Babies, Botulism and Honey - Office for Science and Society
The young mother was surprised by the doctor's question. "What does your little girl eat for breakfast?" "Only hot oatmeal with milk," she answered. "Does she put any sugar on it?" the doctor queried. Now the lady became indignant. "We eat only whole, natural foods. No meat, no processed food, no sugar. Sugar is poison. We use only natural honey on the oatmeal." And with those words, she confirmed the doctor's suspicion. The little girl's baby brother who had been brought to the hospital suffering from some mysterious ailment had botulism poisoning!
It had been a bizarre case. The three-month-old baby suddenly stopped nursing and within four days his body became progressively floppy. He was practically lifeless by the time he was brought to emergency. At first, the doctors suspected spinal muscular atrophy, a rare neurological disease that is essentially a death warrant. This horrific disease, though, doesn't usually come on so suddenly. Such a rapid onset of symptoms smacks of poisoning of some sort. Botulism would explain the muscular flaccidity, but why was the mother unaffected? She swore the baby had no food other than breast milk. The doctor, however, was not so sure. That's what prompted the questions about the boy's sister. Yes, she did like to help with the baby, the mother divulged. Sometimes even pretended to feed him with an empty spoon! Now the lights flashed in the physician's mind. When the parents weren't watching, the little girl probably did more than pretend and treated the baby to a bit of her honey-laced oatmeal. Unfortunately, the honey was likely laced with the poison produced by the Clostridium botulinum bacterium.
This little scenario was eventually confirmed when laboratory tests revealed the presence of the toxin in the baby's serum and feces as well as in the jar of honey. The little boy eventually recovered although he spent five weeks on a respirator. That's what botulinum toxin can do to you. If you're lucky! Want to know how poisonous the substance is? Picture a grain of salt. Now imagine dividing this grain into roughly a million pieces. Each piece will weigh about one nanogram, the amount of botulinum toxin it takes to kill a human! How did the toxin get into the honey? Easily. Spores of this deadly bacterium are everywhere. They're in the earth, in the air and in the pollen and nectar the bees gather. And what are spores? Forms of the bacterium that are in a sort of "suspended state of animation." They do not feed and do not reproduce until they encounter the right conditions. Low acidity, moderate temperatures and the absence of oxygen make them come alive and start spewing out venom. It seems that conditions in the gut are favorable, but the bugs do encounter a problem. Other bugs! The human gastrointestinal tract harbors numerous species of bacteria which compete for food and luckily for us botulinum bacteria do not fare well and cannot establish themselves. Unless of course, there are few competing bacteria, as is the case in the immature gastrointestinal tracts of newborns. That's why children younger than one should not be fed bee regurgitation.
While adults don't have to worry about botulinum spores germinating in the digestive tract, we do have to be concerned about eating food in which the bacteria have multiplied and produced their toxin. In a classic case back in 1985, in Vancouver, thirty-seven people were poisoned when a restaurant used contaminated garlic to make garlic bread. Dirt that adheres to garlic bulbs commonly contains botulinum spores. If the cloves are stored under oil in an anaerobic environment, and the jar is kept at room temperature, the bacteria come alive and produce the toxin. When this enters the bloodstream it binds irreversibly to nerve endings and prevents the release of acetylcholine, the neurotransmitter that triggers muscle activity. The result is droopy eyelids, double vision, difficulty speaking and swallowing, progressive weakness, and, finally, paralysis of the chest muscles and respiratory failure. If the victim survives the initial onslaught of the toxin, recovery is likely because the affected nerves will eventually sprout new branches capable of acetylcholine release.
Ah, I can practically see you frowning out there. But be careful. Frown too much and those wrinkles between the eyebrows can become permanent. There is a treatment though. Doctors can inject tiny amounts of botulin into the muscles, paralyze them and make those wrinkles practically disappear! An ingenious use of a toxin, half a glass of which could kill the entire population of the world.
@JoeSchwarcz
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