Portuguese health authorities have successfully identified the cause behind an outbreak that left over 200 individuals ill following the consumption of a particular type of bread.
The Directorate-General of Health (DGS) disclosed that a total of 209 cases were linked to the consumption of “broa de milho,” a type of cornbread, in select regions of the country since mid-July.
The clinical symptoms observed in affected individuals prompted a comprehensive laboratory investigation, taking into account factors such as the brief incubation period, symptom duration, relevant literature, and insights from experts.
Patients displayed similar symptoms, including dry mouth, vision disturbances, dizziness, mental confusion, and diminished muscle strength. These symptoms manifested between 30 minutes to two hours after food consumption. While most cases were classified as mild, more than 40 individuals required hospitalization.
Discovery of Tropane Alkaloids
Samples obtained from flour, bread, and patients revealed the presence of tropane alkaloids, specifically atropine and scopolamine, at significantly elevated levels.
Further investigation unveiled compelling evidence of contamination with seeds from the Datura genus, a plant that can be encountered as weeds in cultivated fields. This contamination is believed to have occurred during the harvesting process.
This collaborative effort involved regional public health departments, the Economic and Food Safety Authority (ASAE), and the General Directorate of Food and Veterinary Affairs (DGAV).
In response to the incident, DGAV is set to release a guide for producers aimed at ensuring more effective control of this plant in fields and during the post-harvest phase.
Lifting Restrictions
Early in August, authorities issued a warning against the consumption of “broa de milho” in specific areas of the country. However, they emphasized that this product “is, and should continue to be, an integral part of the Portuguese diet.”
Additionally, authorities imposed restrictions on the use of raw materials in the production of the implicated products.
Now, authorities have lifted the advisory against consuming “broa de milho” in the regions of Leiria, Santarém, Coimbra, and Aveiro. This decision is attributed to the absence of new suspected cases and the unavailability of potentially contaminated products in the market. Health officials expressed gratitude to businesses and consumers for adhering to the earlier recommendations.
DGS underscored that a risk assessment does not justify maintaining the guidance to avoid “broa de milho” in the identified regions. However, it was noted that the situation could change if new cases emerge.