In February 2016 two people living in the same household in Grant County, Washington died of symptoms caused by Clostridium botulinum toxin. The public health investigation was challenging due to language and cultural barriers as well as the inability to interview the two patients. Early in the investigation home-preserved fish (salted and dried at room temperature) was implicated. However, a large number of home-canned fruits and vegetables was found in the home. Public health investigators determined the canning practices used were not within the recommended guidelines. Signs of failed seals such as leakage on jars and storage shelves was observed. There was not any leftover, opened jars that the two patients may have eaten from prior to illnesses and the exact food which contained the toxin could not be identified.