Infant Botulism Treatment and Prevention Program

Infant botulism is caused by consuming the spores of the bacterium Clostridium botulinum, which then grow in the intestines and release nerve toxin. It predominantly affects infants (children under 1 year of age), although it may affect adults who have an altered gastrointestinal environment, either through surgery or antibiotic therapy.



The condition can be frightening because it can cause muscle weakness and breathing problems. Infant botulism can occur when a child ingests Clostridium botulinum bacteria, which are found in dirt and dust and can contaminate honey.Infant botulism is considered to be distinct from other types of botulism which differ considerably in the age most commonly affected and in the clinical course. The "food borne" form of botulism most often occurs in adults.



Symptoms



Symptoms of botulism typically appear between 18 and 36 hours after the infant consumes the bacteria. Constipation is often the first symptom of botulism that parents notice. But many other illnesses can also cause constipation. So if your infant has not had a bowel movement in 3 days, it's a good idea to call your child's doctor.



Older children who eat improperly prepared or stored food. A form of botulism can very rarely occur in wounds. Botulism (botulinum toxin) is also of concern as a bioterrorist weapon. The earliest and most common symptom of infant botulism is constipation. Other symptoms include general weakness, a weak cry, a poor sucking reflex, irritability, lack of facial expression, and loss of head control. Symptoms may arise abruptly, in a matter of hours, or they may develop over several days. The progressive weakness usually develops over 1 to 4 days and is often severe enough to bring the baby to medical attention.



Diagnosis



Physicians may consider the diagnosis if the patient's history and physical examination suggest botulism. However, these clues are often not enough to allow a diagnosis of botulism. Other diseases such as Guillain-Barré syndrome, stroke, and myasthenia gravis can appear similar to botulism, and special tests may be needed to exclude these other conditions. These tests may include a brain scan, cerebrospinal fluid examination, nerve conduction test (electromyography, or EMG), and an Edrophonium Chloride (Tensilon) test for myasthenia gravis



Treatment



Most babies with infant botulism have to go the hospital for a few days, or even a few weeks. During treatment, doctors pay close attention to their nutritional needs, and make sure they are able to breathe properly. The babies usually don't need antibiotics or antitoxins, and most make a complete recovery.



Prevention



Theoretically, the disease might be avoided by preventing exposure to spores. Since honey and corn syrup are sources of Clostridium spores, they should not be fed to infants less than 1 year old.