An alarming 50% increase in the number of potentially fatal infant botulism cases in California last year has prompted state health officials to renew warnings about the danger of feeding honey or corn syrup to babies.
The state's Department of Health Services reported that there were 48 cases of infant botulism in 1984, an illness resulting from the ingestion of Clostridium botulinum spores. Symptoms include constipation, listlessness, poor feeding, a weak cry and loss of head control resulting from a form of paralysis. The advance stages of infant botulism could precipitate a sudden stop in breathing and, soon thereafter, crib death.
There is some uncertainty about the various sources for this type of infection, but the most common vehicle seems to be honey.
"We know that a substantial portion of these cases was due to the increased (feeding) of honey to infants," said Dr. Stephen Arnon, a senior investigator with the Infectious Disease Section of the Health Services Department.
A report of the problem was recently published in California Morbidity, a newsletter distributed throughout the medical community by state health officials. Twenty-nine percent of those infants diagnosed with the problem had consumed honey before succumbing to botulism, according to the report.
Although those infected included members of all racial and ethnic groups, the link with honey was particularly acute among Latinos and Asians.
"Approximately 40% of the Hispanic and Asian patients had been fed honey before onset of illness," the newsletter stated.
In the cases where honey was associated with the illness, identical C. botulinum spores were isolated from both the patients and jars of honey found in the home.
The connection between infant botulism and corn syrup was not as strong.
"One-third of all (Latino and Asian) patients had been fed corn syrup . . . before onset of illness; C. botulinum was not isolated from 18 bottles of corn syrup that were tested," according to report.
Arnon speculates that the increase in infant botulism in California is attributable to young mothers being uninformed about the problem.
"Even though the fact that C. botulinum spores are present in honey was announced in 1979 and there was a lot of publicity at the time and since, this information is not reaching the people needing to know, especially the Hispanic and Asian mothers," Arnon said.
While the link with infant botulism and honey has been well documented, there are still many incidents where doctors cannot locate the source of the spores. In fact, health officials are in the midst of discussing whether babies on formula or those breast-fed are more likely to encounter the illness. However, Arnon and his colleagues believe breast-feeding offers infants a form of immunity against botulism.
Another problem in trying to prevent cases of this debilitating disease is getting proper diagnoses.
"The signs are very non-specific at the outset and very tough to diagnose," Arnon said. "The mothers will notice that their babies are not acting normal and the doctor will examine them and often may conclude that the sick infant is just a quiet baby. So, botulism can be difficult to pick up on the first visit to the doctor."
None of the cases reported in the state last year proved fatal. However, hospitalization was lengthy, with stays ranging from seven days to as many as 92. The estimated medical costs for the 48 cases reported in 1984 were $1.8 million.
Bee Placebo--Athletes and others attempting to increase physical prowess have turned to all sorts of questionable nutritional supplements. One of the currently popular items is bee pollen, which is available at most health food stores.
Researchers at Lander and Guilford Colleges in Greensboro, N.C., examined the purported value of the substance and were not stung with the results.
"After double-blind tests involving 46 normal, healthy adults, researchers . . . could find no significant differences in six categories of physiological performance between individuals given capsules containing bee pollen and those receiving visually identical capsules containing granulated brown sugar," according to a report of the study by the National Council Against Health Fraud. "The researchers concluded that claims by proponents that bee pollen enhances physical fitness or energy levels 'remain unsubstantiated by valid scientific research and are apparently exaggerated.' "
A Thin Danger--Those whose opinions sail against the prevailing wind can be found in all professions, but it's especially troubling to find a credible lone voice in the medical profession. Such was the case when Paul Ernsberger, a Cornell University Medical College professor, sharply criticized a National Institutes of Health report that targeted obesity as a "killer disease."