Headlines - Human Botulism in France, 2013–2016

Human botulism is a rare but serious neurological condition that is subject to mandatory reporting (MR) to Santé publique France. The biological diagnosis is performed by the National Reference Center (CNR, Institut Pasteur, Paris). A study presents the situation regarding human botulism in France for the period 2013–2016 based on mandatory reports and biological investigations by the CNR1.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 affected 36 outbreaks (65 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 outbreaks. These were primarily 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 cases of infant botulism, but environmental contamination was suspected in three of them (dust/earthwork).During the recent period of 2013–2016 in Bourgogne-Franche-Comté, only the Jura and the Territoire de Belfort reported cases, the latter being one of the four French departments with the highest incidence. However, during the 1991–2016 period, a significantly higher incidence was noted in the departments of central France: Vienne (4.0/106), Allier (3.2/106), Indre (2.0/106), Saône-et-Loire (2.0/106), and Creuse (1.9/106). Continued surveillance of botulism is necessary to identify early on the potential emergence of a new type of toxin or the involvement of a new food product. 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 industry stakeholders. Finally, the rapid identification of contaminated foods accelerates their removal from the market or from household distribution.