Botulism, 2018

Botulinum toxin, a neurotoxin, is produced by the spore-forming bacteria Clostridium botulinum and other related species. There are 8 distinct toxin types: A, B, C, D, E, F, G, and H. Toxin types A, B, E, F, and H can cause human intoxication. Botulism is characterized by a descending, bilateral paralysis that can be fatal without treatment. Botulism spores are ubiquitous in the environment and cause three main forms of intoxication: foodborne, wound, and intestinal-toxemia, which includes infant botulism and adult intestinal toxemia. Infant botulism, which is the most common form in the United States, results from the ingestion of C. botulinum spores that germinate into vegetative bacteria that colonize the intestinal tract, producing toxin that is absorbed into the circulation.

In 2018, 1 infant botulism case was reported. No foodborne or wound cases were reported. The infant was a 26 week-old who presented to the hospital with symptoms including weakened cry, inability to feed, progressive weakness, and ptosis. She was hospitalized for 11 days, received human botulism immune globulin and made a full recovery. The infant tested positive for C. botulinum toxin type B.

From 2001-2018, 14 cases of infant botulism and 2 cases of foodborne botulism were reported. The median age of infants was 19 weeks (range 5 to 41 weeks), and 8 (57%) were male. Eleven (79%) cases were caused by botulinum toxin type B and 3 (21%) by toxin type A; since 2006 all infant cases in Minnesota have been caused by toxin type B. Eleven infants were known to be hospitalized, for a median of 15 days (range 8 to 30 days); one infant did not require hospitalization. The 2 foodborne cases were of toxin type A, and occurred in 2009 in two men consuming home-canned asparagus. Both were hospitalized for 6 and 16 days. No deaths occurred among the infant or foodborne botulism cases.

• For up to date information see>> Botulism (Clostridium botulinum)
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2018