A botulism outbreak linked to contaminated sandwiches from a street vendor in Italy has resulted in two deaths and 14 hospitalizations, with authorities launching criminal investigations into the incident that occurred in early August in the coastal town of Diamante.
Luigi Di Sarno, a 52-year-old artist and musician from Cercola, near Naples, died on August 8 after consuming a sausage and friarielli sandwich from a food truck during a family vacation. Tamara D’Acunto, 45, from Diamante, became the second fatality on August 6 after eating the same type of sandwich containing the broccoli-like vegetable.
The outbreak affected 18 people who consumed sandwiches with sausage and friarielli from the street vendor during the first week of August in Diamante, in the province of Cosenza, Calabria. Five patients were in intensive care at Annunziata Hospital in Cosenza, with two initially reported in serious condition.
The Paola Public Prosecutor’s Office has placed 10 people under investigation, including the street vendor, three managers from companies that produced the contaminated products, and six doctors from two health facilities in the Cosenza area who treated the victims before their deaths. The charges include culpable homicide, culpable personal injury, and trading in harmful foodstuffs.
According to the Istituto Superiore di Sanita, analyses revealed the poisoning was caused by multiple foodstuffs, not just the friarielli used in the sandwiches. Prosecutors ordered the immediate seizure of commercial products, particularly broccoli preserved in oil, and initiated a nationwide recall of potentially contaminated items.
Francesco Liserre, representing the street vendor, maintained that his client stored products properly in refrigeration and opened them when needed. The lawyer indicated his client believes the contamination existed in the products before they reached the food truck. Liserre described the vendor as “devastated” by the incidents.
Di Sarno was traveling home with his family when he became ill and was forced to pull over near Lagonegro in Potenza. Emergency services responded, but he died before reaching the hospital. D’Acunto’s funeral took place on August 7, the day after her death.
The Calabria Department of Health and Welfare activated emergency procedures requiring immediate notification to the Poison Control Center in Pavia, the only national facility designated for botulism management. Military aircraft transported antitoxin serum to affected hospitals, as standard practice does not require hospitals to maintain stockpiles of the specialized antidote.
This outbreak represents part of a broader botulism crisis affecting multiple Italian regions. Two additional deaths occurred in Sardinia after victims consumed guacamole at a festival in Monserrato near Cagliari in late July. A 62-year-old woman, Valeria Sollai, died on August 20 at a hospital in Monserrato, while Roberta Pitzalis died at Businco hospital in Cagliari. A 14-year-old girl remains hospitalized in the same city.
Carlo Alessandro Locatelli, director of the Maugeri Poison Control Centre in Pavia, emphasized that prevention is crucial, particularly in preparing home preserves. He noted that botulinum toxin is invisible and often does not alter food taste, with antidotes only effective in early stages when toxin remains in the bloodstream.
Italy recorded the highest number of botulism cases in Europe during 2023, with 36 confirmed reports, followed by Germany with 16 cases. Between 2001 and 2020, Italy documented 452 laboratory-confirmed botulism cases with an average lethality rate of 3.1 percent. Approximately 91 percent of cases are foodborne, often linked to home-canned goods.
Experts attribute Italy’s high incidence to traditional canning practices, especially in southern regions. Home food preservation, when conducted improperly, can promote growth of Clostridium botulinum, the bacterium responsible for botulism.
Botulism symptoms typically appear six hours to seven days after consuming contaminated food and include double vision, dilated pupils, drooping eyelids, difficulty speaking and swallowing, dry mouth, and constipation. Severe cases can impair breathing, requiring intubation and mechanical ventilation support.
Mayor Achille Ordine of Diamante issued a public statement on August 7, requesting residents avoid panic and rumor circulation while authorities continue their investigation. The health authority in Cosenza imposed a precautionary health block on the vendor’s activities pending completion of the criminal probe.