Health officials in Orange County responded to a report of potential botulism poisoning in two adults. The case-patients, who were treated at a local hospital, experienced neurological symptoms for over a week. Physicians treated them for botulism poisoning and reported the cases to the health department. Workers looked into the cause of the poisoning and found the case-patients had recently eaten home-prepared, fermented, tofu. The tofu tested positive for the presence of Clostridium botulinum type A and type A toxin. The case-patients noted they had fermented store bought, tofu many times in the past using the same recipe. Health officials believed three factors could have led to the growth of the bacteria: a near neutral pH, the creation of an anaerobic environment through boiling of the tofu, and storage at room temperature for the duration of the fermentation.