Botulism and Honey: Infant and Adult Botulism

Botulism is a rare but potentially fatal illness caused by a toxin produced by the bacteria Clostridium botulinum. The illness targets your nervous system and can lead to paralysis and respiratory failure.

The most common way to get botulism is by consuming food contaminated with the bacteria. You can also get it by:

• breathing in spores
• coming into contact with contaminated soil
• through open wounds

According to the World Health Organization (WHO), the bacteria Clostridium botulinum produces seven types of spores. But only four types can lead to botulism in humans, and one is very rare.

These spores grow in oxygen-free conditions and thrive in improperly stored fermented and home-canned foods.

Honey is one of the most common sources of botulism. About 20 percent of botulism cases involve honey or corn syrup.

One 2018 study looked at 240 multifloral honey samples from Poland. The researchers found that 2.1 percent of the samples contained the bacteria responsible for producing the botulinum neurotoxin. The researchers also noted that their results are in line with results from other countries.

Infants and children under 12 months are at the highest risk of developing botulism from honey. This is because they don’t have the same defenses as older children to fight the spores in their digestive system.

The Mayo Clinic advises against giving honey to children under 12 months of age.

Improperly canned or fermented foods are among the most common sources of botulism. According to the Centers for Disease Control and Prevention (CDC), the following foods have been linked to botulism:

• canned asparagus
• canned green beans
• canned potatoes
• canned corn
• canned beets
• canned tomatoes
• canned cheese sauce
• fermented fish
• carrot juice
• baked potatoes in foil
• chopped garlic in oil

About 90 percent of botulism cases occur in infants younger than 6 months old. Children under 12 months are also at a heightened risk of developing botulism.

Older children and adults have digestive systems that are better equipped to fight off the bacterial spores found in contaminated foods like honey.

The bacteria Clostridium botulinum can germinate in the digestive tract of children younger than 12 months old. Because of this, symptoms of botulism might not develop until 1 month after exposure.

According to the CDC, you may also be at an elevated risk of developing botulism if you:

• make and eat home-fermented or canned foods
• drink homemade alcohol
• get cosmetic botulinum toxin injections
• inject certain drugs, such as black tar heroin

Symptoms usually appear around 12 to 36 hours after being exposed to the toxin.

In adults and older children, botulism causes weakness in the muscles around the eyes, mouth, and throat. Eventually, the weakness spreads to the neck, arms, trunk, and legs.

Signs that you may have botulism include:

For infants, the first symptoms often begin with:

Botulism is potentially fatal and requires prompt medical attention. If your doctor suspects you’ve been contaminated with botulism, they’ll likely order a lab test to confirm the presence of the bacteria in your stool or blood.

Botulism is usually treated with a botulinum antitoxin drug to fight the illness. The drug prevents botulism from further damaging the nerves. Neuromuscular function will eventually regenerate once the toxin is flushed from your body.

If symptoms are severe, it may cause breathing failure. If this happens, mechanical ventilation may be needed, which could last for several months.

Modern medicine has helped to drastically increase the survival rate of botulism. Fifty years ago, about 50 percent of people died from botulism, according to the CDC. But today, it’s fatal in less than 5 percent of cases.

Infants with botulism are treated similarly to adults. The antitoxin drug BabyBIG® is usually given to infants in the United States. Most infants that get botulism make a full recovery.

You can reduce your risk of developing botulism by following these food-safety habits from the CDC:

• Keep canned or pickled food refrigerated.
• Refrigerate all leftovers and prepared foods within 2 hours of cooking or 1 hour if the temperature is more than 90°F (32°C).
• Keep baked potatoes in foil above 150°F (66°C) until served.
• Avoid eating food from leaking, bulging, or swollen containers.
• Keep homemade oil containing garlic and herbs in the refrigerator for no more than 4 days.

For infants and babies under 12 months, the best way to prevent botulism is to avoid giving them honey. Even a small taste can be dangerous.

Botulism is a rare but potentially fatal illness that affects your nervous system. Infants are at the highest risk of developing botulism.

Honey is a common cause of botulism in babies under 12 months old. Children under 1 year of age shouldn’t be given any type of honey due to the risk of botulism.

If you think that you, your child, or someone else may have botulism, it’s important to seek immediate medical attention.