A Foodborne Bongkrekic Acid Poisoning Incident — Heilongjiang Province, 2020
Yuan Yuan, Rui Gao, Qiang Liang, Li Song, Jun Huang, Nan Lang, Jing Zhou
Abstract
<sec> <b>What is already known on this topic?</b> </sec><sec> Poisoning incidents caused by bongkrekic acid (BA), one of the metabolites of <i>Burkholderia gladioli</i> pathovar <i>cocovenenans</i> (<i>B. cocovenenans</i>), have been reported in Indonesia, Mozambique, and China. The reported case fatality rates averaged 60%, 32%, and 26.5%, respectively. In China, <i>B. cocovenenans</i> is often called <i>Pseudomonas cocovenenans</i> subsp. <i>farinofermentans</i>. </sec><sec> <b>What is added by this report?</b> </sec><sec> In October 2020, 9 persons in Jidong County, Heilongjiang Province died after consuming a homemade fermented corn flour product — sour soup — with a case fatality rate of 100%. BA was detected in both food samples and biological samples with a content of 330 mg/kg and 3 mg/L, respectively. The doses of BA consumed by the cases were approximately 22–33 times the lethal dose in human. </sec><sec> <b>What are the implications for public health practice?</b> </sec><sec> The consumption of fermented corn flour products, deteriorated fresh tremella, or black fungus and metamorphic starch products may cause BA poisoning. Health education should be strengthened so that homemade-starch-fermented food should be avoided and foods that have been kept for a long time should not be consumed. Meanwhile, training and emergency capacity building for primary healthcare workers should be strengthened to provide timely diagnosis and response. </sec>