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Five persons consumed home-salted fish and then presented with gastrointestinal symptoms to 3 hospitals; 2 of the patients had minimal cranial nerve palsies. Early serum samples obtained from all patients were negative for botulinum toxin. Remnant fish tested positive for botulinum toxin type E. In patients exposed to low doses of botulinum toxin type E, gastrointestinal symptoms may predominate.
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Sobel et al. (2007) studied this question.
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