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FOOD AND DRINK

What we know so far about the sardine-based botulism poisoning in France

One person has died and 12 were hospitalised after an outbreak of sardine-related botulism poisoning in south-west France. Here's what happened and the risks associated with it.

What we know so far about the sardine-based botulism poisoning in France
Photo by JEAN-SEBASTIEN EVRARD / AFP

What happened?

Over the past few days 12 people have been hospitalised after suffering from botulism poisoning and one person – a 32-year-old woman living in the Paris region – has died.

Eight people remain in hospital – five of them in intensive care, including the partner of the woman who died.

Those affected had all visited the Tchin Tchin Wine Bar in Bordeaux, and health authorities have traced the outbreak to home-made preserved sardines that were served in the bar.

Authorities are calling on anyone who visited this wine bar between September 4th and 10th to seek medical help if they are suffering any symptoms.

The bar appears to be popular with tourists – of those affected the majority are either American, Canadian or German. The nationality of the woman who died has not been specified, but another case has been reported in a man who has returned to Spain after visiting Bordeaux.

There may be further cases to come. 

What is botulism?

Botulism is a rare but life-threatening condition caused by toxins produced by Clostridium botulinum bacteria.

These toxins attack the nervous system (nerves, brain and spinal cord) and cause paralysis and muscle weakness.

Food-borne botulism such as the case in Bordeaux is usually caused by imperfectly preserved or canned food. 

Symptoms include vomiting, stomach cramps, diarrhoea or constipation and – if left untreated – muscle paralysis. Signs of this paralysis can include; drooping eyelids, blurred or double vision, facial muscle weakness, difficulty swallowing, slurred speech and breathing difficulties.

Anyone with those symptoms should seek medical treatment immediately, either by going to a hospital emergency department or calling an ambulance (telephone number 15 in France or the European emergency number 112).

Emergency in France: Who to call and what to say

Is it common in France?

No, botulism is very rare in Europe – France usually has between 20 and 30 cases a year, of which around five percent are fatal.

The most common cause is infected wounds, particularly among heroin-users who use dirty needles.

Food-borne botulism – as in this case – is usually caused by imperfectly prepared canned, pickled or preserved food.

Modern factory techniques make this extremely unlikely in commercially-produced tins, pickles or preserves – although you should not eat food that comes from a damaged or bulging can or if the food has a strong, unpleasant smell.

The cause in this case appears to be a home-made sardine preserve that the owner of the wine bar had made to serve with drinks and snacks or planches (platters of bread, meat and cheese).

What happens now?

French health authorities are continuing to investigate the outbreak and say there may be more victims, as food-borne botulism poisoning can take up to 10 days for symptoms to develop.

The owner of the bar is being questioned, and authorities believe they have now identified all but 13 customers who ate the affected sardines between September 4th and September 10th. 

Hospitals continue to treat those seriously ill – in most cases hospital treatment involves keeping the patient’s airways open, and the paralysis gradually recedes after several weeks or months. 

How can I stay safe in France?

This outbreak is an extremely rare event, and there is no higher risk of food-borne botulism in France than in any other western country. 

Tips to stay safe include; not eating canned food if the tin is damaged or bulging; avoiding any preserved or canned food that has a strong, unpleasant smell; avoiding canned or preserved food that is out of date or stored at the incorrect temperature.

If you are undertaking your own pickling, canning or preserving, make sure you carefully follow the hygiene advice (such as sterilising jars before use) in the recipe. 

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For members

HEALTH

Why dental care could cost you more in France from October

You can expect higher dental costs in France from October 1st, unless you have private top-up health insurance. Here's why.

Why dental care could cost you more in France from October

If you are receiving dental care with a public sector, or conventionné, dentist in France, you are currently eligible to have up to 70 percent of fees reimbursed by the French social security system (Assurance maladie). To benefit from this, you will need to be registered in the system, which is best done by acquiring a carte vitale

READ MORE: Healthcare in France: The essential French vocabulary you’ll need if you’re ill

But from October 1st, only around 60 percent of these fees will be reimbursed by the Assurance maladie – a move that the government hopes will save €500 million each year to help a heavily indebted health system. 

If you have a mutuelle (private health insurance), then the rest of the cost (or a large portion of it) will likely be covered by them, although it’s always worth checking in advance.

If you don’t have a mutuelle, you will have to make up the rest of the cost yourself. According to the consumer association, Que Choisir, some 2.5 million French people do not have private health insurance.

Analysts believe that as a result of these reforms, the cost of mutuelles will increase further – with private insurers arguing that they will have greater overheads. The average price of a mutuelle has been projected to rise by 4.7 percent by the end of the year, in part as a result of inflation.

READ MORE: Medical appointments in France to increase in price

Which dentists are covered by social security? 

When booking a dental appointment in France, it is worth looking for dentists who are conventionné. If you are booking through the Doctolib website, which we would highly recommend, you can filter your search to only show dentists with this status. 

A dentist who is conventionné secteur 1 charges the standard tariffs set by the government – for example a simple consultation will cost €23, a hygienist appointment will cost €28.92 and the removal of an adult tooth will cost €33.44.

Currently, if you are covered by social security, 70 percent of these costs will be reimbursed, but this will soon fall to 60 percent. The rest of the costs will likely be covered by a mutuelle, if you have one. 

A dentist who is conventionné secteur 2 will charge slightly more for their services – this can vary from a few euros to hundreds on euros depending on the case. There are obliged to provide this information to you before you undergo treatment.

If you are registered with the French social security system, you will be reimbursed as if you have received treatment from a secteur 1 dentist. In other words, even if you pay more for a consultation with a secteur 2 dentist, the amount of money you will receive from Assurance maladie will be the same for if you had visited a secteur 1 dentist. A good mutuelle should be able to make up the rest of the costs. 

For private, or non-conventionné secteur 3 dentists, you will not be reimbursed through the French social security system. Only a very good mutuelle will cover the entire cost of these treatments.

READ MORE What you need to know about a mutuelle  

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