France - Five People Treated for Botulism After Eating Pesto Sauce

In France, 5 people are receiving medical treatment after eating pesto contaminated with botulinum toxin.  "According to authorities in the Indre-et-Loire department in west-central France, a locally made brand of wild garlic pesto sauce may have been contaminated with a dangerous toxin that can attack the nerves."  "Authorities were trying to locate some 600 containers with the same "O P'tits Oignons" sauce before they are eaten, say officials."

The five people are currently on respirators - the toxin impairs nerve signals to the lungs.

Pesto is an oil based mixture of basil, garlic, parmesan cheese, pine nuts and olive oil.  It is generally prepared fresh and kept refrigerated.  The pH would tend towards neutral because there are no acidulants.  Oil mixtures provide an anaerobic environment.  So the combination of a more neutral pH and an low oxygen environment are conditions that allow C. botulinum to grow if the temperature is right and other organisms don't outcompete it.   So where one would have problems is when this is temperature abused.

In the US Food Code, oil-based mixtures such as garlic in oil are considered TCS foods (Temperature Control for Safety).  For operations wanting to sell such products, there would need to something called a secondary barrier to prevent growth.  The first barrier is refrigeration.  But as with this case, there needs to be something there to prevent growth if the product is temperature abused.  This could be an antimicrobial compound or an acidulent to lower the pH.

BBC
https://www.bbc.com/news/articles/c1epwqln5e3o
Pesto linked to botulism cases in France
Michelle Roberts
Digital health editor, BBC News
Sept 11, 2024

Five people are receiving emergency medical care in France for suspected botulism linked to eating pesto.

According to authorities in the Indre-et-Loire department in west-central France, a locally made brand of wild garlic sauce may have been contaminated with a dangerous toxin that can attack the nerves.

Cases like this are rare but potentially fatal, and can happen if homemade foods have been improperly preserved.

The French government issued an immediate recall of the product and has sent samples to a lab for analysis.

Authorities were trying to locate some 600 containers with the same "O P'tits Oignons" sauce before they are eaten, say officials.
The sauce is usually sold during local festivities or fairs.
The five patients are on respirators but conscious, spokesperson Patrice Latron told reporters.
"People who bought the same sauce must throw it out, destroy it," Latron said.
What is botulism?
Botulism is a rare but life-threatening condition caused by toxins made by clostridium botulinum bacteria.
These bacteria and its spores can live in soil, and are sometimes found on the surface of fruits, vegetables and herbs.
While the spores are generally harmless, they can grow into the bacteria that make the risky neurotoxins.
The neurotoxin is among the most toxic substances known - even tiny amounts can cause illness or death.
They attack the nervous system, and can cause paralysis. This can spread to the muscles that control breathing and can be fatal in five to 10% of cases if not treated properly.
There is an antitoxin that doctors can give.
Botulism illnesses have been linked to foods such as homemade pickles and garlic in oil.
Supermarket products undergo rigorous manufacturing processes to avoid contamination in preserved foods.
That bacteria is also used to make Botox - shots used by the cosmetic industry to manage wrinkles and frown lines.
Botox has been purified though, so the toxin is controlled.
What foods can cause botulism?
The NHS advises people not to eat food from "bulging or damaged cans", and to avoid eating off-smelling preserved foods, or those stored at the incorrect temperature or which are out-of-date.
People who make their own preserves should be careful. The spores can grow under low-oxygen conditions, in bottles of oil, for example.
The website for the TV cook Nigella Lawson advises: "Be very careful with homemade flavoured oils, especially those using raw garlic, as there is a risk of botulism.
"The garlic can sometimes pick up botulism from being grown in contaminated soil, and the airless environment of a bottle full of oil gives the botulism an ideal environment in which to thrive."
Botulism is an emergency. Seek medical help immediately if you or someone you know has symptoms, which can include:
drooping eyelids
blurred or double vision
facial muscle weakness
difficulty swallowing
slurred speech
breathing difficulties
Symptoms usually appear within 12 to 36 hours after eating contaminated food, although it can sometimes be days later.