Hillary Jackson, from New York, poses outside the Saint-Andre hospital in Bordeaux, southwestern France, Thursday, Sept.14, 2023. Her brother Matt Jackson was riding an electric bike through Bordeaux wine country on vacation when he started feeling strange. Nine days later, he's on a breathing machine in a French ICU, unable to open his eyes, communicating only via notes on a whiteboard and infected with botulism. A 32-year-old woman died in France and eight other people remained hospitalized Thursday after an apparent botulism outbreak linked to homemade sardine preserves and the wine bar in Bordeaux. (AP Photo/Sophie Garcia)

PARIS (AP) — Matt Jackson was riding an electric bike through Bordeaux wine country when he started feeling strange. Nine days later, he's on a breathing machine in a French intensive care unit, unable to open his eyes, communicating only via notes on a whiteboard —- and infected with botulism.

Jackson was among the first of a dozen people who ate preserved sardines in a Bordeaux wine bar last week to be hospitalized with what French authorities believe is the rare and potentially fatal illness.

One, a 32-year-old woman from the Paris region, has died.

Officials issued an appeal around France and beyond to find others who might have eaten the suspicious sardines and might be at risk. Among those sickened have been visitors from the U.S., Ireland, Canada, Germany and Spain, according to the regional health authority ARS.

Jackson and his partner Kristy Benner, on vacation from Hermosa Beach, California, stopped by the Tchin Tchin Wine Bar on Sept. 4, and sampled wine with small plates of sardines and charcuterie.

The next morning, they took a wine-tasting trip to nearby Saint-Emilion. "We’re on e-bikes riding to the vineyards, and around 10 a.m. Matt just said he didn’t feel very well,'' she said.

At first thought she thought Jackson was dehydrated, or having a stroke.

“His abilities were going down quickly," she told The Associated Press on Thursday from Bordeaux. As he spoke, "it was very hard to understand. And his mouth was so unbelievably dry, to the point where he couldn’t swallow water.”

After two days at his side in the hospital, she started feeling parched herself, and having trouble swallowing. She alerted friends and family to seek help, and Jackson's sister Hillary jumped on a plane from New York.

Benner suspected botulism but doctors were at first skeptical. It took days to confirm a link to the sardines, and to get them both access to anti-toxins for a disease that French hospitals encounter infrequently. France records only 10 to 20 cases of botulism nationwide per year.

Foodborne botulism is a rare illness from eating foods contaminated with botulinum toxin and can cause paralysis, breathing difficulty and sometimes death. Homemade foods that have been improperly canned, preserved, or fermented are common sources.

At least 12 people who ate the preserves between Sept. 4 and Sept. 10 have been hospitalized, according to an ARS official. Some have been released but most remain in intensive care or critical condition, the official said.

All exhibited symptoms typical of botulism, which can include severe abdominal pain, vomiting, diarrhea, blurred vision, dry mouth, difficulty swallowing or speaking and neurological problems.

The family is frustrated with the slow initial response, but says the overall reception has been positive.

“People have been so open arms and welcoming to us and trying to to help,” Hillary Jackson said. ’’It’s just that wine bar.”

The restaurant was closed pending further investigation. The regional agency for consumer protection carried out inspections and confiscated all its preserved food for analysis. The restaurant personnel could not be reached for comment.

As of Thursday, Benner was still fatigued and having trouble swallowing. She said Matt “can’t open his eyes and he's on the ventilator ... he's totally not like himself.?

Hillary Jackson said French doctors met with counterparts from around the EU earlier this week to discuss response times to botulism.

’’So hopefully if nothing else comes out of this, it’s an acknowledgement that this is out there, and the key to it is treating it early.”

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Angela Charlton in Paris contributed.

News from © The Associated Press, 2023