botulism, infant

This is a syndrome recognized in recent years. Clostridium botulinum (the causative germ) spores are found in the soil and specifically in all honeys. (They may also be found in light or dark corn syrup (Karo) but in much lower levels. Current literature casts doubt on corn syrup being a source of infection, because the method of processing corn syrup has been changed1) The baby with infant botulism may have a history of being fed honey, but sporadic cases without honey ingestion are more common. Initial constipation is followed by profound weakness and floppiness, poor feeding and a weak cry. The illness most often strikes in the first six months of life, although it may occur up to 11-12 months and has even occurred later in immunocompromised children. Treatment is supportive care, and the complete recovery rate for infant botulism is stated to be 98% or better.

A new treatment for infant botulism is available, BabyBIG®, an FDA licensed botulism immune globulin which is available from the California Infant Botulism Treatment and Prevention Program (part of the California Department of Health Services). The Program website has the relevant information for physicians to obtain this treatment, which "significantly reduces length of hospital stay and hospital costs that result from this disease." The website contains information such as the program's phone number, a checklist for obtaining BabyBIG® to treat the patient, forms to download to obtain the medication, etc.

1. Olsen SJ, Swerdlow DL. Risk of infant botulism from corn syrup (In reply). Pediatr Infect Dis J 2000;19:584-5.

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