Wednesday, May 01, 2013

Infant Botulism case in the USA

Published Date: 2013-04-28 21:21:03
Subject: PRO/EDR> Infant botulism - USA (02): (KS) 
Archive Number: 20130428.1678643
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Wed 24 Apr 2013
Source: Topeka (KS) Capital-Journal [edited]

A mother took her 5-month-old son to Stormont-Vail Regional Health Center's breast-feeding clinic 12 Apr 2013 because he wasn't eating well, was unusually fussy and just wasn't acting like himself. Within 24 hours, the infant was in Stormont's pediatric intensive care unit, limp and weak, and finally needing a ventilator to help him breathe. As doctors filed in and out, eliminating possible causes of The rapid deterioration, both parents began to fear the worst.

Although it took more than a week for laboratory tests to confirm the finding, Muthukumar Vellaichamy, a Stormont-Vail pediatric critical care physician, and Daniel Katz, a Cotton O'Neil Clinic pediatric neurologist, were sure enough of their conclusion that they ordered the BabyBIG botulism antitoxin delivered from California to combat infant's illness.

Infant botulism is caused when spores of _Clostridium botulinum_ are ingested by an infant, and germinate in the large intestine into the vegetative bacteria and produce botulin neurotoxin, according to a California Department of Health website. 

The antitoxin had a hefty price tag of $60 000, the mother said. The California Department of Health had to have a guarantee of payment before it could ship, and thankfully, she said, insurance covered $45 000 and the rest was written off. 

Vellaichamy said he saw a case of infant botulism when working in Wichita 2 years ago, and along with Katz, decided that was the most likely cause of the illness.

This case is just the 5th case of infant botulism reported to the Kansas Department of Health and Environment in Kansas since 2002.

Vellaichamy said he expects the infant to have a full recovery, since infant botulism rarely causes long-term effects.

[Byline: Morgan Chilson]
Comment: I am not sure why we in India do not see cases of Infant Botulism, is it being misdiagnosed as sepsis?
Also the price tag of medicines in USA appears to be highly inflated, USD 60,000 for BabyBIG (Infant botulism anti-toxin) translates to more than INR 30 lakh !

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