Infant botulism claims 6-month-old Tokyo boy who was fed honey

The Japan Times reports that a 6-month-old boy in Adachi Ward, Tokyo, died late last month of infant botulism after his family fed him honey, according to the metropolitan government.

Metropolitan officials said it was the first death caused by infant botulism in Japan since 1986, when the government began compiling such statistics.

The officials warned that babies younger than 1 should not be given honey.

They said the Adachi boy died March 30. He developed a cough on Feb. 16, and was taken to a hospital by ambulance on Feb. 20 after going into convulsions and suffering respiratory failure. He was diagnosed Feb. 28 as having infant botulism.

The officials said the boy’s family had been giving him honey mixed in juice twice a day for about a month, and that they were not aware babies should not be fed honey.

The bacteria Clostridium botulinum was found in an unsealed honey container in the family’s house and in the boy’s excrement. A public health center confirmed that the boy’s death was caused by botulism poisoning.

Infant botulism can occur when newborns, who have immature digestive systems, ingest bacteria that produces toxins inside the bowels.

 

Minnesota infant survives brush with botulism

The 3-month-old daughter of Wesley and Sarah Hendrickson of Brainerd, Della, was diagnosed earlier this month with infant botulism.

botulism microAfter another hospital stay at Essentia Health-St. Joseph’s Medical Center in Brainerd the next day, the Hendrickson family was airlifted to the St. Paul campus of Children’s Hospitals and Clinics later that evening. One of the doctors there had coincidentally treated two cases of infant botulism in his career beforehand and recognized the symptoms.

The doctors called a facility in California and requested them to ship a single antitoxin dose to Minnesota. That dose alone cost more than $45,000—but Della’s parents knew it could shorten her hospital stay from months to weeks.

After the dose was administered early March 13, the Hendricksons began to see a gradual improvement in Della’s condition—a breathing tube taken out one day, her ability to smile coming back another. Eventually, they moved out of the intensive care unit, to a regular hospital wing, and since then they’ve been working with rehabilitative therapists to improve Della’s functions.

Doctors project that Della will make a full recovery with no limitations, Wesley said. They might be able go home as soon as Saturday.

They can’t pin down a source for the spores. It could have been from neighbors clearing debris from the July 12 storm—or it could have been construction, or logging.

Infants can contract botulism through spores because their digestive systems produce less acid than adults—acid which would otherwise kill the toxin-producing botulism bacteria.

So far in 2016, Della has been one of two total cases of infant botulism. The other case was an infant in the metro area.

Botulism can sometimes be contracted when infants eat contaminated honey.

Dirt possible source of botulism in California infant

Botulism is so rare the U.S. Centers for Disease Control and Prevention note only approximately 145 cases are reported yearly – 65% of those are infant botulism.

Here in San Diego, the county’s latest stats show 3 cases from 2009-2013. While people are familiar with honey containing the bacteria for infant botulism, Bri Escobar was surprised to find her daughter may have contracted the bacteria when her father unknowingly brought dirt home from his construction job.

“Spores grow in the ground and when a baby under 6 months inhales or ingest it their intestines are like a good area for that botulism toxin to grow,” Escobar explained.

She’s not a doctor, but after a week at Rady Children’s Hospital, she’s had to learn a lot about what’s ailing her daughter.

She said her daughter is slowly starting to regain the movement she lost a week ago and getting her personality back.

Infant Botulism Caused by Clostridium baratii Type F — Iowa, 2013

The U.S. Centers for Disease Control reports that in June 2013, a male newborn aged 9 days (delivered after a full-term pregnancy) was brought to a hospital emergency department with a 2-day history of constipation, fussiness, and poor feeding.

drooling-babyThe mother reported her son’s symptoms as excessive crying, reluctance to suck, and difficulty in swallowing milk. Within hours of arrival, the infant became less responsive and “floppy,” and was intubated for respiratory failure. Infant botulism was suspected and Botulism Immune Globulin Intravenous (Human) (BIG-IV), licensed for the treatment of infant botulism types A and B, was administered on hospital day 2. Results of preliminary stool studies were reported positive for botulinum toxin type F on hospital day 3. Clostridium baratii type F was subsequently isolated in stool culture.

National experience with type F botulism in newborns and infants indicates that rapid clinical improvement could occur even without the administration of anti-type F antitoxin. However, 3 days after treatment with BIG-IV the newborn continued to require ventilator support and showed no signs of clinical improvement. On hospital day 6, equine-derived botulism antitoxin heptavalent (A-G) (BAT) was administered to the boy, despite the limited experience reported for its use in pediatric cases. This is the second newborn treated with BAT in the United States; the first was treated in 2008 in Colorado (1).

Within 24 hours of BAT treatment, spontaneous movements of the newborn’s extremities increased. On hospital day 8 the endotracheal tube was removed. By the following day, the boy could tolerate oral feedings, had regained muscle tone and strength in his extremities, and had normal pupillary responses. The only adverse event associated with BAT treatment was an intermittent, low-grade fever that developed within 1 hour of BAT administration and lasted 72 hours. Blood, urine, stool, and cerebrospinal fluid bacterial cultures were otherwise negative. Contrast magnetic resonance imaging of his brain showed normal findings, and cerebrospinal fluid studies for herpes simplex virus and enterovirus also were negative. The newborn was discharged on hospital day 12. At the 2-week follow-up examination, his mother reported he was doing well: taking 100% of his feedings orally, exhibiting no residual weakness, and having normal bowel movements.

The parents reported feeding the newborn ready-to-feed and powdered formula from the same brand. No other solid or liquid foods or homeopathic remedies or supplements were given before symptom onset. No classic risk factors for infant botulism were reported, such as exposure to honey or soil. The parents reported strong winds and minor construction in the area surrounding their home. Pets present in the home included cats, turtles, fish, geckos, sugar gliders, and a mouse.

Environmental samples were collected from 1) feces from all animals in the home, 2) food and water from the turtle enclosure, 3) dust from the vacuum cleaner bag and the windowsill and ceiling fan closest to where the child slept, and 4) potting soil from the only indoor plant in the home. Although Clostridium species were isolated in several of the samples, none produced botulinum toxin.

Through 2012, only 13 cases of C. baratii type F infant botulism have been reported in the United States; this is the third confirmed case in Iowa. Extensive investigations for an environmental source of toxigenic C. baratii have been undertaken, including for all three cases in Iowa (2). Unlike typical infant botulism caused by C. botulinum (3), no source has been identified and prevention strategies remain unknown for C. baratii. While C. baratii infant botulism remains a rarely diagnosed disease, health care providers should maintain a high index of suspicion especially in very young infants who present with new onset floppiness or progressive respiratory failure.

Acknowledgment

Minnesota Department of Health Epidemiology and Public Health Laboratory.

1Division of Infectious Diseases, Department of Pediatrics, Blank Children’s Hospital, Des Moines, Iowa, 2Division of Acute Disease Prevention, Emergency Response, and Environmental Health, Iowa Department of Public Health, 3Infant Botulism Treatment and Prevention Program, California Department of Public Health (Corresponding author: Amaran Moodley, amaran.moodley@unitypoint.org, 515-241-8300)

References

Al-Sayyed B. A 3-day-old boy with acute flaccid paralysis. Pediatr Ann 2009;38:479–82.

Barash JR, Tang TWH, Arnon SS. First case of infant botulism caused by Clostridium baratii type F in California. J Clin Microbiol 2005;43:4280–2.

CDC. Botulism. Atlanta, GA: US Department of Health and Human Services, CDC; 2014. Available at http://www.cdc.gov/nczved/divisions/dfbmd/diseases/botulism/.

You see a cute turtle, I see a bug factory: Infant botulism from C. butyricum

We describe two cases of infant botulism due to Clostridium butyricum producing botulinum type E neurotoxin (BoNT/E) and a previously unreported environmental source.

how-to-care-for-terrapins.WidePlayerThe infants presented at age 11 days with poor feeding and lethargy, hypotonia, dilated pupils and absent reflexes. Fecal samples were positive for C. butyricum BoNT/E. The infants recovered after treatment including botulism immune globulin intravenous (BIG-IV).

C. butyricum BoNT/E was isolated from water from tanks housing pet ‘yellow-bellied’ terrapins (Trachemys scripta scripta): in case A the terrapins were in the infant’s home; in case B a relative fed the terrapin prior to holding and feeding the infant when both visited another relative. C. butyricum isolates from the infants and the respective terrapin tank waters were indistinguishable by molecular typing. Review of a case of C. butyricum BoNT/E botulism in the UK found that there was a pet terrapin where the infant was living.

It is concluded that the C. butyricum-producing BoNT type E in these cases of infant botulism most likely originated from pet terrapins. These findings reinforce public health advice that reptiles, including terrapins, are not suitable pets for children aged <5 years, and highlight the importance of hand washing after handling these pets. 

Infant botulism due to C. butyricum type E toxin: a novel environmental association with pet terrapins

Epidemiology and Infection / Volume 143 / Issue 03 / February 2015, pp 461-469

E.B. Shelley, D. O’Rourke, K. Grant, E. McArdle, L. Capra, A. Clarke, E. McNamara, R. Cunney, P. McKeown, C.F.L. Amar, C. Cosgrove, M. Fitzgerald, P. Harrington, P. Garvey, F. Grainger, J. Griffin, B.J. Lynch, G. McGrane, J. Murphy, N. Ni Shuibhne and J. Prosser

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9527948&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG&utm_reader=feedly

Infant with botulism identified in Israel; treated with antitoxin

Botulism is scary. In adults, consuming small amount of toxin (as little as a couple of nanograms) can cause paralysis; victims often end up on a ventilator for months. Intoxication is fatal in 5-10% of cases (depending on the type).
In infants, the risk comes from ingesting C. botulinum spores (most often associated with honey)Household dust has also also been identified as a potential source in at least one case.botulism_starter_kit_by_strangecraftdesign-d3cwcvg
Regardless of the source, the consequences can be catastrophic. Illness severity is linked to how quickly the right treatment is administered — identification of the symptoms takes an on-the-ball physician who knows a bit about food safety.
According to Algemeiner.com, an Israeli doctor’s access to antitoxin may have saved an infant’s life.
A 7-month-old child is in serious condition in an Israeli hospital after ingesting spores of a rare and deadly disease just days earlier.
 
“During our checkup, we concluded that he was suffering from botulism,” Dr. Eli Shapiro, Pediatric Intensive Care Unit chief at Rehovot’s Kaplan Hospital, told Army Radio on Wednesday.
 
Kaplan, like all Israeli medical facilities, keeps ample supplies of biological and chemical warfare antidotes on hand in case of war or terrorist attacks, and regularly drills staffers in dealing with the symptoms of various chemical, neural and blister agents.
 
The quick-thinking mother immediately brought the child to the hospital when she saw he was suffering from vomiting, difficulty in breathing, listlessness and an inability to nurse or eat, hospital officials said.
 
“The infant is still in a life-threatening situation, however, the muscular paralysis has been checked and there’s been a small degree of improvement in his muscular weakness,” Shapiro said.
 
Shapiro said it was, as yet, unclear as to the source of the poisoning, however, Health Ministry officials have been alerted and are investigating the circumstances.

Botulism in Australia: Lucas Whitelegg is going home after 241 days at Monash Children’s Hospital

Lucas Whitelegg is finally ready to embrace the world with both arms after spending 10 months with his entire body paralysed by botulism.

Three days after celebrating his first birthday, Lucas will on Friday wave goodbye to the Monash Children’s Hospital staff who helped him through 241 days in intensive care and the gradual return of his movement from the pure form of Botox. For Lucas’ mother Bree Lucas WhiteleggBailey it will mark the end of nightmare that began when he was 8 1/2 weeks old and ingested a spore that sprouted botulism in his belly, which then spread through his bloodstream and paralysed his entire body.

One of only 13 cases of botulism in Victoria in the last five years, doctors had to retrieve a $100,000 antitoxin from the US to save Lucas and then wait for the paralysis to wear off.

It was weeks before Lucas could even open his eyes, three months before his fingers and toes wiggled, and eight months before his lungs and diaphragm freed up allowing him to breath without a ventilator.

Mother speaks of infant loss to E. coli

Heartbroken mum Samantha Waller today spoke of the tragic loss of her seven-week-old baby to E. coli poisoning.

And she said little son Henley was now “my guardian angel.”

Samantha, 25, of Percy Street, Middlesbrough, told the Gazette she thought about her treasured son every day.

A Teesside coroner’s inquest earlier heard Henley McLeod’s life had barely begun when he fell victim to a serious E. coli infection.

The beloved tot was found lifeless at his home.

Just the day before he died, he’d been unwell and his worried mum had taken him to the doctor’s surgery.

But an examination found nothing untoward and Samantha was allowed to take him home.

Tragically, next morning on February 3 2012, Samantha found her baby son motionless and not breathing.

Teesside coroner Michael Sheffield said every effort was made to revive the baby “tragically to no avail.” He recorded a verdict of natural causes.

219 – mainly kids — sick in six Salmonella outbreaks linked to small turtles

Turtles traumatized me as a child; now they frighten me for food-safety-related reasons: they make little kids sick.

In the current outbreaks, 30 per cent of the confirmed sick are children 1 year of age or younger; that’s at least 66 infants barfing because their parents wanted them to hang out with small turtles.

The U.S. Centers for Disease Control is tracking six different outbreaks of human Salmonella infections linked to small turtles:

• a total of 219 persons infected with outbreak strains of Salmonella Sandiego, Salmonella Pomona, and Salmonella Poona have been reported from 34 states;

• 36 ill persons have been hospitalized, and no deaths have been reported;

• 66% of ill persons are children 10 years of age or younger, and 30% of ill persons are children 1 year of age or younger; and,

• 49% of ill persons are of Hispanic ethnicity.

Results of the epidemiologic and environmental investigations indicate exposure to turtles or their environments (e.g., water from a turtle habitat) is the cause of these outbreaks.

Small turtles are a well-known source of human Salmonella infections, especially among
young children. Because of this risk, the Food and Drug Administration has banned the sale and distribution of these turtles as pets since 1975.

Turtles with a shell length of less than 4 inches in size should not be purchased as pets or given as gifts.

Dog food Salmonella outbreak grows; family of infant files lawsuit

When I talk about toddlers learning to crawl and heading for the dog dish, I’m not thinking of 8-week-olds.

A federal lawsuit in New Jersey alleging an infant was sickened by salmonella-contaminated dog food may be the first in the nation to hit the courts in the wake of a recent pet food recall.

The New Jersey Law Journal reports at least 15 people in nine states and Canada have reportedly fallen ill as a result of contact with pet food made by Diamond Pet Foods, which announced the recall on April 6 and has since expanded it to additional brands.

Eisenberg v. Diamond Pet Food Processors, 12-cv- 3127, filed May 25 in federal court in Trenton, alleges that a two-month-old child became sick with diarrhea, fever and loss of appetite on April 11. A day later, his pediatrician sent him to St. Peter’s University Hospital, where he spent three days and was diagnosed with salmonella. A stool sample later tested positive for the same strain of salmonella that spurred the recall, salmonella infantis.

The child’s father, Nevin Eisenberg of Marlboro, alleges he bought a bag of a Diamond brand — Kirkland Signature Super Premium Healthy Weight Dog Food with chicken and vegetables — at the Costco Wholesale Corporation store in Morganville.

The complaint does not specify how the child, identified as C.A.E., became exposed to salmonella.

But, the U.S. Food and Drug Administration warned yesterday the multi-state outbreak of Salmonella Infantis infections continues to grow.

FDA became involved in early April when the Michigan Department of Agriculture and Rural Development reported detecting Salmonella from an intact package of Diamond Naturals Lamb and Rice Formula for Adult Dogs, collected during retail surveillance sampling. Diamond Pet Food was notified of the sampling results, and agreed to voluntarily recall this product on April 6, 2012.

At that time, there were no known dog illnesses reported.

An additional finding of Salmonella in a sample taken by the Ohio Department of Agriculture, from an opened bag of Diamond Brand Chicken Soup for the Pet Lover’s Soul Adult Light Formula dry dog food collected from the home of an ill person, and an unopened bag of the product collected from a retail store led to a recall of that product on April 26, 2012

A sample of Diamond Puppy Formula dry dog food collected by FDA during an inspection at the South Carolina production facility also yielded Salmonella Infantis, which led to a recall of that product on April 30, 2012.

Public health officials used DNA fingerprints of Salmonella bacteria obtained through diagnostic testing with pulsed-field gel electrophoresis, or PFGE, to investigate cases of human illness. CDC reports that this outbreak strain (Infantis) is rare, and typically only 0 to 3 cases are reported per month to PulseNet.

Through interviews by state public health officials, FDA’s review of consumer complaints, and from a comparison of pet products from human exposure, some brands of dry pet food produced by Diamond Pets Foods at a single manufacturing facility in South Carolina have now been linked to human Salmonella infections.

FDA, CDC, and state investigations are ongoing in an effort to determine if other brands of dry dog food produced at the South Carolina facility may be linked to confirmed human illnesses. FDA will provide updates on the investigation as new information becomes available.