Botulism, 2015

Botulinum toxin is one of the most lethal poisons known. This neurotoxin is produced by the bacteria Clostridium botulinum and other related Clostridial species; there are eight distinct toxin types: A, B, C, D, E, F, G, and newly recognized type 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. Botulinum spores are ubiquitous in the environment and cause three main forms of human botulism intoxication: foodborne, wound, and intestinal-toxemia form, which includes infant botulism and adult intestinal toxemia. Infant botulism, which is the most common form of botulism in the United States, results from the ingestion of C. botulinum spores that germinate and colonize the intestinal tract, producing toxin that is absorbed into the circulation.

In 2015, no foodborne or wound botulism cases were reported. One case of infant botulism was reported in a 10 month-old male who presented to the hospital with symptoms including weakened cry, inability to feed, progressive weakness, constipation, and ptosis. The infant tested positive for C. botulinum toxin type B; he received human botulism immune globulin and made a full recovery after an 8 day hospitalization.

From 2001-2015, 11 cases of infant botulism and 2 of foodborne botulism were reported. The median age of infants was 18 weeks (range 5 to 41 weeks), and 7 (64%) were male. Eight (73%) infants’ illnesses were caused by botulinum toxin type B and 3 (27%) by toxin type A; since 2006 all infant botulism cases in Minnesota have been caused by toxin type B. Nine infants were known to be hospitalized, for a median of 15 days (range 8 to 30 days). The 2 foodborne cases were of toxin type A, and occurred in 2009 in 2 men consuming home-canned asparagus. The men were aged 50 and 54 years, both hospitalized, for 6 and 16 days. No deaths occurred among the infant or foodborne botulism cases.

• For up to date information see>> Botulism
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2015