What is infant botulism? Let’s find out the symptoms, causes and possible treatments for this form of botulism in children.
What do we talk about when we discuss infant botulism? And why is it very often linked to honey and its unwanted effects? Among the rare diseases of early childhood, this form of botulism is of particular concern to parents of very young children within the first year of life. Although it is not an infectious disease (and therefore not contagious for others), infantile botulism arouses many thoughts due to the risks associated with the presence of this pathology. So let’s clarify the signs to recognize, what infant botulism is (and how it differs from alimentary botulism) and how to react in case of symptoms.
In this article
What is infant botulism
As reported in the document of the ISS (Istituto Superiore di Sanità) dedicated to this pathology, infantile botulism is one rare pathology non-infectious which occurs in infants under one year of age.
What are the causes of infant botulism?
The cause of the onset of infant botulism is one toxin, which is produced by microorganisms called Clostridia, as reported by an in-depth study of the Bambin Gesù Hospital. The peculiarity of these toxins is that they are able to transform into spores, even more dangerous. The spores are a transformation of the bacterium that protects itself under different layers and puts itself in a sort of “hibernation” even if the surrounding environment is not favorable. As soon as this becomes, the spore proliferates. In infant botulism, botulinum toxin is produced in the intestine thanks to bacteria. In the forms of classic alimentary botulism, on the other hand, the toxin already produced by Clostridium is ingested. The spores of Clostridium botulinum are dangerous, considered the most “poisonous” as reported by the study “Botulinum Toxin” published in the Indian Journal of Dermatology. For this reason, when they are inhaled or ingested and germinate, they favor the production of the toxin which at a certain point is absorbed and begins to circulate in the blood.
As reported by the ISS, there is still no scientific evidence on why the spore finds a favorable environment in the intestines of some infants and in others it does not. The clinical cause is the proliferation of the spore in the blood and its consequences unfortunately are the blocking of nerve transmission to the muscles.
But why is infant botulism often linked with the honey? The American studies, where the incidence of cases of infantile botulism is higher (as reported by the in-depth analysis of Bambin Gesù, worldwide the highest frequency is found in the United States with about 80-110 cases a year and a incidence of about 2 cases per 100,000 live births, followed by Argentina, Australia and Italy with an incidence of 0.2 cases per 100,000 live births), deepen the connection between infantile botulism and honey. In fact, the Clostridium botulinum bacterium is more present in the latter and, according to other studies such as the one reported by KidsHealth, also in the common household dust.
Me too’water and in general soil they can be the main cause of infant botulism, because, for example, in environmental dusts (such as those created during a renovation, for example) the bacterium is more present. Analyzes report that 95% of cases occur in the first 6 months of life: as confirmed by a deepening of the NHS, infant botulism does not affect adults and older children because, after the first year of life, the immune system acquires the to defend against this particular type of bacterium.
Symptoms of infant botulism
There is no rule regarding the incubation period, because it depends on the amount of toxin inhaled or ingested. But the estimate reported by the Baby Jesus experts is that it can last 3 to 30 days from exposure to the spores.
One of the direct consequences of ingesting the bacterium is constipation. Other symptoms reported in the Medical news Today article “Everything you need to know about infant botulism” include:
- difficulty in feeding the baby
- muscle flaccidity
- respiratory difficulties
- symmetrical flaccid paralysis that starts from the face and spreads over the whole body
- difficulty in movement
- difficulty swallowing
- loss of head control
- loss of tendon reflexes
The clinical picture is extensive and related to the amount of ingested bacterium. Having a diagnosis helps reduce risks and complications. Sampling the baby’s feces and also environmental factors (such as ingested honey or dust to which the baby has been exposed) favors and speeds up diagnosis. Among the exams that can be prescribed to deepen there is usually the Electromyography which is used precisely to make precise diagnoses of the neuromuscular diseases.
How infant botulism is treated and how to prevent it
Early diagnosis is, as in many cases, the first ally to combat and limit the impact of the complications of a disease such as botulism. Recognize i symptoms it is the first step, especially in relation to the ingestion or inhalation of the agents identified as dangerous and more common and if the child is less than one year old. In cases where these symptoms occur, it is necessary to call the doctor: in the most serious manifestations the child may find it difficult to breathe and it is important to intervene immediately.
As reported by MSD Manual, the therapy that is followed in cases of infantile botulism is usually that ofhuman botulinum immunoglobulin, with hospitalization and ventilatory support if they have breathing difficulties. Thanks to the antitoxin of the treatment provided in these cases and which falls within the Infantile Botulism Treatment and Prevention Program antibodies to toxin A and / or B are provided to the child via human donors.
Unfortunately, the extreme consequences of this pathology can even lead to death. But, as reported by the Bambin Gesù paper, correct and timely diagnosis and improvement of therapies have brought down the mortality rate, bringing it to 5% today compared to 70% in the early twentieth century. Healing is possible, but with a very long course, with a recovery that includes neurorehabilitation therapy.
How to prevent infant botulism?
Avoiding honey under one year of age is a fundamental rule. The ISS is recommended not to keep the child in contact with very dusty places, as this could favor the inhalation of the toxin.
Sources for the article: ISS, “Infant botulism”; Bambin Gesù Pediatric Hospital, “Infantile Botulism”; IBTPP, “Infant Botulism Treatment and prevention program”; MSD Manual, “Infant botulism”; Indian Journal of Dermatology, “BOTULINUM TOXIN”; KidsHealth, “Infant Botulism”; NHS UK, “Botulism”; Medical News Today, “Everything you need to know about infant botulism”