When a food-triggered reaction isn't a food allergy

Two studies shine a light on eosinophilic esophagitis, an allergic condition that is on the rise

American College of Allergy, Asthma, and Immunology

Facebook

XLinkedInWeChat
WhatsAppEmail

image: 

ACAAI 2026 Annual Scientific Meeting

view more 

Credit: American College of Allergy, Asthma and Immunology

PHOENIX (Nov. 12, 2026) – It can be scary to have a reaction to something you’ve eaten and believe the symptoms indicate a food allergy. But for some, the cause of symptoms may be a different condition that can go unnoticed for years. Two new studies being presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting look at how eosinophilic esophagitis (EoE) diagnoses are on the rise, and how EoE symptoms can be mistaken for a food allergy.

EoE is an allergic condition of the esophagus, the tube that carries food from your mouth to your stomach. In people with EoE, a type of white blood cell called an eosinophil builds up in the esophagus. This causes swelling and irritation. Over time, it can make it hard to swallow and can cause food to get stuck.

The first study looked at 29 adults who had been sent to an allergist because doctors thought they experienced anaphylaxis, a severe allergic reaction, after eating certain foods. On average, each patient had gone to the emergency room three times, and most had been given at least one dose of epinephrine.

Their symptoms included a tight throat, trouble swallowing, chest pain, drooling, and food getting stuck in their esophagus. But testing did not show a true food allergy. Instead, tissue samples taken from their esophagus showed that the patients had EoE. On average, it took more than five years for them to get the right diagnosis.

“Not every frightening reaction after eating is anaphylaxis” said allergist Talal Nsouli, MD, ACAAI member and lead author of the study. “Eosinophilic esophagitis can closely mimic food allergy and may lead to repeated emergency visits before the correct diagnosis is made. When throat tightness, difficulty swallowing or food impaction recur, especially with negative food allergy testing, we should think about EoE. Early recognition can prevent years of uncertainty and progressive esophageal damage.”

Getting a prompt and accurate diagnosis is important. Additional research shows that when EoE is not treated, scar tissue can build up and narrow the esophagus. The chance of this narrowing increases about 9% for every year the disease goes untreated.

The second study used health records from more than 300 million patients in the U.S., making it the largest study of EoE in the country to date. Researchers found more than 500,000 people with an EoE diagnosis.

Key findings include:

• The number of people diagnosed with EoE has increased by about 7 times since 2009.
• EoE was most often first diagnosed in two age groups: the teen years and people in their 40s.
• Males were more likely to have EoE than females.
• Rates were highest in northern states, with New Hampshire at the top.
• People with several allergic conditions, such as asthma, hay fever, eczema, and food allergies, were much more likely to have EoE. Among food allergies, wheat allergy had the strongest link.

“We are seeing increased EoE over time,” said allergist Bushra Tbakhi, MD, lead study author and ACAAI member. “Associated allergic conditions may help identify patients at high risk for EoE.”

Abstract Title: When Anaphylaxis Is Not Anaphylaxis: Eosinophilic Esophagitis Mimicking Food Allergy

Presenter: Talal Nsouli, MD   

Abstract Title: Epidemiology and Clinical Features of Eosinophilic Esophagitis: Analysis Using the COSMOS Database

Presenter: Bushra Tbakhi, MD   

For more information on the diagnosis and treatment of EoE, or to find an allergist in your area, visit AllergyandAsthmaRelief.org. The ACAAI Annual Scientific Meeting is Nov. 12-16. For more news and research from the ACAAI Scientific Meeting, go to our newsroom and follow the conversation on X/Twitter #ACAAI26.

About ACAAI

The American College of Allergy, Asthma & Immunology (ACAAI) is a professional medical organization of more than 6,500 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. Founded in 1942, the College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. For more information and to find relief, visit AllergyandAsthmaRelief.org. Join us on Facebook, Instagram, Threads and X.

WHEN ANAPHYLAXIS IS NOT ANAPHYLAXIS: EOSINOPHILIC ESOPHAGITIS MIMICKING FOOD ALLERGY
R033
T. Nsouli*, N. Diliberto, E. Abou-Jaoude, S. Nsouli, J. Bellanti, Washington, DC. Introduction:
Eosinophilic esophagitis (EoE) may present with acute food-triggered symptoms that
closely resemble IgE-mediated anaphylaxis. We reviewed patients referred for recurrent
presumed food-induced anaphylaxis who were ultimately diagnosed with EoE.
Methods:
A retrospective review was performed of clinical history, allergy evaluation, treatment
response, and endoscopic/histopathologic findings in 29 consecutive patients
subsequently diagnosed with EoE.
Results:
The cohort included 20 males (69%) and 9 females (31%), with a mean age of 38.5 ± 9.1
years. Patients reported recurrent episodes following ingestion of common food allergens
and experienced a mean of 3.24 ± 1.30 emergency department visits (median 3, range
1–6) and 0.97 ± 0.84 epinephrine administrations (median 1, range 0–3). The mean time
to diagnosis was 5.55 ± 2.20 years (median 6, range 2–10). Predominant symptoms
included throat tightening, dysphagia, chest pain, hypersalivation, food impaction, and
inability to swallow. Allergy evaluation failed to support IgE-mediated anaphylaxis.
Esophageal biopsies demonstrated ≥15 eosinophils per high-power field in all patients,
confirming EoE. This prolonged diagnostic delay is clinically important, as the risk of
fibrostenotic stricture increases by approximately 9% for each year of untreated disease.
Fibrostenosis is driven by chronic type 2 inflammation, with IL-4, IL-13, and TGF-β1
serving as key profibrotic mediators.
Conclusion:
EoE should be considered in patients with recurrent food-associated dysphagia, throat
tightening, or food impaction, particularly when allergy testing is negative or response to
epinephrine is incomplete. Early recognition and prompt endoscopic biopsy are essential
to prevent misdiagnosis, unnecessary treatment for presumed anaphylaxis, and
progressive fibrostenotic esophageal remodeling.

EPIDEMIOLOGY AND CLINICAL FEATURES OF EOSINOPHILIC ESOPHAGITIS: ANALYSIS USING THE COSMOS DATABASE
R304
B. Tbakhi*, R. Lee, M. Rothenberg, S. Andorf, S. Zhang, Cincinnati, OH.

Background: Eosinophilic esophagitis (EoE) is a chronic allergic disease of the esophagus with increasing prevalence. We aimed to characterize EoE epidemiology and clinical features in the largest U.S. cohort to date.

Methods: We retrospectively analyzed the Epic Cosmos database (1990–2024), comprising over 300 million deidentified patients, for prevalence, incidence, geographic distribution, comorbidities, and treatment patterns. EoE was identified by diagnostic code alone (diagnostic code) or in combination with endoscopy and histology (combined criteria).

Results: Of 300,278,878 patients, 508,739 had EoE by diagnostic code and 159,279 by combined criteria. Among patients with EoE identified by diagnostic code alone, there was a bimodal distribution of peak incidence in the second followed by the fifth decade of life. There was an overall higher proportion of males to females (59%), but this predominance decreased with increasing age. Since 2009, prevalence and incidence increased by 7.1 fold and 1.3 fold, respectively. Rates were highest in northern states (i.e. New Hampshire 0.31%). EoE is strongly associated with the presence of multiple allergic comorbidities (OR 23.7), food allergy (OR 6.3) and gastrointestinal diseases (i.e. celiac disease; OR 11.1). Amongst specific IgE mediated food allergies, wheat showed the strongest association (OR 37.1). Proton pump inhibitors were the most common treatment (83.4%); however, dupilumab use rose 4.4 fold since FDA approval in 2022, without increased risk of eosinophilia or malignancy.

Conclusion: EoE prevalence is rising in the U.S. with regional variation and strong associations with atopic and gastrointestinal comorbidities. These findings provide updated epidemiologic and clinical insights and highlight evolving treatment trends.

Allergic comorbidities among patients with eosinophilic esophagitis (EoE)

A) Odds ratios (ORs) for the presence of EoE in patients with single or various combinations of atopic comorbidities, including asthma (n = 3,016), allergic rhinitis (n = 67,644), eczema (n = 5,301), and food allergy (n = 20,261).

B) ORs (middle marker) with 95% CI (left and right markers) for the presence of EoE in patients with specific food allergies, including milk (n = 4,946), egg (n = 2,313), wheat (n = 914), soy (n = 48), fish/shellfish (n = 4,306), peanut (n = 3,210), tree nut/sesame (n = 760), and patients with multiple food allergies (FA) (n = 23,424).

C) ORs for the presence of EoE in patients with gastrointestinal and food protein–induced disorders, including food protein–induced enterocolitis syndrome (FPIES) (n = 674), food protein–induced enteropathy (FPE) (n = 105), food protein–induced allergic proctocolitis (FPIAP) (n = 23), inflammatory bowel disease (IBD) (n = 22,782), and irritable bowel syndrome (IBS) (n = 48,230).
 

---

Journal

Annals of Allergy Asthma & Immunology

Method of Research

Literature review

Subject of Research

People

Article Title

WHEN ANAPHYLAXIS IS NOT ANAPHYLAXIS: EOSINOPHILIC ESOPHAGITIS MIMICKING FOOD ALLERGY

Article Publication Date

12-Nov-2026

Refusing to cross, unable to escape: Seafarers recount Hormuz dangers to Euronews

Copyright AP Photo

By Euronews Persian with Euronews Romania

Published on 22/10/2026 - 

Euronews spoke to a crew member of a cargo vessel anchored off Pakistan for weeks and an Iranian maritime manager about dangers in the vital waterway — where traffic has fallen 90% since the war began and at least 95 seafarers in commercial roles have died.

The Al Ruwais, a 314-metre liquefied natural gas carrier flying a Bahamian flag, has been sitting adrift off the coast of Pakistan for weeks.

Fearing for its safety, its 34-member crew does not want to test the waters and attempt to cross the Strait of Hormuz, despite demands from the ship's owners.

"What strikes me as strange is that this company is willing to risk the ship just to pass through the Strait of Hormuz," an electrician aboard the UAE-owned vessel told Euronews.

"If it were up to the company, we'd go through, but for that to happen, the entire crew would have to agree. And they don't. I am waiting to leave by boat for Pakistan, where I will board another vessel."

Under maritime regulations, the right to refuse transit into a designated warlike area is individual, meaning that one sailor objecting is enough to stop a vessel from moving into a danger zone.

On ships whose crews do agree to cross, companies have offered captains up to $100,000 (€89,000) per month plus $50,000 (€44,500) risk bonuses, while ordinary crew wages have risen four to six times.

"On other ships, they give as much as $10,000 (€8,900), but not everyone gets the same amount, and it depends a lot on the position and base salary," the sailor aboard Al Ruwais told Euronews.

"It's only fair that everyone gets the same amount, otherwise, it would mean that the captain's life is worth more than that of the deckhand."

No passage is safe, sailors say

A vital waterway for the world's energy trade, the Straight of Hormuz has been under two concurrent naval blockades since the outbreak of the Iran war following US-Israeli strikes in late February.

The southern corridor near Oman is patrolled by US forces, while the northern route passes through Iranian-controlled waters. The IRGC Navy has stated that vessels transiting routes it considers unauthorised face what it described as "punitive action".

Traffic through the strait has collapsed as a result. More than 125 vessels passed daily before the war. That figure has fallen to fewer than 10 to 12, a drop of more than 90%, according to ship-tracking firm Kpler.

Drone attacks, sea mines and strikes from unknown projectiles have driven the decline, with UK Maritime Trade Operations recording multiple incidents involving fires, sinkings and power failures aboard tankers and LNG carriers.

Ships that do attempt the crossing have taken to turning off satellite AIS transponders, extinguishing running lights at night and shutting down radio equipment to avoid detection.

IRGC boats navigating the Strait of Hormuz AP Photo

The dangers are somewhat different for Iranian sailors. Hamed, a 50-year-old former captain who now runs a maritime management company in Iran, told Euronews that since March of last year the war has resulted in the deaths of some 95 seafarers in commercial, fishing, passenger, tugboat and offshore platform support roles.

Military vessels have suffered heavy damage and ships undergoing repairs in Bandar Abbas have been struck, he said, although precise casualty figures have not been officially released.

"Nearly 60% of our ships are sanctioned and forbidden from calling at foreign ports such as India, Pakistan, the UAE, Oman, Kuwait, and Iraq," Hamed said. "Even Pakistan's maritime borders, where Iranian vessels used to travel, have now been closed to us."

Around 40% of southern Iranian seafarers have refused sea assignments, he said, with many shifting to the Caspian Sea to handle increased grain imports from the north. Wages in the south have been raised by 30 to 100%.

Sailors now earn between 50 and 80 million tomans (€165 to €265) per month, and captains between $1,200 and $4,000 (€1,100 to €3,700).

US forces have boarded Iranian commercial vessels roughly 15 times since the war began, Hamed said, arriving by helicopter and speedboat to inspect cargo for explosives, with no guarantees of their safety.

“The US has provided no safe-passage guarantees for Iranian commercial ships," Hamed said. "Every week we witness aerial or naval drone attacks on Iranian vessels."

Related

• Super tanker ablaze after striking mine in Strait of Hormuz, IRGC says
• Military signals building: Is the US-Iran war about to escalate?

He estimated that roughly 35,000 Iranian seafarers across approximately 2,000 vessels continue operating in southern waters to deliver wheat, corn and medicine to ordinary Iranians.

If the situation deteriorates further, he warned, authorities could be forced to declare a complete shutdown and evacuate coastal facilities.

Year later, Gaza ceasefire promises mostly unfulfilled

Jerusalem (AFP) – One year after US President Donald Trump declared the war in Gaza to be over, few of the long-term promises of the ceasefire have come to fruition.


Issued on: 10/10/2026 - RFI

Here is a list of some of the key points of the October 10, 2025 ceasefire and where things stand:
Hostages released, calm in Israel

Three days after the agreement was announced, Hamas freed the 20 remaining living hostages seized during the group's October 7, 2023 attack, the deadliest day in Israel's history.

The captives' return was a key priority for Israel, whose public had agonised over their fate.

The ceasefire anniversary also marks one year of quiet for Israel from the Gaza front, with no rocket attacks by Hamas.

The group's missile inventory was depleted by near-constant Israeli bombardment, which damaged or destroyed the vast majority of buildings in the Palestinian territory.

The US military set up a command post with foreign allies near the Gaza border to monitor the truce.
No Israeli withdrawal or let-up

Israel has reduced its level of attacks but has kept striking Gaza on a near-daily basis.

Israeli strikes have killed some 1,450 Palestinians since the ceasefire, according to Gaza's health ministry, which operates under Hamas and whose figures are considered accurate by the United Nations.

Prime Minister Benjamin Netanyahu, who is in a tight election race, has vowed to kill everyone involved in the October 7 attack.

Netanyahu said on the attack's anniversary that 4,000 out of 6,000 "Hamas monsters" had been killed.

Israel has reduced its level of attacks but has kept striking Gaza on a near-daily basis © Omar AL-QATTAA / AFP

Israeli forces were allowed to stay in 53 percent of Gaza under the terms of the ceasefire, but a year later they control about 70 percent of it, according to official accounts.
Hamas remains, with weapons

The second phase of the agreement was supposed to include a political transition away from Hamas, and technocrat Ali Shaath was appointed head of a new National Committee for the Administration of Gaza (NCAG).

Hamas announced in July that it was disbanding its governing body and handing over Gaza's administration to the US-blessed NCAG.

But Hamas effectively remains in charge of security in Gaza, and Shaath has taken a low profile.

The Palestinian Islamist movement elected a new leader, Khalil al-Hayya, in July. Shortly afterwards, the group announced it would give up its weapons, a step hailed by Trump as a breakthrough.

But Israel has been sceptical, with Netanyahu demanding verifiable decommissioning of all weapons down to individual guns.

Hamas has not gone ahead with disarmament, and Israel has refused to reciprocate by starting to withdraw forces.
Reconstruction just talk

Trump set up a new global body for the deal dubbed the "Board of Peace", tapping as key figures former British prime minister Tony Blair and Bulgarian diplomat Nickolay Mladenov, who serves as "Gaza high representative".

Trump, a critic of foreign aid, in January promised $10 billion in US funding to the board he controls, and Gulf allies have pledged more, but no money is known to have made its way to Gaza reconstruction.

In September, the board proposed a $2.45 billion Gaza recovery plan at a meeting of its members and stakeholders, in an effort meant to span over six months.

© 2026 AFP



Hunger and malnutrition stalk Gazans, a year on from ceasefire

Khan Yunis (Palestinian Territories) (AFP) – Every day, Gazan mother Niyaha al-Masri spends six exhausting hours or more queueing at a community kitchen in the hope of getting some food for her family.


Issued on: 10/10/2026 - RFI

Nihaya Al-Masri is struggling to feed her family of 10 people, who are surviving on one meal a day © Bashar Taleb / AFP

It has been a year since a ceasefire between Hamas and Israel was supposed to allow food to flood into the ruined territory, yet widespread hunger persists there.

Masri has little choice. Without the kitchen run by humanitarian groups, she and her eight children would have "nothing at all", the 35-year-old told AFP.

Each day she sets out early in the morning and returns in the afternoon, this time bringing four containers of rice, lentils and a little chicken, which the family throws itself at.

Among them is her husband, wounded in both legs by an airstrike, meaning he "cannot go and fight with the others" to get food.

This will be the only meal of the day for the family of 10, living in a tent in Khan Yunis. There was no breakfast and they will have no dinner.

What little flour they have, Masri explained, has to be rationed.

In August 2025, a United Nations-backed body, the IPC, declared a state of famine in Gaza © Bashar Taleb / AFP

In August 2025, a United Nations-backed body, the IPC, declared a state of famine in Gaza, though Israel quickly denounced it as a lie.

By December, the UN had lifted that declaration, saying that the ceasefire had allowed in enough supplies over the course of two months to ease conditions.

COGAT, the Israeli defence ministry organisation responsible for civilian affairs in the Palestinian territories, told AFP that the humanitarian situation in Gaza was stable.

But Shaun Hughes, of the UN's World Food Programme, was less sanguine.

The food security situation, he said, "is still extremely serious".

The most recent figures, from July, show that "1.4 million out of the population of about 2.1 million people are acutely food insecure", he said, with 200,000 of them "just one step below famine".
'Shameful'

While some food is getting in, a lack of sufficient nutritional variety continues to pose a health threat.

"Dietary diversity is a major food security issue in Gaza," said Hughes.

"You cannot survive on dry goods and wheat flour and bread alone. Particularly children, particularly pregnant and breastfeeding mothers, they need the micronutrients that come with high protein foods, fresh vegetables, fresh fruits," he explained.

While some food is getting into Gaza, a lack of sufficient nutritional variety continues to pose a health threat © Bashar Taleb / AFP

Masri said that her children, aged between three and 14, "dream of eating fruit" but the family doesn't have the means to buy any.

She said one of her sons suffered from malnutrition during the 2025 famine, although "little by little, his condition is improving".

Malnutrition isn't only caused by a lack of food, but also essential nutrients. It weakens the immune system of children, making them vulnerable to illnesses and stunting their growth.

"Repeated bouts of acute malnutrition amongst children is something that human beings just don't recover from," said Hughes.

Cognitive and physical impairments "continue into later life", he added.

At Khan Yunis's Nasser hospital, the head of the malnutrition unit, Israa al-Najjar, told AFP she had "observed an increase in syndromes and conditions" linked to malnutrition that affect the immune system.

In a report published on Thursday, the day after the third anniversary of the October 7 Hamas attack that sparked the Gaza war, Medecins du Monde published a study that found 93 percent of pregnant or breastfeeding women had symptoms of anaemia, which is closely linked to malnutrition.

Just 17 percent had a sufficiently varied diet to meet their nutritional needs, the group found.

All the while, Masri has kept visiting the community kitchen, despite asthma leaving her exhausted.

Her children spend their days collecting "pieces of nylon, bits of cardboard and chunks of foam" to try and reinforce their tent, which is in a poor state.

She said it was "shameful" that her children had to do so.

"I swear to God, this isn't normal."

© 2026 AFP

  

Bulgaria calls off search for 10 missing sailors after drone attack sinks cargo ship

By Simon Ormiston & Anna Kirchheim

Published on 07/10/2026 - EURONEWS

A second vessel hit in the same strike is still on fire and expected to go down, as Bulgaria's president convenes her national security council.

Bulgaria has called off the search for the 10 crew of a cargo ship sunk in a drone attack in the Black Sea, after finding no trace of the sailors.

The operation ended at 5pm local time (4pm CET) on Tuesday and will not resume, Rumen Nikolov, head of rescue operations at Bulgaria's Maritime Administration, told reporters in Varna on Wednesday.

Searchers found three life rafts and an overturned lifeboat from the 83-metre long Alfa Watan but no one from its crew, he said, adding that no trace of the sailors was likely to be found.

The second ship hit in the attack, the Able, will probably sink as well, Nikolov said, according to shipping news site Maritime.bg. Its engine room flooded after a sea drone struck the stern, it is sitting heavily down at the stern and it was still burning on Wednesday morning.

Pollution in the area is minimal, he said.

Bulgaria President Iliana Iotova has convened the country's national security council to discuss maritime security.

All 18 of the Able's crew, 11 Turkish and seven Indian, were rescued by the Bulgarian ferry Dioscuria and are now in Varna. Two were hospitalised, one with burns and one with a head injury.

Sea and aerial drones hit the ships at about 3am local time (2am CET) on Tuesday, around 70 nautical miles east of the town of Byala in Bulgaria's exclusive economic zone, Bulgarian Prime Minister Rumen Radev said.

The crew of the Dioscuria, which was in the area, saw an explosion on the first ship and rushed to the scene, Radev confirmed. They found an overturned lifeboat and life jackets but no one from the crew.

Radev said two helicopters were sent to Varna to pick up rescue teams and a Su-25 aircraft was deployed to carry out aerial reconnaissance over the area.

Both vessels had sent distress signals during the night and one disappeared from Border Police radar at about 9am local time (8am CET) on Tuesday, public broadcaster BNR reported.

Both vessels are Turkish-owned, according to the Equasis merchant shipping database and it is believed to be the first attack on shipping in Bulgaria's exclusive economic zone.

Ship tracking website vesselfinder.com shows the Alfa Watan was sailing under the flag of Togo and was headed for the Romanian port of Sulina.

The second ship was carrying wheat and sailing south, Radev said. The cargo of the sunken Alfa Watan is not yet known.

Radev, who called the attack "absolutely unacceptable", did not say who launched the drones, while European Commission President Ursula von der Leyen called the developments "concerning".

Three attacks on civilian shipping in the Black Sea within two days

Tuesday's attack occurred the day after a Turkish-owned cargo ship carrying grain from Ukraine to Italy was attacked off Romania's coast in the Black Sea by at least one drone and sank after catching fire, killing two crew members.

Azerbaijan's Foreign Ministry said the ship's captain, Azerbaijani national Rustam Ismayil oglu Hasanov, died and his body was being repatriated. A second Azerbaijani crew member, Mahammad Hamza oglu Suleymanzade, is still missing and the search and rescue operation is ongoing. Azerbaijan's Foreign Ministry said their families were informed and they were receiving logistical and financial support.

11 other crew members were rescued by the Romanian authorities. Three Azerbaijani sailors and one Indian crew member among them are receiving emergency medical care in Romania.

Azerbaijan's Foreign Ministry explicitly reiterated its urgent warning to Azerbaijani citizens to refrain from travelling to active conflict zones, working in high-risk areas, or taking employment on transport vessels operating along contested maritime corridors.

Ukraine's President Volodymyr Zelenskyy blamed Russia for yesterday's sinking of the cargo ship and called it "a horrific strike by two Russian drones on a civilian vessel" in neutral waters.

India condemned Tuesday's attack as part of the crew members were Indian nationals. The Indian Foreign Ministry released a statement saying that "India views these attacks on commercial shipping and seafarers with grave concern," adding that "the targeting of traffic in international waterways is severely undermining global commerce and welfare of people across the world."

Bulgaria Suspends Search for Missing Crew as Russia Denies Attack

Alfa Watan was lost will all hands (Photo in 2023 by Alkhdair - courtesy of Vessel Finder)

By The Maritime Executive 2026-10-07 14:21:36

The crew of a small Turkish cargo ship struck early Tuesday morning, October 6, off the coast of Bulgaria has not been located, and based on the results of the search, Bulgaria ended the search. Officials told the media in a briefing on Wednesday about the two attacks, that they believe the cargo ship Alfa Watan (3,200 dwt), registered in Tonga, sank in a matter of minutes, and that they were continuing to monitor the second vessel, Able (7,400 dwt), which has been abandoned in the Black Sea.

Multiple agencies from Bulgaria, aided by Romanian aircraft, searched the Black Sea approximately 70 miles east of the Bulgarian coast. Another cargo ship, Mercy, flagged in St. Kitts and Nevis, also diverted to the area to aid in the search. 

The authorities said they had received a signal from the Alfa Watan’s distress beacon at around 02:30 local time. Initial reports said they had located an overturned lifeboat, three rafts, and various debris. There was no sign of the crew, and the search was unable to locate any traces of the crew.

Bulgarian authorities have declined to comment on the specific number of seafarers who were lost, but media reports are saying there were between 10 and 12 crew, likely all from Syria. The ship, which was built in 1976, was owned by a Turkish company and was sailing into the Black Sea.

The second ship that was hit yesterday, another Turkish-owned general cargo ship, Able, registered in Palau, continues to draft after the evacuation. The Chief Director of Bulgaria’s Maritime Administration Agency, Rumen Nikolov, reported that the ship had issued a distress call around 03:30, with the crew reporting they were preparing to evacuate the ship.

Nikolov reported the ship was struck in the stern and that a large fire had resulted. The captain suffered a head injury but was released from the hospital. The chief engineer was severely burned and is in a hospital. The other crewmembers received a medical check and are in a hotel in Varna.

The authorities reported that the Able is low in the water at the stern. Nikolov set the odds at 90 percent that he believed the ship would sink in the coming hours.

Russia’s embassy in Bulgaria told Reuters that the two ships were not on the Ministry of Defense’s target list. It cautioned that an investigation was needed to identify the source of the drones that struck the two ships.

The Maritime Administrator in Bulgaria, however, said the ship was outside the country’s direct responsibility and that they were not planning an underwater search. He did not comment on whether any debris from the drones had been recovered.

Bulgaria’s president, Illiana Votova, however, convened the National Security Advisory Council to map out steps to increase security in the region. She said Bulgaria would be working with Romania and Turkey to strengthen safety measures for merchant shipping while also calling on both Russia and Ukraine to stop the attacks on merchant shipping in the Black Sea.

Top photo from 2023 by Alkhdair - courtesy of Vessel Finder

Bulgaria Says One Crew is Missing and Second Rescued After Drone Attack

Bulgaria was continuing to search for the missing crew of the vessel that was believed to have sunk after the attacks (Bulgarian Border Police)

By The Maritime Executive 2026-10-06 13:11:40

Bulgarian officials are denouncing the attack on two small cargo ships in the Black Sea while reporting that the crew of one vessel is missing. The reports said the two ships were attacked overnight, with 18 seafarers rescued and a search and rescue operation continuing.

Bulgaria's Prime Minister Rumen Radev convened a special meeting of the government, and he called the attacks “absolutely unacceptable” and a “gross violation of international law.” He declined to officially state who had attacked the ships, but reports are widely attributing the strikes to Russia, a charge repeated by Ukrainian President Volodymyr Zelensky in a posting on social media.

“If this war is not ended in time, it will continue to expand its spatial scope and increase the risk of even a global conflict,” said Radev. He pointed out that Bulgaria does not border Ukraine or Russia and lies at a critical point in the Black Sea, more than 140 nautical miles from Ukraine.

According to the reports, the Bulgarian ferry Dioscuria was in the area approximately 70 nautical miles east of Byala in the eastern part of Bulgaria when the attacks took place. Bulgarian officials said the strikes were attacks by air and sea drones.

The ferry’s crew saw an explosion and headed to the area, which officials emphasized was in Bulgaria’s EEZ. The Navy, Air Force, and Border Police also responded.

The ferry crew reported seeing an overturned lifeboat, three rafts, and life jackets in the water but was unable to locate any crewmembers. The ship, which is being identified as the Turkish-owned Alfa Watan (3,160 dwt), is believed to have sunk. Built in 1976, it is registered in Togo. The ship was sailing from Egypt and bound for Sulina, Romania, according to its AIS transmission.

The Bulgarian forces also responded to a second vessel that was on fire and aided in the rescue of 18 crewmembers from Turkey and India. Two were reported to be severely injured and were transported by the Bulgarian Navy to Varna for medical treatment. The 16 other crewmembers were transported to shore by a border patrol boat.

The second vessel is identified as the Turkish-owned Able. Built in 1991, the ship is registered in Palau and reportedly had a cargo of wheat heading for Italy.

Bulgarian officials reported they are continuing to search for the crew from the first ship. They did not comment on the number of missing individuals.

The reports said it was the first attack in Bulgarian waters, and it was quick to draw international commendation. Hungary’s Prime Minister posted on social media that they would stand with Bulgaria.

Ship sinks after drone attack in Bulgaria's Black Sea zone, crew missing

PM Rumen Radev said the attack was "absolutely unacceptable". / government.bgFacebook

TwitterLinkedInTelegramFlipboardFeedly

By bne IntelliNews October 7, 2026

A cargo ship sank and its crew went missing after drones attacked two merchant vessels in Bulgaria's exclusive economic zone in the Black Sea on October 6, Bulgarian officials said, raising concerns about the widening risks to civilian shipping from the war in Ukraine.

The vessels were attacked by air and sea drones at about 3 a.m. local time, around 70 nautical miles (130 km) east of the Bulgarian coastal town of Byala, Prime Minister Rumen Radev said.

One of the ships, the Togo-flagged Alfa Watan, sank. The vessel was Turkish-owned and was reportedly heading towards the Romanian port of Sulina. Its cargo and the number of people aboard were not immediately clear.

A Bulgarian vessel that went to the scene found an overturned lifeboat, life jackets and rafts but no crew members, Radev said. A search-and-rescue operation was under way.

The second vessel, the grain carrier Able, was hit and caught fire. Its 18 crew members - 11 Turkish and seven Indian nationals - were rescued by the Bulgarian roll-on/roll-off vessel Dioscuria, Radev said. Two crew members, including the captain, were seriously injured and taken to a military hospital in Varna.

"This is an absolutely unacceptable attack, a gross violation of international law and maritime affairs," Radev said at an emergency government meeting, BTA reported.

He said it was not immediately known whether the drones had originated from Russia or Ukraine.

Rising Black Sea risks

The incident comes as attacks on commercial shipping in the Black Sea have increased, with vessels carrying Ukrainian grain among those hit, and as European governments warn of a growing threat from Russian hybrid warfare.

European Commission President Ursula von der Leyen condemned the attacks, saying the situation in the Black Sea was becoming increasingly concerning.

"Commercial ships – and innocent crews – are being targeted, with lives already lost at sea," von der Leyen said on X. "Attacks on civilian shipping are unacceptable."

She noted that the incident came a day after a Turkish ship carrying Ukrainian grain was hit and sunk off Romania.

Radev did not directly blame Russia for Tuesday's attack, but linked the incident to the war in Ukraine.

"As I have long maintained, if this war is not halted in time, it will continue to expand its geographical reach and increase risks, including the risk of a global conflict," he said, according to BNR.

Bulgaria, a NATO member, does not border Russia or Ukraine but occupies a strategically important position on the western Black Sea. Its exclusive economic zone covers more than 29,000 square kilometres.

President Iliana Iotova will convene Bulgaria's Consultative Council on National Security on October 7 to discuss risks to maritime security and critical infrastructure stemming from the war in Ukraine, her office said.

The Bulgarian authorities were also monitoring the sunken vessel and the surrounding area for possible environmental risks, Radev said.

The incident followed a separate attack near Ukraine's port of Odesa in which a Marshall Islands-flagged vessel was reportedly hit, killing one crew member and injuring seven others.

  

Drones hit two ships off Bulgaria's coast, search and rescue ongoing as one sank

By Simon Ormiston & Anna Kirchheim

Published on 06/10/2026 - EURONEWS

Drones hit two ships off Bulgaria's coast and one of them sank, with the crew missing, the day after another drone attack sank a ship near Romania's shore in the Black Sea, in two consecutive drone attacks on NATO's Eastern flank countries.

A massive search is under way in the Black Sea for the crew of a cargo ship that sank after drones struck two commercial vessels off Bulgaria's coast early Tuesday, the day after another drone attack sank a Turkish grain ship off the coast of Romania, killing 2 crew members.

Sea and aerial drones hit the ships at about 3am local time (2am CET), around 70 nautical miles east of the town of Byala in Bulgaria's exclusive economic zone, Bulgarian Prime Minister Rumen Radev said.

The crew of the Bulgarian ferry Dioscuria, which was in the area, saw an explosion on the first ship and rushed to the scene, Radev confirmed. They found an overturned lifeboat and life jackets but no one from the crew.

Officials have not said how many people were on board, nor the origin of the drones.

A second ship was attacked and caught fire, with all 18 of its crew rescued by the Dioscuria. Eleven are Turkish and seven Indian, according to the televised address from Radev.

Two of them were hospitalised, one with burns and one with a head injury. The other 16 were being brought ashore on a Border Police patrol boat.

Radev said two helicopters were sent to Varna to pick up rescue teams and a Su-25 aircraft was deployed to carry out aerial reconnaissance over the area. The operation is being run by the Maritime Rescue Coordination Centre.

Both vessels sent distress signals during the night and one disappeared from Border Police radar at about 9am local time (8am CET), public broadcaster BNR reported.

Bulgarian shipping news site Maritime.bg named the sunken ship as the Alfa Watan and the second as the Palau-flagged Able. It said the strikes were the first attack on shipping in Bulgaria's exclusive economic zone.

Both vessels are Turkish-owned, according to the Equasis merchant shipping database.

Ship tracking website vesselfinder.com shows the Alfa Watan was sailing under the flag of Togo and was headed for the Romanian port of Sulina.

The second ship was carrying wheat and sailing south, Radev said. The cargo of the sunken Alfa Watan is not yet known.

Radev, who called the attack "absolutely unacceptable", did not say who launched the drones, while European Commission President Ursula von der Leyen called the developments "concerning".

Three attacks on civilian shipping in the Black Sea within two days

Tuesday's attack occurred the day after a Turkish-owned cargo ship carrying grain from Ukraine to Italy was attacked off Romania's coast in the Black Sea by at least one drone and sank after catching fire, killing two crew members.

Azerbaijan's Foreign Ministry said the ship's captain, Azerbaijani national Rustam Ismayil oglu Hasanov, died and his body was being repatriated. A second Azerbaijani crew member, Mahammad Hamza oglu Suleymanzade, is still missing and the search and rescue operation is ongoing. Azerbaijan's Foreign Ministry said their families were informed and they were receiving logistical and financial support.

11 other crew members were rescued by the Romanian authorities. Three Azerbaijani sailors and one Indian crew member among them are receiving emergency medical care in Romania.

Azerbaijan's Foreign Ministry explicitly reiterated its urgent warning to Azerbaijani citizens to refrain from travelling to active conflict zones, working in high-risk areas, or taking employment on transport vessels operating along contested maritime corridors.

Ukraine's President Volodymyr Zelenskyy blamed Russia for yesterday's sinking of the cargo ship and called it "a horrific strike by two Russian drones on a civilian vessel" in neutral waters.

India condemned Tuesday's attack as part of the crew members were Indian nationals. The Indian Foreign Ministry released a statement saying that "India views these attacks on commercial shipping and seafarers with grave concern," adding that "the targeting of traffic in international waterways is severely undermining global commerce and welfare of people across the world."

Bulgarian PM says drone attack on two ships is 'flagrant' breach of maritime law

Copyright AP Photo

By Simon Ormiston

Published on 06/10/2026 - EURONEWS

The EU pledged "full solidarity" with its eastern members as the search went on for the sunken vessel's crew, and no one has yet been blamed for the strikes.

Bulgarian Prime Minister Rumen Radev has condemned a drone attack on two commercial ships in the Black Sea that sank one of them, calling it "a flagrant violation of maritime law"

"Such an attack within the Bulgarian exclusive economic zone is absolutely unacceptable," he told reporters on Tuesday at the start of an emergency government meeting on the strikes.

Sea and aerial drones hit the vessels at about 3am local time (2am CET), around 70 nautical miles east of the town of Byala according to Radev, the Bulgarian Telegraph Agency (BTA) reported. He did not say who was behind the attack.

Radev warned that unless the war in Ukraine is brought to an end, it will keep widening its reach and raising the risks, including that of a global conflict.

"The situation significantly complicates navigation in the Black Sea, drives up insurance premiums, and makes maritime traffic extremely difficult," Radev said.

European Commission President Ursula von der Leyen said attacks on civilian shipping were "unacceptable" and that the EU stood "in full solidarity with our member states on the eastern flank".

"The situation in the Black Sea is increasingly concerning. Commercial ships – and innocent crews – are being targeted, with lives already lost at sea," she wrote on X.

The crew of the sunken ship are still missing and the search for survivors is continuing. Radev said the state's priority was to protect lives regardless of who was sailing in Bulgaria's economic zone.

The Bulgarian prime minister also addressed the Emil, a cargo ship attacked by Russian drones in August and now drifting towards Bulgaria's waters. Moscow confirmed the strike, claiming that the ship was carrying military equipment for Ukraine.

"We will not in any way allow the Bulgarian coast to be threatened," Radev said.

The emergency meeting brought together the defence, interior, transport and environment ministries, the presidency and the security services.

The attack came a day after a Turkish-owned cargo ship carrying grain in the Black Sea was hit by at least one drone and sank after catching fire.