Italy is on high alert after a second person has died in a botulism outbreak linked to contaminated broccoli.

Tamara D’Acunto, 45, died shortly after eating a panini bought from a food truck in southwest Italy. She fell ill within hours and was rushed to hospital, but could not be saved. Her death follows that of artist and musician Luigi Di Sarno, 52, who collapsed last week after eating a broccoli and sausage sandwich on the Diamante seafront in the province of Cosenza.

Eight others, including members of Di Sarno’s family, were hospitalised. The outbreak is being linked to toxins produced by Clostridium botulinum bacteria, which cause botulism, a rare but potentially fatal illness, per World Health Organization.

Authorities have recalled broccoli nationwide and seized the food truck where the sandwiches were prepared. The Paola Public Prosecutor’s Office has ordered the immediate seizure of the contaminated product, while the Calabria Region’s Department of Health and Welfare has activated emergency protocols.

In a statement, the department explained that Italy’s botulism antitoxin is held exclusively by the Ministry of Health and distributed through the Lombardy Poison Control Centre, per The Mirror.

The first vials for treatment were flown from the Military Pharmacy in Taranto, and additional supplies have since been dispatched via air ambulance from Rome to hospitals treating patients.

Botulism cases are rare (with only around 1,000 reported worldwide each year) but the illness can cause muscle paralysis, respiratory failure, and death if untreated. Symptoms often appear within 12 to 72 hours and may include blurred vision, slurred speech, muscle weakness, and fatigue.

How to reduce your risk of botulism:

Be cautious with low-acid foods: Homemade oils infused with herbs or vegetables should be refrigerated and consumed within four days, per the CDC.
Avoid damaged canned goods: Never eat food from bulging, dented, or leaking containers.
Use proper pressure canning: Only a pressure canner can reach the temperatures needed to destroy C. botulinum spores in low-acid foods like vegetables and meats.
Acidify tomatoes: When preserving tomatoes, add bottled lemon juice or citric acid to keep pH at or below 4.6.
Heat thoroughly: Cooking food above 85°C for at least five minutes destroys botulinum toxin.
Refrigerate promptly: Keep perishable foods chilled at 4°C or below and never leave them out for more than two hours (or one hour in hot weather).
Health officials stress that botulinum toxin cannot be seen, smelled, or tasted; and even tiny amounts can be lethal. Their advice: when in doubt, throw it out.