Paraquat, a widely used herbicide in the world, has caused severe and fatal poisonings. Because of its high toxicity, the European Union withdrew paraquat from its market in July 2007. The purpose of this report is to describe cases of paraquat poisoning recorded at the Poison Control Center in Marseille over the 9-year period starting and ending 4.5 years before and after the paraquat ban. Data analysis showed that the most severe exposures were linked to ingestion. The fatality rate of deliberate consumption was near 50 % (34 suicide attempts and 15 deaths). Our data showed a marginal decline in total number of poisonings observed after the paraquat ban (38 vs 33 after the ban) mostly due to a decrease in the number of unintentional exposure (21 vs 16 after the ban). However, there was no apparent change in the number suicidal attempts using paraquat. Regarding geographical distribution, data showed that most poisonings in mainland France were unintentional, while poisonings in overseas French territories were mostly voluntary. Despite the European ban and the preventive measures, paraquat continues to contribute to severe and life-threatening poisonings in Southeastern and overseas France.

From January 2011 to March 2018, 26 patients aged from 20 to 80 years old reported being sick in France after eating sea figs of the genus Microcosmus. The patients had symptoms evoking a cerebellar syndrome: blurred or double vision, ataxia and dizziness, asthenia, headache, muscle cramps, paresthesia and digestive disorders (nausea, vomiting and diarrhea). Three of the 18 food poisoning events recorded by the Poison Control Center in Marseille and involving four patients were further investigated as the meal leftovers were collected and analyzed. A previous study ruled out the presence of the regulated lipophilic marine toxins after high-resolution mass spectrometry, but further analyses were required to look for hydrophilic cyanotoxins. The sea fig leftovers from food poisoning case Numbers 1 (January 2011), 6 (December 2012) and 17 (March 2018) of this published case series were analyzed by hydrophilic interaction liquid chromatography coupled to low- and high-resolution mass spectrometry to investigate the presence of hydrophilic cyanotoxins. The sea fig samples showed anatoxin-a (ATX-a) concentrations ranging from 193.7 to 1240.2 µg/kg. The sea fig control sample analyzed was also contaminated with ATX-a but in a much smaller concentration (22.5 µg/kg). To the best of our knowledge, this is the first report of human food poisoning involving ATX-a as the possible causative toxin where the cyanotoxin could be unequivocally identified.

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