Twelve cases, one death… What we know about cases of botulism detected in France

2023-09-13 09:47:38

12 cases of botulism have been identified in France in recent days, linked to sardines served in a restaurant in Bordeaux. One death was recorded in Île-de-France. Due to the disease’s incubation time, authorities expect to detect cases until this weekend.

One death, twelve cases, one bar inspected… Health authorities took stock this Wednesday of the evolution of cases of botulism, a rare but serious neurological condition, detected in France in recent days.

• Where is the situation in France?

A first case of botulism presented itself on Saturday at the Bordeaux University Hospital, medical intensive care doctor Benjamin Clouzeau explained this Wednesday during a press conference. Since then, 12 cases have been identified, including eight treated at the Bordeaux University Hospital (seven in intensive care, five on respiratory assistance and one in a continuing care unit).

Two cases have been recorded in Île-de-France: a woman died and her companion is in intensive care. A case, linked to the others, was detected in Spain, but “his days are not in danger”, specified Doctor Clouzeau.

“Coming across so many patients at once is obviously exceptional,” he underlined this Wednesday.

• Where do these cases come from?

Informed on Monday of these cases, the Departmental Directorate for Population Protection traced their origin to a bar in Bordeaux, the Tchin Tchin Wine Bar. The deputy director of the DDPP, Thierry Touzet said on Wednesday that there was “no longer any doubt regarding the causal link” between canned sardines served by the bar and the appearance of symptoms in those affected.

They all frequented this bar between Monday September 4 and Sunday September 10. The DDPP noted “a real lack of control of the canning process”, declared Thierry Touzet, with a “very artisanal operating mode” which must be improved. All canned goods have been seized there and it is no longer allowed to serve homemade products.

As the establishment’s clientele is rather international, some of the patients treated in France are of foreign origin, according to the authorities.

• What is botulism?

Botulism is a “rare but serious neurological condition” caused by a powerful neurotoxin produced by the bacteria Clostridium botulinum, according to Public Health France (SPF).

The most common form is foodborne botulism, according to this public establishment dependent on the Ministry of Health. It develops “in preserved foods that have not undergone an extensive sterilization process: cured meats, cold meats or even preserves of family or artisanal origin”, according to the ARS of Nouvelle-Aquitaine.

This disease is not transmitted from one individual to another. In France, the average annual incidence for botulism is 0.4 cases per million inhabitants, according to SPF.

• What do the authorities recommend?

SPF explains on his website that incubation time (time between the moment of contagion and the appearance of symptoms) for foodborne botulism is on average 12 to 72 hours, but depends on the quantity and type of toxin ingested. Because of this incubation period, authorities expect to see new cases through this weekend.

People who have visited the restaurant concerned and present with digestive signs (diarrhea, vomiting) or vision or speech problems must therefore contact the emergency services to benefit from anti-toxin treatment.

According to the World Health Organization (WHO), a UN agency, botulism can be fatal in 5 to 10% of cases. Mortality is particularly high for people who are not diagnosed early.

“It’s a disease that progresses very quickly” and whose “signs are different from one patient to another,” Dr. Benjamin Clouzeau underlined on Wednesday.

Diagnosed patients receive a botulinum antitoxin and sometimes benefit from intensive respiratory care (assisted ventilation). “The vast majority of patients treated without delay recover without following-effects, but the duration of treatment and convalescence can last several months,” said the ARS of Nouvelle-Aquitaine on Tuesday.

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