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A case of infant botulism from a honey dipped pacifier
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A 16 week Scottish baby is being treated for infant (intestinal) botulism in an Edinburgh hospital. Reports say the infant got the infant form of the intoxication from sucking on a “dummy” (pacifier) dipped in honey.
The child is in critical but stable condition.
In the U.S., there are approximately 100 cases of infant botulism reported annually. It is the most common form of botulism. It affects children under 12 months of age, with most cases being in infants 6 weeks to 6 months.
Unlike food borne botulism where the person ingests preformed toxin in food, the infant ingests the spores of the bacteria in food stuffs like honey. The spores germinate in the intestine where they produce the bacteria which in turn reproduce and release the toxin.
The bacteria can colonize in the infant’s intestines because normal bowel bacteria which would compete with the botulism bacteria aren’t fully established.
Because honey can contain spores of Clostridium botulinum, infants under 1 year old should not be fed honey.
Symptoms in the infant can start as constipation, weakness, poor suck, and a loss of head control. It can range from mild illness to sudden infant death. Disease is typically more severe in infants less than 2 months of age.
Some studies suggest that infant botulism may cause an estimated 5 per cent of cases of sudden infant death syndrome (SIDS).
Intestinal botulism occurs rarely in older children and adults.
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