Human botulism in France, 2013–2016

Human botulism is a rare but serious neurological condition that has been a reportable disease to Santé publique France since 1986. Biological diagnosis is performed by the National Reference Center (CNR) for Anaerobic Bacteria and Botulism (Institut Pasteur, Paris). This study presents the situation regarding human botulism in France for the period 2013–2016, based on epidemiological data from Santé publique France and biological investigations by the CNR. Thirty-nine confirmed botulism outbreaks (68 cases) and 3 suspected outbreaks (4 cases) were identified: 6 type A outbreaks (10 cases), 26 type B outbreaks (47 cases), 2 type F outbreaks (5 cases), and 5 outbreaks of undetermined type (6 cases). Foodborne botulism accounted for 36 outbreaks (6 cases), and infant botulism was confirmed in 6 infants. All cases of foodborne botulism of types A and F were severe. Two deaths related to botulism poisoning were recorded during this period. The food responsible was identified in 15 of the 36 foodborne botulism outbreaks. These were predominantly homemade or artisanal charcuterie products, particularly cured ham, which caused 13 type B botulism outbreaks, 3 of which were due to imported charcuterie. Homemade or artisanal charcuterie was suspected in 12 other outbreaks. A pheasant pâté was implicated in one type A outbreak, and consumption of canned asparagus was suspected of causing two other outbreaks. One of the two type F botulism outbreaks was caused by industrially produced ground meat contaminated with Clostridium baratii F7. No food was identified as the source of the infant botulism cases, but environmental contamination was suspected in three of them. A strain of C. botulinum A2 resistant to penicillins and metronidazole was identified in a case of infant botulism with relapses. Botulism remains a rare disease in France, but continued surveillance is necessary to detect early the potential emergence of a new type of toxin or the involvement of a new food product, as was the case with the two outbreaks of C. baratii type F in 2014 and 2015. Surveillance also enables the rapid identification of outbreaks so that recommendations for changes in food hygiene and storage practices can be promptly communicated to consumers and food manufacturers. Finally, the rapid identification of contaminated foods accelerates their removal from the market or from household distribution.

Author(s): Mazuet C, Jourdan Da Silva N, Legeay C, Sautereau J, Popoff MR

Publishing year: 2018

Pages: 46-54

Weekly Epidemiological Bulletin, 2018, n° 3, p. 46-54

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