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.

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.

Prue Salasky of the Newport News Daily Press writes that a 5-month-old Mya Williams is on her way to a full recovery from infant botulism thanks to a good catch by a pediatric neurologist and the application of botulism immune globulin.

It was on a Thursday night that Lavista Williams noticed her daughter’s cry sounded different. By the next morning, even though Mya took her formula fine, her cry was "really, really weak. Her arms were floppy, her head fell back. She couldn’t roll on her side." Alarmed at her daughter’s condition called an ambulance to take her to a local emergency room. The doctor there ordered X-rays and blood work which revealed nothing. "She’s OK, take her home," he advised. There was no pediatrician on staff in the emergency room.

Williams ignored the directive to go home, called ahead to the children’s hospital and made the 40-minute drive to its emergency room. "Everything was immediately fast-paced," she says. "They took her vitals and ran three tests on her. By then her legs, which had been strong, stopped moving. Her cry was a whisper and her breathing was raspy." When the two doctors who treated her saw how weak she was, they called in a pediatric neurologist.

Pediatric neurologist Ralph Northam responded and ran a nerve conductivity test and a spinal tap, both of which came back fine. The final tip-off for the neurologist was that in addition to her saliva pooling from her difficulty swallowing, Mya had been constipated for a couple of days. "Her muscles were not getting the message from her nerves," he says. He admitted her to the intensive care unit where she stayed for 17 days, 12 of those on a ventilator.

Mya’s recovery time was speeded up significantly — from several months to a few weeks — by the administration of a single dose of botulism immune globulin, better known as "BabyBIG," an antidote that had to be ordered from California. Administered by IV in a couple of hours, the single dose cost $45,300.

It’s unclear what the spore source was for Mya’s illness but she had reportedly not been fed honey.