paralytic illness known as botulism. There are seven types of botulism toxin, classified alphabetically A through G; only types A, B, E and F cause illness in humans. Image: CDC/ Dr. George Lombard. Pruno. Hooch. Buck. Inmate Wine. Chalk. Brew. Juice. Jump. The core requirements for this illicit alcoholic beverage consist only of sugar and water. That custom “microbrew” touch can be achieved with anything that can be scrounged from such an environment. No, not coriander seeds,orange peel, or applewood-smoked bacon - this is craft brewing on a budget, people! Think ketchup, corn, rice and bread (1). Formulas for bootleg booze vary but invariably require a plastic bag or bottle to create a sealed anaerobic environment for alcohol fermentation, some form of heat and, of course, time, which inmates have more than plenty of. The consumption of pruno is, understandably, a popular pastime in prisons throughout the United States: alcohol dulls the passage of time, a much-needed antidote for those surrounded by concrete walls and steel bars for years at a time (2). Drinking pruno is a risky endeavor, both in terms of its offense to culinary sensibilities and to one's health. However, turned stomachs are not the only hazard here; you may add a desire to avoid botulism to your list of reasons to shy away from you'r mates latest batch of prison hooch. The soil-dwelling bacterium Clostridium botulinum can contaminate fruits and veggies, and, in warm, oxygen-deprived conditions, produces the neuroparalytic toxin botulinum. Even more wholesome DIY endeavors, such as canning fruits and crafting jams, can create an excellent staging ground for growing one's own C. botulinum.

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Inside a medium-security housing area within Wasatch, one of the buildings of the Utah State Prison (USP) outside Salt Lake City. Source: Utah Department of Corrections. More images and information can be found by clicking on the image.. Due to improvements in food canning techniques and a overall decline in this homesteading activity, cases of botulism are rare in our part of the world and thankfully so: the toxin, "the most poisonous substance known," may be a godsend for wrinkles but is quite another matter when introduced to the intestinal tract and to open wounds (3). Botulism is an acute and deadly infection that can result in paralysis, respiratory failure or death if supportive medical care and the anti-botulinum neutralizing antibody aren’t provided immediately. In any event, the DIY ethos is still flourishing in our nation’s prisons as evidenced by five botulism outbreaks in nine years within the country’s western states. In one of the largest pruno-associated botulism outbreaks in October of 2011, eight maximum security inmates incarcerated at the Utah State Prison in Salt Lake City County fell seriously ill due to pruno made with oranges, grapefruit and one baked potato. One "moist sock" was employed to filter the precious, C. botulinum-laced hooch (2). The CDC's investigation of the outbreak has a nice rundown of how to brew your own jailhouse brew if you're so inclined:

The potato was removed from a meal tray, stored at ambient temperature for an undetermined number of weeks in either a sealed plastic bag or jar obtained from the commissary, peeled [by an inmate] using his fingernails, and added to a plastic bag containing other ingredients a few days before brew A consumption. The ingredients were fermented in this bag for several days before being distributed to other inmates in resealable plastic bags. Toxin likely was produced when the potato was added to a bag containing low-acidity pruno ingredients under warm, anaerobic conditions during pruno fermentation.

All eight had to be admitted to neuro-critical care unit, with three requiring mechanical ventilation, at a total cost of nearly $500,000 to Utah taxpayers (2). One penal institution, the Arizona State Prison Complex-Eyman located in Florence, was hit with two botulism outbreaks in 2012: four inmates were pruno'd in August followed by eight more in late November (4). All twelve men had to be hospitalized, with seven of the men in the second outbreak requiring intubation and tracheotomies to assist in breathing. All outbreaks were associated with potatoes, forcing the prison to ban the treacherous tuber from the prison kitchen (1). California has had their own spate of prison wine problems with two outbreaks in 2004 and 2005. In the 2004 outbreak, the pruno recipe included "unpeeled potatoes smuggled from the kitchen, apples from lunches, one old peach, jelly, and ketchup". Will make 2 gallons of pruno, with multiple servings depending on your guests’ proclivity for a substance "magenta in color … smelling like baby poop." (5) There is plenty going on inside our prisons for public health workers and epidemiologists to occupy themselves with. Chronic infectious diseases are extraordinarily prevalent among inmates, including hepatitis B and C, HIV, and tuberculosis (6, 7). Acute infections are also common; influenzas and food borne illnesses pay no heed to maximum security precautions. Botulism infection, however, is that rare microbial phenomenon born of confinement and boredom and potatoes. Resources The highest rates of botulism in the United States occur in our northern-most state Alaska, and is attributed to changing methods of fermenting meat and the loss of indigenous culinary knowledge among Native Alaskans. Check out an older article of mine, "This Ain’t Yo Momma’s Muktuk: Fermented Seal Flipper, Botulism, Being Cold & Other Joys of Arctic Living."

Botulinum toxin is an incredibly powerful protein used for the treatment of multiple muscular disorders. Find out more here.

Making money off of redemption: a 1998 article from The Atlantic on the prison-industrial complex. An incredible poem by Jarvis Masters, currently on death row at San Quentin State Prison in California, "Recipe for Prison Pruno." References

  1. CDC (February 8, 2013)Notes from the Field: Botulism From Drinking Prison-Made Illicit Alcohol — Arizona, 2012. MMWR Morb Mortal Wkly Rep. 62(05): 88-88

  2. CDC. (October 5, 2012) Botulism From Drinking Prison-Made Illicit Alcohol — Utah 2011. MMWR Morb Mortal Wkly Rep. 61(39): 782-784

  3. Zhang JC, et al. (2010) Botulism, where are we now? Clin Toxicol (Phila).48(9): 867-79

  4. S Hensley (Feb 7, 2013) Botulism from 'Pruno' Hits Arizona Prison. NPR [Online]. Accessed May 21, 2013 here.

  5. DJ Vugia et al. (2009) Botulism from Drinking Pruno. EID. 15(1): 69-71

  6. KA Hennessey et al. (2009) Prevalence of infection with hepatitis B and C viruses and co-infection with HIV in three jails: a case for viral hepatitis prevention in jails in the United States. J Urban Health. 86(1): 93-105

  7. E Gough et al. (2010) HIV and Hepatitis B and C incidence rates in US correctional populations and high risk groups: a systematic review and meta-analysis. BMC Public Health. 21(10): 777

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Centers for Disease Control and Prevention (CDC) (2013). Notes from the field: botulism from drinking prison-made illicit alcohol - Arizona, 2012. MMWR. Morbidity and mortality weekly report, 62 (5) PMID: 23388552

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