Headlines - Botulism in 2016

Human botulism is a rare but serious neurological condition that has been a reportable disease since 1986. Laboratory diagnosis is performed by the National Reference Center for Anaerobic Bacteria and Botulism. In 2016, 13 botulism outbreaks involving a total of 21 patients were reported in France. Eight outbreaks occurred within families. The number of cases per outbreak ranged from 1 to 4. The outbreaks occurred between May and November. The incidence rate of botulism in 2016 was 0.32 per million inhabitants (vs. an average of 0.38 per year for the period 1991–2016).Although no outbreaks occurred in the Bourgogne-Franche-Comté region in 2016, Saône-et-Loire is among the five departments with the highest average annual incidence rate (1991–2016) (Vienne (4.0/106), Allier (3.2/106), Indre and Saône-et-Loire (2.0/106), and Creuse (1.9/106)). The high incidence in Haute-Corse (1.8/106) is attributable to a family-related foodborne illness outbreak involving 5 cases that occurred in 2010. The majority of departments have been affected by the disease at least once since 1991. Among the 21 patients in 2016, 12 were men and the median age was 40 years (range: 0–85 years). The diagnosis of botulism was confirmed in 11 outbreaks: 10 outbreaks, including the case of infant botulism, were type B, and 1 outbreak was type A. All patients reported at least one gastrointestinal sign (nausea, vomiting, or diarrhea) and at least one visual symptom (blurred vision, diplopia). Twelve patients were hospitalized, and 2 required respiratory support due to diaphragmatic paralysis (1 case involving toxin A and 1 case involving toxin B). One death was reported (toxin type A). A foodborne origin (primarily homemade deli meats) was confirmed in 8 outbreaks. In 4 of the 6 outbreaks where the food source was identified, a strain of C. botulinum type B was detected. An environmental source is strongly suspected in one case of infant botulism. Type B botulism, primarily associated with charcuterie products, remains the most prevalent form in France. Although the vast majority of botulism cases are linked to traditionally high-risk products (such as homemade deli meats, homemade preserves, or smoked fish), it remains important, whenever botulism is suspected, to consider other foods that could potentially be sources of botulism poisoning.