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Seven-Year Case-Control Study in California of Risk Factors for Infant Botulism.

Mayuri V Panditrao1, Haydee A Dabritz1, N Neely Kazerouni1

  • 1Infant Botulism Treatment and Prevention Program, California Department of Public Health, Richmond, CA.

The Journal of Pediatrics
|July 10, 2020
PubMed
Summary
This summary is machine-generated.

Infant botulism risk factors in California included slower intestinal transit time (≤1 bowel movement/day) in infants under two months old. Other identified factors varied by control group and infant age, with few consistent associations found.

Keywords:
Clostridium botulinumbirth orderbotulinum toxinbreastfeedingconstipationformula feedingmultivariate analysispediatric infections

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Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Infant botulism is an intestinal infectious form of human botulism.
  • The condition was first recognized in California in 1976.

Purpose of the Study:

  • To identify potential risk factors for infant botulism.
  • Investigate factors in the years following its initial recognition.

Main Methods:

  • Case-control study involving 159 infant botulism cases and 318 healthy controls.
  • Comprehensive questionnaires (>300 factors) and age-stratified logistic regression analyses were used.
  • Two control groups were utilized: neighborhood controls and county controls.

Main Results:

  • Slower intestinal transit time (≤1 bowel movement/day) was associated with infant botulism, except in the ≤2-month-old county controls group.
  • Risk factors differed based on infant age and the type of control group used.
  • Factors like birth order >1, cesarean delivery, and windy residence area were associated with illness in some analyses.

Conclusions:

  • Slower intestinal transit time is a significant risk factor for infant botulism.
  • Few consistent physiologic, environmental, or maternal factors were identified across all analyses.
  • The study highlights the complexity of identifying risk factors for infant botulism.