Identification of the potent toxin bongkrekic acid in a traditional African beverage linked to a fatal outbreak

- Identification of the toxin bongkrekic acid in an African beverage is reported.
- A LC-MS/MS method for quantitation of bongkrekic acid in this matrix is described.
- Potentially fatal levels of bongkrekic acid in the beverage are reported.
- Production of the toxin by isolates from a starting ingredient is demonstrated.
- Concern for bongkrekic acid intoxication in a new geographic region is established.

In January 2015, 75 people died and 177 were hospitalized in the Mozambique village of Chitima after attending a funeral. The deaths were linked to the consumption of a traditional African beverage called pombe. Samples of the suspect pombe were subjected to myriad analyses and compared to a control sample. Ultimately, non-targeted liquid chromatography-mass spectrometry screening revealed the presence of the potent toxin bongkrekic acid, and its structural isomer, isobongkrekic acid. Quantitative analysis found potentially fatal levels of these toxins in the suspect pombe samples. Bongkrekic acid is known to be produced by the bacterium Burkholderia gladioli pv. cocovenenans. This bacterium could not be isolated from the suspect pombe, but bacteria identified as B. gladioli were isolated from corn flour, a starting ingredient in the production of pombe, obtained from the brewer's home. When the bacteria were co-plated with the fungus Rhizopus oryzae, which was also isolated from the corn flour, synergistic production of bongkrekic acid was observed. The results suggest a mechanism for bongkrekic acid intoxication, a phenomenon previously thought to be restricted to specific regions of Indonesia and China.

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