Cause
Botulism is caused by the bacterium Clostridium botulinum. Infant botulism, which is seen in infants six months and younger, occurs when spores of the bacteria are consumed, grow in the intestines, and release a toxin that blocks the messages between nerves and muscles throughout the body, leading to paralysis. Food-borne botulism is caused by eating foods—such as contaminated home-canned foods—that contain the botulism toxin.
Symptoms
Symptoms of infant botulism may include constipation, poor suck, increased drooling, lethargy, weak cry, and worsening muscle weakness. Food-borne botulism may include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness.
How It Spreads
The bacteria live in soil and dust or may contaminate food, including honey (uncommon). The infection is not transmitted from person to person. Spores or the toxin must be consumed.
Incubation Period
The incubation period of infant botulism is 3 to 30 days. With foodborne botulism, symptoms usually begin 18 to 36 hours after eating the contaminated food, but the period can range from 2 hours to as long as 8 days.
How Long Symptoms Last
The average hospital stay is one month.
When to Call Your Child’s Doctor
Untreated cases can be fatal. Call your child’s doctor immediately if your infant has trouble breathing, is drooling abnormally, or has trouble swallowing. Also see the doctor if move normally.
How the Diagnosis Is Made
The doctor detects toxin in the stool or blood or finds the bacteria in the stool.
Treatment
Botulism is treated with supportive care, usually in the intensive care unit. If diagnosed early, food-borne botulism may be treated with an antitoxin that blocks the effects of the toxin circulating in the blood. Doctors may also try to remove contaminated food by inducing vomiting or using enemas. Currently, antitoxin is not routinely given for treatment of infant botulism.
Prevention
Most cases of infant botulism cannot be prevented, but children younger than one year should not be given honey. For food-borne botulism, people who do home canning should follow strict hygienic procedures. Because botulism is destroyed at high temperatures, consider boiling home-canned foods for 10 minutes to ensure safety. Oils infused with garlic or herbs should be refrigerated. Potatoes baked in aluminum foil should be served hot or kept refrigerated.
Complications
Death is rare for patients who are hospitalized in the United States. However, some children may develop other complications, such as respiratory problems, pneumonia, or sepsis (blood poisoning). After recovery, children appear to have an increased incidence of strabismus, a misalignment of the eyes (“wandering” or “crossing” eyes).