A 45-year-old woman has become the second person to die after eating a contaminated sandwich from a food truck in southern Italy, as authorities scramble to contain a deadly botulism outbreak that has left 17 people hospitalised and sparked a criminal investigation.
Tamara D’Acunto, from Diamante in Calabria, died on Wednesday after consuming a panini filled with sausage and turnip greens from the same vendor that sold a fatal sandwich to Luigi Di Sarno, 52, who died last Thursday. The artist and musician from Cercola, near Naples, had been returning from a family holiday when he stopped at the food truck.
Health officials have confirmed that laboratory tests detected botulism toxin in food samples from the truck, prompting an immediate seizure of the vehicle and a nationwide recall of the contaminated products. The Paola Public Prosecutor’s Office has launched an investigation into nine people, including the food truck owner, three managers from companies that manufactured the sandwich ingredients, and five doctors accused of failing to provide timely treatment.
“The toxin is extremely potent. Just a very small amount is enough to cause serious harm, as we have seen,” Dr Enrico Di Rosa, president of the Italian Society of Workplace Hygiene, told local media. The deadly bacteria thrives in improperly preserved foods, particularly oil-preserved vegetables.
The outbreak has exposed critical gaps in Italy’s food safety system and emergency medical response. Di Sarno’s sister revealed her brother was sent home from hospital despite still feeling unwell, raising serious questions about the initial medical assessment. He later died during the journey back to Naples.
Among the 17 hospitalised victims are two 17-year-olds and several women in their forties, with at least five patients requiring intensive care treatment. All fell ill within 24 to 48 hours of eating the sandwiches, experiencing classic botulism symptoms including breathing difficulties, muscle paralysis, and blurred vision.
The contaminated sandwiches contained “cime di rapa” or turnip tops, a leafy vegetable similar to broccoli that is popular in southern Italian cuisine. Investigators believe the vegetables, preserved in oil, became contaminated with Clostridium botulinum bacteria during improper storage or processing.
Giuseppe Santonocito, 33, the food truck owner, is reportedly “devastated” by the deaths. His lawyer, Francesco Liserre, insisted his client followed proper storage procedures: “The products were stored in the refrigerator and opened when needed. He is convinced that the contamination was already in the products.”
The crisis has prompted emergency measures across Italy, with the Calabria Region’s Department of Health activating special protocols. “No region or hospital in the country is authorised to store the antivenom in their own facilities,” health officials stated. This serum is exclusively available to the Ministry of Health, which holds it in designated secure locations.
Italy’s struggle with botulism is not new. The country recorded 452 confirmed cases between 2001 and 2020, with a fatality rate of 3.1 per cent. In 2023 alone, Italy reported 36 cases, the highest in Europe, largely attributed to the traditional practice of home canning and preserving foods.
The Diamante outbreak marks the second deadly botulism incident in Italy within days. In late July, a 38-year-old woman died after eating contaminated guacamole at a festival in Sardinia, with seven others suffering acute food poisoning. An 11-year-old boy from that incident required emergency airlift to Rome for treatment.
Post-mortem examinations on both victims are scheduled for this week, with D’Acunto’s body requiring exhumation from the cemetery in Cirella where she was buried following her funeral last Thursday. A team of specialists from Magna Græcia University and the National Reference Centre for Botulism will conduct the autopsies.
Local prosecutor Domenico Fiordalisi is leading the investigation, which now focuses on whether proper food safety protocols were followed and if medical staff responded appropriately to the victims’ symptoms. Charges being considered include manslaughter, personal injury through negligence, and trafficking in harmful food substances.
The mayor of Diamante, Achille Ordine, attempted to reassure residents, calling the incidents “circumscribed and limited.” However, health experts warn that Italy’s high incidence of botulism cases reflects broader issues with food preservation practices, particularly in the south where artisanal preserving remains common.
Dr Carlo Alessandro Locatelli, director of the Pavia Poison Control Centre, emphasised: “There is no alarm, but prevention is essential, especially in the preparation of home preserves. These products, if not treated properly, maintain a non-acidic pH, an ideal environment for the toxin to proliferate.”
The Italian Health Ministry has responded by distributing emergency supplies of botulinum antitoxin to affected hospitals, though officials stress that early detection and treatment remain crucial. The antitoxin can prevent progression of the disease but cannot reverse paralysis that has already occurred.
For the families of the victims, questions remain about how a simple roadside meal could turn fatal. Luigi Di Sarno’s family lawyers have demanded answers: “One cannot die like this. We demand justice, we want the truth. Mistakes and omissions have been made that led to the death of two people.”
As investigations continue, health authorities have issued urgent warnings about the dangers of improperly preserved foods. Consumers are advised to avoid any products with swollen lids, unusual odours, or signs of spoilage, and to seek immediate medical attention if experiencing symptoms after eating preserved foods.
The tragedy has cast a shadow over Italy’s vibrant street food culture, where mobile vendors are a common sight at festivals and tourist destinations. With the peak summer season underway, authorities face pressure to ensure public safety whilst supporting legitimate businesses affected by the crisis.
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