Association Between Honey Consumption and Infant Botulism

Abstract

Infant botulism, a disease that results in a blockade of voluntary motor and autonomic functions, was first recognized in the United States in the late 1970s. Since then, more than 1000 cases in this country have been reported to the Centers for Disease Control and Prevention (CDC). Numerous studies have shown that the ingestion of honey is linked with infant botulism. In addition, honey samples across the United States have tested positive for Clostridium botulinum spores and toxins. Such substantial evidence led the CDC to recommend that honey not be given to infants younger than 12 months old. It is important that clinicians be familiar with this risk and should not recommend honey-containing products or supplements or the use of honey as a flavoring agent for infants in this age group.

Management of upper respiratory tract infections in children

“…35 Honey should not be given to infants under 12 months of age, however, because of a real danger of infant botulism. 36 The promotion of hand washing in households significantly reduces the incidence of both respiratory and gastrointestinal infections in children from both impoverished and wellresourced communities. 8,37 Parental smoking exacerbates respiratory infections in children and predisposes to asthma.…”

Infant botulism

“…[36][37][38] The mouse neutralization assay is used to test for the presence of toxin in feces or the serum. Therefore, serum and fecal specimens should be collected as soon as the diagnosis of botulism is suspected.…”

“…[43][44][45] A controversy exists regarding the sensitivity and specificity of EMG depending on the point in course of the illness and the timing and amount of nerve stimulation. 37,45 Because of the unique clinical findings and the availability of toxin assay, the painful EMG testing is not usually performed.…”

“…36,37,50 Furthermore, exposure to honey has been implicated as a significant risk factor for type B IB. 50 A survey of honey samples not associated with cases of IB found that 7.5% contained C. botulinum, toxin producing type A or type B or both.…”

Contamination of honey produced in the Republic of Kazakhstan with Clostridium botulinum

“…Moreover, samples of honey in the United States have tested positive for C. botulinum spores and toxins. Given such evidence, the Centers for Disease Control and Prevention have issued a special recommendation that honey should not be given to children under the age of 12 months (25). In California, 29.2% (12/41) of hospitalised botulism patients had been fed honey prior to the onset of constipation; worldwide, honey exposure occurred in 34.7% (28/75) of hospitalised cases.…”