Infant botulism. Epidemiological, clinical, and laboratory aspects

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Abstract
Clostridium botulinum organisms and toxin were identified in the feces of 6 infants, aged 5-20 wk, who had illnesses clinically consistent with botulism. Five of the infants lived in California [USA] and became ill within a 6-mo. period in 1976; 1 infant became ill in New Jersey [USA] in 1975. Three cases were type A botulism and 3 were type B. No source of ingested botulinal toxin could be found in any case. However, 1 infant with type B botulism had ingested a food containing C. botulinum type B organisms, but no toxin was found in it. The clinical findings in these cases include constipation, weak sucking and crying ability, pooled oral secretions, cranial nerve deficits, generalized weakness and, on occasion, sudden apnea. A characteristic electromyographic pattern termed brief, small, abundant, motor-unit action potentials (BSAP) was observed. The sources of C. botulinum toxin for these 6 infants may have been in vivo (gastrointestinal) production following ingestion of C. botulinum organisms. Studies are underway to determine the full clinical spectrum, incidence and potential public health importance of this infectious disease newly recognized in infants.

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