Food-borne illness outbreaks are often tied to fresh foods — unwashed raw vegetables, tainted undercooked meat, raw dairy products — but not the neon yellow nacho cheese sauce you’d get at a movie theater or convenience store. However, one batch of this processed cheese-like product has been linked to multiple, potentially lethal cases of botulism.

Sacramento County Public Health officials are in the midst of investigating the possible causes of illnesses in five patients recently hospitalized with food borne botulism — a rare but serious paralytic illness that can be fatal caused by a nerve toxin that is produced by the bacterium Clostridium botulinum — that is believed to have been spread by nacho cheese sauce served the Valley Oak Food and Fuel gas station in Walnut Grove, CA.

Another three probable cases and one suspect case are also under investigation, reports The Sacramento Bee, with all patients still in the hospital. Officials have since temporarily revoked the gas station’s permit to sell food and drink.

The family of one of those confirmed cases is now suing the gas station, claiming negligence, product liability, and breach of implied warranty, the Bee reports.

Her family says she picked up a bag of Doritos at the gas station on April 21 on her way home from work, and drizzled them with cheese sauce. Her partner says that within hours she felt fatigued, and complained of double vision the next morning. She went to the hospital, but was sent home. Hours later she was throwing up and had a hard time breathing, so she went back to the emergency room.

She was put on a ventilator the next day and admitted to the intensive care unit, where she remains. The neurotoxins have left her unable to open her eyes or speak.

“Only human mistakes create the environment for botulinum toxin to form,” her attorney told the Bee. “We will use the lawsuit to learn more about the source of the food product that was contaminated. The source of the food product may be unrelated to the gas station; it could be a commercially made, pre-packaged item. That’s an essential question.”

It’s rare for botulism to spread from stores, he notes, as most botulism outbreaks are associated with home canning, like the 2015 outbreak in Ohio linked to home-canned tomatoes.

In 2015, 39 of 199 confirmed total cases of botulism were food-borne, according to the Centers for Disease Control’s most recent National Botulism Surveillance Summary [PDF].

Attorneys haven’t estimated how much in damages the family will seek, but noted that past botulism cases have been resolved for millions of dollars.

[h/t Los Angeles Times]

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