Infant botulism is the systemic disease that results when spores of Clostridium botulinum germinate in an infant's intestinal tract and produce botulinal toxin that is absorbed.1 The natural habitat of C botulinum spores is soil and water. It is puzzling that exposure to the spores is probably universal, yet infant botulism occurs rarely (only 188 laboratory-confirmed cases were reported to the Centers for Disease Control, Atlanta, from 1975 through 19802).
Three toxin types—A, B, and E—are the principal causes of human botulism. Before this report, C botulinum type F had been identified as causing human disease in only two outbreaks—both of food-borne botulism.3,4 Type F C botulinum spores have rarely been isolated from natural sources. Five of six published microbiology reports noted that the organism was found in samples taken from fresh or salt water, whereas neither of the two human outbreaks was related to water