Infantile Botulism

Excerpt

Infantile botulism is caused by Clostridium botulinum, an anaerobic, spore-forming, gram-positive bacillus. This bacterium is found in soil, water, and air, with a lethal toxin dosage as low as 1 mcg/kg. Botulism can develop through 5 distinct mechanisms, though this article focuses on infantile botulism.

Foodborne botulism occurs when a person ingests the preformed toxin. Infantile botulism results from C. botulinum colonization in the gastrointestinal tract of infants younger than 1 year. Wound botulism arises when infected wounds harbor C. botulinum and produce toxin. Iatrogenic botulism is associated with systemic intoxication following cosmetic or therapeutic use of botulinum toxin. Intestinal colonization in individuals older than 1 year leads to toxin production within the gastrointestinal tract, similar to infantile botulism but occurring in older children or adults.

Despite these different routes of infection, only 3 primary C. botulinum serotypes account for cases in humans. Type A is most prevalent west of the Mississippi River. Type B is more common in the eastern United States. Type E is frequently found in the Pacific Northwest, particularly in Alaska.

Approximately 100 cases of infantile botulism are reported annually in the United States. Around 20% are linked to raw honey consumption, with most cases occurring in infants from immigrant families. In the majority of affected infants, the source of C. botulinum spores remains unidentified. Experts suggest that contamination may result from exposure to environmental sources, such as dust from construction sites or soil.