In May 2017 ten people were diagnosed with botulism after eating nacho cheese sauce sold at Valley Oak Food and Fuel gas station located in Walnut Grove, California. All 10 case-patients were laboratory confirmed with C. botulinum toxin type A. All patients were hospitalized. Nine were in an intensive care unit. Seven required ventilator support. One man died. Investigators confiscated an open five pound bag of Gehl Foods jalapeno cheese sauce from the gas station. A sealed bag of cheese sauce collected at the station was negative for the toxin. Due to the extensive distribution of the same lot code of nacho cheese throughout the United States without additional botulism cases, internal testing conducted by the Wisconsin manufacturer of the nacho cheese, and only a single bag of cheese linked to human illness, investigators suspect the nacho cheese was likely contaminated at the retail location.