The deceased victim is a 32-year-old woman who had frequented Bordeaux with her husband before returning to her home in the Paris region.

According to Dr. Benjamin Clouzeau, anaesthetist-resuscitator at the Pellegrin hospital in Bordeaux, she had presented herself "with signs that do not orient towards the disease" in the emergency room of a hospital structure in Île-de-France, before succumbing suddenly at home to a cardio-respiratory arrest. His companion is in intensive care.

The Regional Health Agency (ARS) in Nouvelle-Aquitaine lists 12 cases in total, aged 30 to 40 years with the exception of one in her seventies. Most are of foreign nationality (USA, Canada, Germany, Ireland).

Eight cases were hospitalized in Bordeaux, six of whom were on respiratory assistance Wednesday afternoon, and two in Île-de-France (the couple). A Spanish consumer was treated in Barcelona, as was another man in Germany, who returned home and was taken care of in his country. "Their lives are not in danger," according to the doctor.

All these people have in common to have eaten in the same restaurant, the "Tchin Tchin Wine Bar", between September 4 and 10 in Bordeaux, where tourist attendance is important in September.

In this downtown establishment, popular with Anglo-Saxon customers, all the patients consumed sardines in jars of artisanal manufacture.

Possible new cases

The health authorities recommend that people who have frequented the restaurant on the same dates and have symptoms (diarrhea, vomiting, vision or speech disorders) "consult a doctor urgently or contact 15".

In view of the delays in action of the toxin that causes the disease, "we could have new cases until this weekend," warned Benoît Elleboode, director general of the ARS.

Payment tickets and phone numbers of potential customers were retrieved from the restaurant. Up to 25 people may have consumed nine jars, containing three or four sardines each, served at the table.

The Ministry of Health has sent an alert message to all health professionals, in France and abroad via WHO.

Botulism is a serious neurological condition, fatal in 5 to 10% of cases, caused by a very powerful toxin produced by the bacterium clostridium botulinum, which develops especially in poorly preserved food due to insufficient sterilization.

In France, the majority of cases of botulism correspond to food poisoning by ingestion of said toxin in cured meats, deli meats or preserves of family or artisanal origin.

"It is an extremely rare disease, which had almost disappeared, with an incidence of less than 0.4 per million in France," said Dr. Clouzeau, describing the episode as "exceptional".

An anti-toxin antidote was transported from a military stockpile in Marseille.

"Bad smell"

An inspection of the Departmental Directorate for the Protection of Populations (DDPP) was carried out Monday in the establishment, confirming a "manufacturing defect" of canned sardines.

"The restaurateur confirmed that when the jars opened, there was a bad smell and the absence of emptiness," said Thierry Touzet, deputy director of the DDPP.

"The establishment was rather well kept" but the professional "has a very artisanal modus operandi that was not mastered," he added, adding that the establishment had never been reported in the past.

The prefecture has prohibited the manager from manufacturing new products "until further notice" and prescribed a "thorough cleaning" of the bar-restaurant, which remained closed Wednesday. All canned goods manufactured on site have been recorded. The first results of analysis of the samples are expected on Friday.

Botulism is a reportable disease caused by neurotoxins that attack the nervous system, causing eye problems (double vision), swallowing defect and, in advanced forms, paralysis of muscles, including respiratory muscles, which can lead to death.

According to Dr. Clouzeau, the management of patients in intensive care promises to be long "because once the toxin is blocked and fixed, it paralyzes the muscles for several weeks", with various risks of complications.

© 2023 AFP