In Bordeaux, Barcelona, and the Île-de-France region, at least twelve cases of botulism have been detected in recent days. A 32-year-old person died on Tuesday, September 12, in the Paris region as a result of the disease. In the Gironde region, eight people have been placed in intensive care or continuous monitoring units. In the Catalan capital, the patient has been taken care of by medical services.
All infected individuals consumed homemade canned sardines served in a Bordeaux restaurant, the Tchin Tchin Wine Bar, which was not authorized to sell them. Its fish is suspected to be the source of the illness. “There is little doubt about the causal links between the canned food and the onset of symptoms,” according to Thierry Touzet, deputy director of the Gironde departmental directorate for consumer protection.
What is botulism? Botulism is a rare neurological condition. According to data from the French National Public Health Agency, Santé publique France (SPF), from 2017, the national incidence rate is low, at 0.08 per million inhabitants. The disease can be severe when not treated promptly, and in 5% to 10% of cases, it is fatal, according to the World Health Organization (WHO).
The condition is caused by a toxin that acts on the nervous system, produced by the bacterium Clostridium botulinum, explains Santé publique France. Seven types of botulism are identified, classified from A to G. Up to five of them can affect humans: A, B, E, and the less common F, according to the Pasteur Institute, and C as well, according to SPF.
Three forms of botulism are known. It can be caused by the colonization of the intestine in the presence of the bacterium’s germs, as is the case with infant botulism, or by contamination of a wound, especially when using intravenous drugs.
The most common form of botulism remains food poisoning through the ingestion “of the toxin in preserved foods that have not undergone extensive sterilization processes,” explains the Pasteur Institute. Commonly implicated foods include preserved meats, charcuterie, or homemade, artisanal, or mass-market canned goods. The disease is not contagious.
How does the disease manifest? The time between the introduction of the bacterium into the body and the onset of initial symptoms can range from a few hours to several days, depending on the mode of contamination. SPF estimates it to be a minimum of two hours and a maximum of eight days.
The onset of the condition is marked by “ocular involvement (accommodation defect, blurred vision), dryness of the mouth accompanied by swallowing and speech difficulties, followed by muscle weakness and, in severe cases, muscle paralysis,” as described by the Pasteur Institute. The disease can also cause digestive disturbances such as diarrhea, abdominal pain, nausea, or vomiting.
In the most severe cases, Benjamin Clouzeau, a physician in medical intensive care at the University Hospital of Bordeaux, explained during a press conference on Wednesday morning that the condition can lead to respiratory paralysis. The severity of symptoms can vary and may depend on the amount of ingested toxin.
What are the risks? One of the risks is respiratory paralysis, requiring intensive care, which can be life-threatening, “with types A and E being responsible for the most severe forms,” writes the National Public Health Agency. The disease is fatal in 5% to 10% of cases, according to the Pasteur Institute, which also notes that “the vast majority of patients who receive prompt treatment recover without sequelae, but the duration of treatment and convalescence can last several months.”
