International Research Journal of Public and Environmental Health

Original Research Article

Investigation of a Clostridium botulinum mass poisoning and lessons learned, Ivory Coast, 2023

Damus Paquin Kouassi1,2, Sory Ibrahim Soumahoro1,2,*, M’Begnan Coulibaly1, Salifou Yeo1, Arsene Deby Kouame1,2, Fatoumata Bamba3, Edmond Kouame4,5, Vincent Asse4,5, Vincent Achi4,5, Pacome Monemo4,5,Ouffoue Kra4,5, Thomas Aba Yapo4,5, Aissata D6, Gnissan Henri Auguste Yao1,2, Marc-Eric Ebouat 2,5, Joseph Benie Bi Vroh7

1Regional Office of the National Institute of Public Hygiene, Bouaké, Cote d’ivoire.
2Department of Public Health, Alassane Ouattara University, Bouaké, Cote d’ivoire.
3Gbêkê Regional Health Directorate,Bouake,Cote d’Ivoire
4Medical Sciences Faculty, Alassane Ouattara University, Bouake, Cote d’ivoire.
5University Hospital of Bouaké, Bouake, Cote d’ivoire.
6National Public Health Laboratory
7Public Health, Felix Houphouet Boigny University, Abidjan, Cote d’ivoire.

*Corresponding Author Email : ssoryibrahim(at)

Damus Paquin Kouassi

Sory Ibrahim Soumahoro

M’Begnan Coulibaly

Salifou Yeo

Arsene Deby Kouame

Fatoumata Bamba

Edmond Kouame

Vincent Asse

Vincent Achi

Pacome Monemo

Ouffoue Kra

Thomas Aba Yapo

Aissata D

Gnissan Henri Auguste Yao

Marc-Eric Ebouat

Joseph Benie Bi Vroh

Article Number: irjpeh.24.004  |   Pages: 30-36  |   Vol. 11(1), January 2024   |   DOI:

 Received: October 5, 2023  Accepted: December 12, 2023  Published: December 20, 2023


Botulism is a severe neuroparalytic disease caused by neurotoxins produced by certain members of the anaerobic Gram-positive spore-forming bacteria Clostridium. Less documentation is available regarding botulism outbreaks in natural environments within subtropical and tropical climate zones. In the village of Kpo-Kahankro, in the Bouaké-sud district of Côte d’Ivoire, an unusual phenomenon caused 22 deaths. The phenomenon occurred in two separate episodes, the first in December 2022 and the second in January 2023. Epidemiological investigations were carried out to identify the source and stop the phenomenon. The unusual circumstances and the management of this rare epidemic phenomenon merit the sharing of experiences. The aim of our approach was to contain the phenomenon by taking preventive measures. The investigation consisted of questioning patients and their relatives about the circumstances in which the phenomenon occurred. We then counted the cases on the basis of the signs presented by the first patients. An investigation form was used for this purpose. In addition, after data analysis, the suspected sources were collected and sampled for biological and toxicological investigation. These sources were sampled in a clean jar and then sent to the National Public Health Laboratory (LNSP) and the Pasteur Institute of Côte d’Ivoire for toxicological and microbiological tests. The two episodes involved 78 cases, 22 of which died, giving a case-fatality ratio of 28.2%. Symptoms were characterized by vomiting (59.0%), diarrhea (30.8%) and abdominal pain (30.8%). For both episodes, 20 cases out of 44 (45.5%) lived on the same islet where the fetish was installed. Toxicological analyses conducted on the liquid within the fetish yielded negative results, whereas microbiological assessments identified the presence of Clostridium botulinum. The destruction of the fetish and the disinfection of its location on January 23, 2023, followed by the disinfection utilizing chlorinated water applied to all residential and public areas within the village, resulted in the absence of any newly recorded cases. The management of this atypical phenomenon in Kpokahankro highlights the need to follow only the results of epidemiological investigation when investigating the causes of a public health event and making decisions.

Keywords: Bouaké,Epidemiology,Côted'Ivoire.investigation,Clostridium botuilinum

How to Cite this Article

Kouassi DP, Soumahoro SI, Coulibaly MB, Yeo S, Kouame AD, Bamba F, Kouame E, Asse V, Achi V, Monemo P, Kra O, Yapo TA, Aissata D, Yao GHA, Ebouat M-E, Vroh JBB(2024).Int. Res. J. Public Environ. Health 11 (1):30-36.DOI:

© 2024 The authors.
This is an Open Access article that is distributed under the terms of the Creative Commons Attribution License ( and the Budapest Open Access Initiative (, which allow unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

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