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The Salt Lake Valley Health Department confirmed Wednesday it is investigating an illness — suspected to be botulism from home-made alcohol brewed in a cell — that has sickened 12 inmates at the Utah State Prison.

Eight inmates, three of whom are in critical condition, are receiving treatment at a local hospital, and four are under medical observation at the prison.

All the affected inmates consumed "brew," made in a plastic bag hidden in an inmate's cell, according to a health department news release.

Three inmates initially were taken to the University of Utah Hospital with symptoms including nausea, vomiting, facial paralysis and blurry vision, prison officials said.

Botulism is a rare but serious paralytic illness caused by a nerve toxin produced by bacteria. Botulism has a 5 percent fatality rate, but people only die if they do not receive the antitoxin early enough.

The Centers for Disease Control in Atlanta control the antitoxin, and officials at the Salt Lake Valley Health Department have worked closely with the federal agency to obtain the antitoxin. The eight hospitalized inmates have received it, but the four at the prison medical facility are showing such mild signs they have not yet received it, said Nicholas Rupp, public information officer for the health department. Recovery can take weeks or months, and prison and health officials will closely track the hospitalized inmates' recoveries to determine when they can be returned to prison.

The inmates affected likely came in contact with the bacteria by drinking the home-made alcohol. Inmates often use fruit, water and sugar to craft the brew, which they often hide in the cell's toilet tank, and when those foods are in an anaerobic environment — meaning one absent oxygen — they can create a breeding ground for the bacteria.

According to confiscation reports obtained earlier this year by The Tribune, brew is made fairly frequently, with 44 confiscations of the substance occurring between October 2009 and December 2010. However, the prison has not ever had a case of botulism, according to Rupp.

But "there's always a health risk any time there is inappropriate food handling," Rupp added.

Health officials believe there was at least a gallon of the fermented alcoholic brew made, based on the number of drinkers who fell ill. A single sip of liquid containing the toxin is enough to cause symptoms, Rupp said. Health department officials were able to obtain a sample of the brew in question and have sent it to the state lab for testing.

Prison officials are seeking other potential victims of the bad brew. They say they want to make sure inmates feel comfortable about coming forward to be assessed, despite the fact that making and drinking the stuff is an illegal activity in the prison.

"First and foremost, we want to make sure they [inmates] are healthy and protect their sense of health and welfare," Department of Corrections spokesman Steve Gehrke said.

The incubation period for the disease is anywhere from six hours to several days, Rupp said.

The outbreak at the prison peaked on Oct. 1, and health officials said they hope they are at the tail-end. The last case of botulism in Utah was in the southern part of the state in 2003, and the Salt Lake Valley hasn't had a case in more than 20 years, Rupp said.

Botulism is always a public health concern, but there is no person-to-person transmission. This outbreak also appears to be contained solely to the prison.

Food-borne botulism is caused by consuming foods that contain the toxin. Classic symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness.

According to the Centers for Disease Control, an average of 145 botulism cases are reported each year in the United States; of these, approximately 15 percent are food-borne and are usually caused by foods canned improperly at home. Foods with a low acid content, such as asparagus, green beans, beets and corn, are the most susceptible.

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