Epidemiologic Characteristics of Infant Botulism in the United States, 1975-1978

Most cases occurred in the western states, with the majority in California and Utah, where active surveillance is in progress. Most of the cases reported have occurred in the fall months, but this pattern may be attributable to a reporting artifact. The me-dian age at onset of illness was 10 weeks, with a range of three to 35 weeks. The case-fatality ratio was 3.7 % (3 of 81). CDC has developed a reporting form for case inves-tigation and has encouraged private physicians and state and territorial epidemiolo-gists and laboratory directors to keep active surveillance of cases of infant botulism. State health departments and CDC are available for consultation regarding suspected cases of the illness. In mid-1976, infant botulism was diagnosed and recognized.as a distinct clinical entity when four infants in California became ill with a syndrome of muscular paralysis with subsequent recovery [1]. The diagnosis was made by identifying botu-linal toxin and Clostridium botulinum organ-isms in their fecal specimens. The data presented here are derived from case reports received by the Center for Disease Control (CDC) of botulism in infants with onset of illness between January 1, 1975 and July 31, 1978. An infant with the ap-propriate neurologic syndrome from which botu-We thank the following for their contributions: Daniel Brand and Richard Swanson of the Emergency Operations Branch, Food and Drug Administration, for their assistance in the investigation of suspect cases; Dr. Charles Hathe