Foodborne botulism outbreak in intensive care: experience and clinical challenges

Abstract

In September 2023 during the Rugby World Cup, Bordeaux faced a foodborne botulism outbreak linked to artisanal sardine consumption. Eight patients from various nationalities were admitted to intensive care with progressive neuromuscular paralysis, 75% requiring mechanical ventilation. Botulinum toxin type B was identified in biological samples and the implicated food. Management involved close respiratory monitoring, prompt administration of specific antitoxins, and exceptional mobilization of healthcare teams, including crisis units, to coordinate local and national responses. This event highlights the importance of early diagnosis and multidisciplinary care in rare neurotoxic syndromes. It also underscores the critical role of public health authorities, poison control centers, and intensive care units in containing such outbreaks. The Bordeaux experience offers valuable lessons for anticipating and effectively managing similar scenarios, emphasizing the need for team preparedness, antitoxin availability, and collaboration between intensivists and public health services.