First confirmed case of infant botulism in Africa, caused by a dual-toxin-producing Clostridium botulinum strain

Abstract

Botulism, a rare life-threatening toxemia, is probably underdiagnosed in all of its forms in Africa. This study reports the first laboratory-supported case of infant botulism on the African continent. A 10-weekold, previously well infant presented with progressive global weakness, feeding difficulty, and aspiration pneumonia. During a lengthy hospitalization, a rare bivalent Clostridium botulinum strain, producing subtype B3 and F8 toxins and with a new multilocus sequence type, was isolated from stool. The infant was successfully treated with a heptavalent botulinum antitoxin infusion and pyridostigmine. Despite the relative rarity of infant botulism, this case illustrates the importance of maintaining a high level of clinical suspicion when assessing hypotonic infants. The value of modern diagnostic modalities in identifying and characterizing this under-recognized condition is also demonstrated.

Medical-grade Spore-free Natural Honey is an Effective Choleretic in Neonatal Cholestasis: A Pilot Single-center Trial

“…22 No cases of infant botulism have ever been reported in Africa, and the only case of infant botulism reported in Africa was confirmed to be not caused by honey. 23,24 No cases of infant botulism or flaccid paralysis have been reported (botulism is a reportable disease in Egypt), 25,26 while the average annual incidence of infant botulism in Argentina is 2.2 per 100,000 live births 27 and that in the United States is 2.1 per 100,000 live births. 28 We advise strict analysis for botulinum spores in honey prior to its use in infants with cholestasis.…”

New Modified Recombinant Botulinum Neurotoxin Type F with Enhanced Potency

“…Although rarely responsible for Botulism cases in humans, the serotype F botulinum neurotoxin family encompasses a high sequence diversity with strains isolated from different sources and geographical sites. For instance, recently, two foodborne cases were reported: the first in an infant in Africa from a rare bivalent Clostridium botulinum strain, producing subtype B3 and F8 toxins [26], and the second in an adult caused by type B and F [27]. These differences translate especially in differential substrate recognition and cleavage mechanism [2,19,20].…”