Arnon S S, Midura T F, Clay S A, Wood R M, Chin J
JAMA. 1977 May 2;237(18):1946-51. doi: 10.1001/jama.237.18.1946.
Clostridium botulinum organisms and toxin were identified in the feces of six infants, aged 5 to 20 weeks, who had illnesses clinically consistent with botulism. Five of the infants lived in California and became ill within a six-month period in 1976; one infant became ill in New Jersey in 1975. Three cases were type A botulism, and three were type B. No source of ingested botulinal toxin could be found in any case. However, one infant with type B botulism had ingested a food containing C botulinum type B organisms, and no toxin was found in it. The clinical findings in these cases include constipation, weak sucking and crying ability, pooled oral secretions, cranial nerve deficits, generalized weakness, and, on occasion, sudden apnea. A characteristic electromyographic pattern termed "brief, small, abundant, motor-unit action potentials" (BSAP) was observed. The sources of C botulinum toxin for these six infants is thought to have been in vivo (gastrointestinal) production following ingestion of C botulinum organisms. Studies are underway to determine the full clinical spectrum, incidence, and potential public health importance of this infectious disease newly recognized in infants.
在6名年龄为5至20周、临床症状符合肉毒中毒的婴儿粪便中，鉴定出了肉毒梭菌及其毒素。其中5名婴儿居住在加利福尼亚州，于1976年的6个月内发病；1名婴儿于1975年在新泽西州发病。3例为A型肉毒中毒，3例为B型。在任何病例中均未发现摄入肉毒毒素的来源。然而，1例B型肉毒中毒婴儿摄入了含有B型肉毒梭菌的食物，但其中未发现毒素。这些病例的临床症状包括便秘、吸吮和哭闹能力减弱、口腔分泌物积聚、颅神经功能缺损、全身无力，偶尔还会突然出现呼吸暂停。观察到一种特征性的肌电图模式，称为“短暂、小型、丰富的运动单位动作电位”（BSAP）。这6名婴儿的肉毒毒素来源被认为是摄入肉毒梭菌后在体内（胃肠道）产生的。目前正在进行研究，以确定这种新发现的婴儿传染病的完整临床谱、发病率及其潜在的公共卫生重要性。
