Outbreak: 75 Fatalities After a Funeral Poisoning in Mozambique

In this episode of The Poison Lab Outbreak, Ryan talks with Dr. Alaina Steck about a devastating mass poisoning in Mozambique that began at a funeral and ultimately sickened more than 200 people, with a fatality toll of over 70.

Early reports blamed crocodile bile. Others suspected intentional poisoning. But as the investigation unfolded, the clinical picture, timeline, and exposure history did not fit neatly with the early theories.

Dr. Steck, then a medical toxicology fellow at Emory, joined a CDC-supported outbreak investigation team sent to Mozambique. She walks through what it was like to investigate the outbreak on the ground, including the overwhelmed rural health center, limited medical records, scarce biological and environmental samples, early toxicologic hypotheses, and the eventual role of comparative food testing in identifying the cause.

This episode explores the real-world uncertainty of outbreak investigation: incomplete data, competing theories, community fear, and the importance of epidemiology, toxicology, public health, and analytical chemistry working together.

Topics Covered

Mass poisoning investigation in rural Mozambique
Early reports of crocodile bile and suspected intentional poisoning
Clinical presentations including GI symptoms, seizures, pulmonary edema, liver injury, kidney injury, and multisystem disease
Challenges of interpreting sparse medical records during a mass casualty event
How toxicologists approach possible intentional poisoning
Why exposure history and timing matter in outbreak investigation
The importance of control samples in analytical testing
Lessons for clinicians, poison centers, and public health teams

Guest

Dr. Alaina Steck

Medical toxicologist, Emory University

Former medical toxicology fellow involved in the CDC-supported investigation of the Mozambique outbreak

Resources (Spoilers)

Instagram @tox_talk • Twitter @LabPoison • Email toxtalk1@gmail.com

Disclaimer: The Poison Lab is for educational purposes only and does not provide medical advice. If you suspect a poisoning, contact your local poison center. In the U.S., call 1-800-222-1222.