BOTULISM, INTESTINAL
(Formerly INFANT BOTULISM)

Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February, 2005)

I. IDENTIFICATION

A. CLINICAL DESCRIPTION: An illness of infants, characterized by constipation, poor feeding, and “failure to thrive” that may be followed by progressive weakness, impaired respiration, and death.

B. REPORTING CRITERIA: Clinical diagnosis in an infant with subsequent laboratory confirmation.

C. LABORATORY CRITERIA FOR CONFIRMATION:

  • Detection of botulinum toxin in stool or serum, OR
  • Isolation of Clostridium botulinum from stool.

D. CASE DEFINITION: A clinically compatible illness that is laboratory confirmed, occurring among children < 1 year of age.

II. ACTIONS REQUIRED / PREVENTION MEASURES

A. WISCONSIN DISEASE SURVEILLANCE CATEGORY I: Report IMMEDIATELY BY TELEPHONE to the patient's local health officer upon identification of a case or suspected case. Complete and mail an Acute and Communicable Disease Case Report (DPH 4151) to the local health officer within 24 hours.

B. EPIDEMIOLOGY REPORTS REQUESTED:

1. Acute and Communicable Diseases Case Report (DPH 4151).

2. Outbreak Investigation: Infant Botulism (CDC 52.73).

C. PUBLIC HEALTH INTERVENTION:

  • Clostridium botulinum spores are ubiquitous. Identified sources such as honey and possibly dark and light corn syrup should not be fed to infants.
  • Source investigation by LHD.

III. CONTACTS FOR CONSULTATION

A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-9009.

B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.

C. WSLH / BACTERIOLOGY: (608) 263-3421.

IV. RELATED REFERENCES

1. “Botulism, Infant” DPH Disease Fact Sheet Series, POH 4436:
View a list of all current Communicable Disease Fact Sheets

2. Heymann DL, ed. INTESTINAL BOTULISM, FORMERLY INFANT BOTULISM. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004: 69-75.

3. Pickering LK, ed. Botulism and Infant Botulism. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:243-246.

V. DISEASE TRENDS

The incidence of infant botulism is rare in Wisconsin . Between 1999 and 2003 there was only once confirmed case of infant botulism reported to the BCDP.