Rapid communication Open Access
Like 0


In September 2023, a botulism outbreak affecting 15 individuals occurred in Bordeaux, France, during the Rugby World Cup. We report on eight individuals from four different countries on two continents admitted to the intensive care unit at our hospital, where six required invasive mechanical ventilation. Cases reported consuming locally produced canned sardines at a restaurant. This report highlights the importance of rapid, worldwide alerts from health authorities to prevent severe consequences of such outbreaks, particularly during events attracting international visitors.


Article metrics loading...

Loading full text...

Full text loading...



  1. Préfet de la Gironde/Agence Régionale de Santé Nouvelle Aquitaine. Intoxication alimentaire : signalement de 7 cas probables de botulisme dont 6 sont pris en charge au CHU de Bordeaux. [Food poisoning: report of 7 probable cases of botulism, 6 of which are being treated at Bordeaux University Hospital]. Bordeaux: Préfet de la Gironde/Agence Régionale de Santé Nouvelle Aquitaine; 2023. French. Available from: https://www.gironde.gouv.fr/Actualites/Communiques-de-presse/Communiques-de-presse-2023/Septembre-2023/Intoxication-alimentaire-signalement-de-7-cas-probables-de-botulisme
  2. Centurioni DA, Egan CT, Perry MJ. Current developments in diagnostic assays for laboratory confirmation and investigation of botulism. J Clin Microbiol. 2022;60(4):e0013920.  https://doi.org/10.1128/jcm.00139-20  PMID: 34586891 
  3. Vanhomwegen J, Berthet N, Mazuet C, Guigon G, Vallaeys T, Stamboliyska R, et al. Application of high-density DNA resequencing microarray for detection and characterization of botulinum neurotoxin-producing clostridia. PLoS One. 2013;8(6):e67510.  https://doi.org/10.1371/journal.pone.0067510  PMID: 23818983 
  4. Direction Générale de la Santé. DGS-Urgent N°2023_15. Intoxication alimentaire grave : plusieurs cas de botulisme en lien avec la fréquentation d’un restaurant à Bordeaux. [Severe food poisoning: several cases of botulism linked to visiting a restaurant in Bordeaux]. Bordeaux: Centre opérationnel de régulation et de réponse aux urgences sanitaires et sociales; 2023. French. Available from: https://sante.gouv.fr/IMG/pdf/dgs-urgent_2023-15_-_intoxication_alimentaire_grave_-_plusieurs_cas_de_botulisme.pdf
  5. Santé Publique France. Urgence Intoxication alimentaire grave : 10 cas de botulisme, dont 8 hospitalisés et 1 décès, liés à la fréquentation d’un restaurant à Bordeaux. [Emergency severe food poisoning: 10 cases of botulism, including eight hospitalized and one death, linked to frequenting a restaurant in Bordeaux]. Bordeaux: Santé Publique France; 2023. French. Available from: https://www.santepubliquefrance.fr/presse/2023/urgence-intoxication-alimentaire-grave-10-cas-de-botulisme-dont-8-hospitalises-et-1-deces-lies-a-la-frequentation-d-un-restaurant-a-bordeaux
  6. European Centre for Disease Prevention and Control (ECDC). Communicable disease threats report. Week 37, 10-16 September 2023. Stockholm: ECDC; 2023. Available from https://www.ecdc.europa.eu/sites/default/files/documents/communicable-disease-threats-report-week-37-2023.pdf
  7. World Health Organization (WHO). Botulism - France. Geneva: WHO; 2023. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON489
  8. Rao AK, Sobel J, Chatham-Stephens K, Luquez C. Clinical guidelines for diagnosis and treatment of botulism, 2021. MMWR Recomm Rep. 2021;70(2):1-30.  https://doi.org/10.15585/mmwr.rr7002a1  PMID: 33956777 
  9. European Centre for Disease Prevention and Control (ECDC). Botulism - Annual epidemiological report for 2021. Stockholm: ECDC; 2023. Available from: https://www.ecdc.europa.eu/en/publications-data/botulism-annual-epidemiological-report-2021#:~:text=In%202021%2C%2082%20confirmed%20cases,cases%20per%20100%20000%20population
  10. Le Bouquin S, Lucas C, Souillard R, Le Maréchal C, Petit K, Kooh P, et al. Human and animal botulism surveillance in France from 2008 to 2019. Front Public Health. 2022;10:1003917.  https://doi.org/10.3389/fpubh.2022.1003917  PMID: 36504929 
  11. Boyer A, Salah A. Le botulisme en France: épidémiologie et clinique. [Clinical and epidemiological characteristics of botulism in France]. Ann Med Interne (Paris). 2002;153(5):300-10. PMID: 12442075 
  12. Hughes JM, Blumenthal JR, Merson MH, Lombard GL, Dowell VR Jr, Gangarosa EJ. Clinical features of types A and B food-borne botulism. Ann Intern Med. 1981;95(4):442-5.  https://doi.org/10.7326/0003-4819-95-4-442  PMID: 7283294 
  13. Nummer BA, Schaffner DW, Fraser AM, Andress EL. Current food safety issues of home-prepared vegetables and herbs stored in oil. Food Prot Trends. 2011;31:336-42. Available from: https://www.foodprotection.org/files/food-protection-trends/Jun-11-Nummer.pdf
  14. Sobel J. Botulism. Clin Infect Dis. 2005;41(8):1167-73.  https://doi.org/10.1086/444507  PMID: 16163636 
  15. Chatham-Stephens K, Fleck-Derderian S, Johnson SD, Sobel J, Rao AK, Meaney-Delman D. Clinical features of foodborne and wound botulism: a systematic review of the literature, 1932-2015. Clin Infect Dis. 2017;66(suppl_1):S11-6.  https://doi.org/10.1093/cid/cix811  PMID: 29293923 
  16. Silva Campos JJ, Abels E, Rinder HM, Tormey CA, Jacobs JW. Botulism mimicking Guillain-Barre syndrome: The question of plasma exchange in an unusual case of acute paralysis. J Clin Apher. 2023;jca.22081.; Epub ahead of print.  https://doi.org/10.1002/jca.22081  PMID: 37519071 
  17. Yu PA, Lin NH, Mahon BE, Sobel J, Yu Y, Mody RK, et al. Safety and improved clinical outcomes in patients treated with new equine-derived heptavalent botulinum antitoxin. Clin Infect Dis. 2017;66(suppl_1):S57-64.  https://doi.org/10.1093/cid/cix816  PMID: 29293928 
  18. O’Horo JC, Harper EP, El Rafei A, Ali R, DeSimone DC, Sakusic A, et al. Efficacy of antitoxin therapy in treating patients with foodborne botulism: a systematic review and meta-analysis of cases, 1923-2016. Clin Infect Dis. 2017;66(suppl_1):S43-56.  https://doi.org/10.1093/cid/cix815  PMID: 29293927 
  19. Peñuelas M, Guerrero-Vadillo M, Valdezate S, Zamora MJ, Leon-Gomez I, Flores-Cuéllar Á, et al. Botulism in Spain: epidemiology and outcomes of antitoxin treatment, 1997-2019. Toxins (Basel). 2022;15(1):2.  https://doi.org/10.3390/toxins15010002  PMID: 36668823 

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error