Health chiefs issue warning as lunchbox favourite is linked to deadly botulism that almost killed a baby

Daily Mail​

4 days ago

Health chiefs have issued a warning after a baby who ate peanut butter contaminated with deadly bacteria spent six weeks in hospital.
The child was diagnosed with infant botulism, a life-threatening condition caused by toxins produced by Clostridium botulinum bacteria.
According to the World Health Organization (WHO), these toxins are among the most lethal substances known because they can block nerve functions and cause respiratory and muscular paralysis.
The recent case was described in Eurosurveillance, Europe's journal on infectious disease surveillance, epidemiology, prevention and control.
It revealed that a six-month-old baby in the UK fell ill in May last year after being fed peanut butter in an attempt to prevent it from developing a nut allergy.
The advice followed national guidance, first issued in 2018, which recommends introducing peanuts to babies at around this age.
However, the authors said: 'Nuts may become contaminated with Clostridium spores at agricultural source or during processing.'
The infant, after two weeks of constipation, suddenly developed extreme tiredness, a hoarse cry and noisy breathing, and struggled to eat.
The previously healthy baby had recently started on solids after being breastfed from birth.
In their report, the authors noted the child had also been exposed to dust and soil while playing in the garden.
While general tests came back normal, adenovirus and rhinovirus were detected in a nose and throat swab. Both viruses can cause respiratory illnesses ranging from the common cold to flu-like symptoms.
Initially, doctors suspected sepsis — a severe and potentially fatal reaction to infection — and began treatment with antibiotics.
By day five, however, the baby developed high-pitched wheezing, a drooping eyelid, reduced responsiveness to stimulation and head lag, where the head falls back when seated.
In a desperate attempt to find the cause of the illness, medics carried out multiple tests, but almost all returned normal results.
It wasn't until a special type of test called an electromyography revealed problems with the baby's muscles that botulism was suspected.
After consulting experts in the US, doctors ordered a human-derived Clostridium botulinum antitoxin (BIG-IV), on day five.
This is a human immunoglobulin—an antibody—developed to neutralise the botulinum toxin in infants.
However, on day six, the baby required intubation and ventilation due to worsening hypoventilation, which led to respiratory failure.
On day seven, stool samples were sent to a specialist laboratory at the UK Health Security Agency (UKHSA).
The following day, tests detected Clostridium botulinum type A, a foodborne bacterium capable of producing potent toxins.
The crucial BIG-IV antibody finally arrived at the hospital and was administered on day 10.
The baby was eventually able to breath on her own again on day 20 but required non-invasive respiratory for a further 10 days.
This was followed by intensive physiotherapy aided recovery before the infant was eventually discharged on 44.
When the baby was finally discharged from hospital, it still had 'head lag'—meaning its neck muscles were too weak to hold the head upright, causing it to flop backwards—as well as loss of balance and coordination.
Although the infant gradually regained muscle strength, constipation persisted until day 234.
Later, a used container of 'commercially prepared peanut butter' the baby had eaten ten days before the onset of symptoms tested positive for the deadly bacteria.
Further testing confirmed the bacteria in the container was identical to that detected in the infant.
'This is consistent with the peanut butter being the source of the infection,' the authors said.
They added: 'The product was made of roasted peanuts without addition of honey.'
Infant botulism, while serious, is rare.
There have only been 23 cases reported in the UK since it was first recognised in the US in 1977. It mostly affects infants under 12 months through ingestion or inhalation of bacterial spores.
Just last week, a man died and nine others were hospitalised in Italy amid a botulism outbreak.
Luigi Di Sarno, 52, died on August 7 after buying a broccoli and sausage sandwich from a street vendor on the Diamante seafront in the province of Cosenza.
Nine others, including several of Mr Di Sarno's family members, were taken to hospital with similar symptoms.
All showed signs of botulism, with two patients reportedly in a serious condition on arrival at intensive care.
Authorities have seized the food truck and opened an investigation into the spread of the toxin.
Officials have also ordered the immediate seizure of a commercial product, understood to be jars of broccoli in oil.