Risk factors for infant botulism in the United States

Article Abstract:

Botulism, food poisoning caused by the toxin produced by Clostridium botulinum, has been reported in 600 infants since 1976. Spores of the bacteria have been isolated from honey that was fed to infants prior to the onset of botulism. In another study, breast-feeding was practiced in 66 to 100 percent of infants who developed botulism. The risk factors for infant botulism were studied in 68 confirmed cases in the US (excluding California). Infants with botulism were 9.8 times more likely to have eaten honey prior to the onset of symptoms. However, only 11 infants (16 percent) had been fed honey. A significant correlation was found between the use of corn syrup and botulism in infants who were at least two months old. The most common symptoms to be reported by parents whose infants became ill with botulism were poor infant feeding (52 percent of cases) and less than one bowel movement per three days (47 percent). Thirty-seven of 58 infants, one month of age and older, had one bowel movement per day for at least two months prior to their illness. Decreased intestinal motility, which is associated with decreased frequency of bowel movements, may enable C. botulinum spores to produce toxin. In addition, infants with botulism were more likely to have been living on a farm or in a rural area. Environmental contaminants in rural settings may also be a source of botulism spores. Breast-feeding was associated with botulism in infants at least two months old. The severity of botulism was similar for breast- and formula-fed infants. However, illness severity was greater in younger than in older infants, whether they were breast-fed or not. Although contaminated food is a significant risk factor for botulism, the bacterial content of the intestine and the frequency of bowel movements are more important risk factors. Breast-feeding practices should not be abandoned because botulism in infants is rare; the benefits of breast-feeding outweigh the risks of disease. However, honey should not be given to infants who are less than one year of age. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Demographic aspects, Food poisoning, Gastrointestinal diseases, Botulism

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A waterborne outbreak in Missouri of Escherichia coli O157:H7 associated with bloody diarrhea and death

Article Abstract:

An outbreak of infections caused by Escherichia coli O157:H7 in a rural town in Missouri may have been caused by contamination of the municipal water supply after two water mains ruptured. Among 243 patients with symptoms of an Escherichia coli infection, 86 developed bloody diarrhea, 32 were hospitalized, two developed severe kidney failure and four died. Escherichia coli O157:H7 was grown in the laboratory from 21 stool specimens. Patients drank an average of eight cups of municipal water during the seven days before becoming ill, compared to an average of six cups among town residents who did not become ill. Individuals who drank water from the municipal water supply were almost 20 times more likely to develop bloody diarrhea than those who drank water from a private well. The number of infections decreased after the town's water supply was chlorinated and residents began boiling municipal water before drinking it.

Health aspects, Escherichia coli infections, Municipal water supply, Waterborne infections

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