Report of the Scientific Committee of the Spanish Agency for Food Safety and Nutrition (AESAN) on infant botulism

Infant botulism is a disease that occurs in infants between 1 and 52 weeks years of age when spores of Clostridium botulinum are ingested. These spores germinate and produce neurotoxins in the large intestine lumen. These toxins act at the neuromuscular junction blocking release of acetylcholine neurotransmitter. Clinical severity varies from a mild hipotony to systemic flaccid paralysis. It has even been considered as the cause of infant sudden death. C. botulinum spores are commonly found in soil samples and aquatic sediments throughout the world. Honey is the most well-documented food source of C. botulinum spores for infants although corn syrup, infant formulas, dry cereals, plants infusions and dust have been also associated with infant botulism. However, for the majority of cases the source of the causative spores remains unclear. Researchers have also stressed the importance of the child’s natural environment that may facilitate the exposure to C. botulinum spores. Contact with dust or soil in houses from rural areas, where farming activities are carried out, has also been cited as a risk factor. As well as urban areas with big areas under construction involving earthmoving or restoration works in buildings. It is considered that the minimum infective dose of spores of C. botulinum may be as low as 10100 spores. Current epidemiological data indicate that the risk of disease is low in infants less than 1 year old by avoiding the consumption of honey and/or plants infusions.