Tracing all potential victims of the suspected botulism outbreak in Bordeaux – in which one woman has died and nine others been hospitalised – is being made difficult by the high number of international visitors to the bar.
The Tchin Tchin Wine Bar in the heart of Bordeaux’s city centre was predominantly filled with clientele visiting the city from elsewhere, including many international tourists.
Authorities believe up to 25 people could be affected, with a number of these being travellers who have already left France.
So far, the nationalities of those sick with suspected botulism include American, German, and Canadian – one woman is currently hospitalised in Spain, although it is unknown whether she is Spanish or visiting the country.
Alongside her, there are eight victims currently hospitalised in France – either in Bordeaux or the Île-de-France region – five of whom remain in intensive care.
This includes the partner of the 32-year old woman who died who was hospitalised in the Île-de-France region on Tuesday.
Whilst foodborne botulism cannot be passed from person to person, the sickness can sometimes take up to 72 hours to appear after eating contaminated food.
This means a number of tourists could have left the country before becoming sick.
Bar has been closed, authorities wait to see if more cases appear
Health authorities are waiting to see if more cases are reported, either domestically or abroad, that can be traced back to the bar.
The bar itself has been closed, with authorities conducting a deep clean of the premises, alongside removal of all tinned products.
Preliminary results of further testing of potentially contaminated products from the bar will be available on Friday.
What are some of the symptoms?
Foodborne botulism is extremely rare with only 0.4 cases per million inhabitants per year in France.
The fatality rate for foodborne botulism is around 5% – 10% but many who are sick require intensive care and may even need to be put on life support.
Common symptoms include dizziness, diarrhoea, fatigue, vomiting, or abdominal pain – one or more of these occur in around 85% of cases.
In 60% of cases, blurry vision is a symptom, and for around half of those sick with the bacteria they have difficulty swallowing.
If you have eaten at the Tchin Tchin Wine bar and are experiencing any of the symptoms, you are recommended to seek immediate medical assistance.
How can you detect botulism?
All of the cases traced back to the bar originate from customers eating tinned sardines that were tinned by the restaurant owner.
Commercially tinned and canned products have to undergo rigorous sterilisation to prevent botulism and other illnesses, meaning the majority of foodborne cases come from home-made tinned or canned products.
Botulism itself does not have a distinct smell, but foods infected by the toxin may smell ‘off’ when the tin or can is opened for the first time.
One telltale sign is that the tin or can is damaged from the inside before being opened, either by looking gassy or swollen.
If you are canning foods at home, you should rigorously follow the rules relating to the specific product itself.
There are differences in canning depending on the Ph chemical balance of the food item, which can affect how long it needs to be soaked in brine or acid.
General advice includes using a bain-marie to sterilise jars before using them, and replacing jars after being used to can products a few times, instead of overusing them.
More general advice on spotting botulism in home-canned food can be found in English from the US Centre for Disease Control and Prevention here.