Sarah Shrum Davis, One Health epidemiologist with NMDOH, tells parents what they need to know to keep their babies safe. She spoke with KC Counts. Here's a transcript of their conversation:
KC Counts:
So I think this was a shock to a lot of people to see botulism come up, which, we've become accustomed to botulism, but just the benign kind that we insert into our bodies so we can look younger, right? So why don't you start just by telling us what botulism is?
Sarah Shrum Davis:
Botulism is a bacteria. And what it does is in, at certain points, depending on a person's immune system or things like that, it can overgrow and produce a toxin. And so in the case of botulism, that is actually what makes you sick, is the toxin acting, rather than the bacterium themselves. So we don't take antibiotics for botulism. We actually have to administer an anti-toxin. And botulism is a very severe disease that can unfortunately result in really severe sickness and even death in some instances. We see botulism in a kind of a variety of settings, right? So very traditionally, you think of home canned goods. We have seen, a concern over botulism toxin being used in cosmetic procedures. And unfortunately, we also do see infants being susceptible to botulism because they don't have kind of the gut flora that older children and adults have. So it's really easy for the bacteria to overgrow and begin producing toxin at the levels we're talking about. This is why, like traditionally, it's recommended not to feed infants under one year old honey; because there's a concern that the honey can have the clostridium botulinum spores in it, and then can overgrow in the infant's gut flora and cause botulism. Unfortunately, in this instance, it is a known contaminated product, which is why, more than anything else from this interview, I want parents to be aware that they should not use any formula that was made by ByHeart.
KC Counts:
So how common is it that something like this would show up in infant formula?
Sarah Shrum Davis:
This is somewhat unusual. I've been working here for five years and this is the first botulism outbreak linked to infant formula that I've ever worked on.
KC Counts:
And we have no cases in New Mexico as of when we are having this conversation, which I'll say is Monday, November 17th, just after 2 o'clock in the afternoon. Things can change, I know, but so far so good, right?
Sarah Shrum Davis:
Yes, absolutely. However, botulism can take several weeks to develop in infants. So we really want to be sure that if parents have fed their infants this formula, that they are monitoring their infants for signs and symptoms and take them to seek medical care at the earliest signs.
KC Counts:
All right, well, let's talk about those signs and symptoms.
Sarah Shrum Davis:
Yeah, so in infants, a lot of times the first things people notice are constipation. They may have difficulty feeding, so like weak sucking, difficulty latching. They may begin to develop lack of head control. So you may notice the infant's head sort of flop to one side. They may also notice the baby becoming what many parents describe as floppy, kind of their limbs become a little bit, they're less able to control them. They may also notice things like drooping eyelids, decreased facial expression, and unfortunately, if untreated, this can progress to difficulty breathing and even respiratory failure leading to death. So we would want parents to take their infant to either an urgent care or an ER as soon as possible if they're noticing any of these signs or symptoms.
KC Counts:
Can you talk a little bit about what you know about finding things like this, how it's found, and generally speaking that we hope to find these things before they end up in the food supply, right?
Sarah Shrum Davis:
Absolutely. So that's always our goal with public health is to, prevent these kind of illnesses in situations like this. So, and it's difficult in a product like this where it's distributed nationwide and even online. So for this, CDC uses a nationwide surveillance system and they are able to look at cases of infant botulism from across the country, and we're able to see that there is this really strong signal that, you know, a number of recent infant botulism cases reported using this ByHeart brand. That led them to an investigation in conjunction with FDA to look at the product and ultimately issue a recall.
KC Counts:
I can imagine if I were a parent of an infant that no matter what brand of infant formula I had, I'd be feeling a little nervous at this point. So what's your advice?
Sarah Shrum Davis:
Absolutely. So as of this time, we do not have any indication that any other brands are implicated. They don't use the same sourcing, they don't use the same warehouse, anything like that. We, also at this time, do not anticipate that this will lead to any kind of formula shortage. This product represents less than 1% of the national market share for infant formula. So as of right now, the main message to parents is if you are using this, stop using it, switch immediately to another brand. Also, please wash anything, so like scoops, counters, anything like that may have come in contact with this product. Wash it with hot water and soap or run it through the dishwasher.
KC Counts:
All right, and a place to go for more information.
Sarah Shrum Davis:
Yeah, so folks can either look at the CDC outbreak investigation website, which is on cdc.gov. They can also look at the FDA investigation website. For example, if they want to see pictures of what the product looks like, places on the canisters where they can find the lot number, and that's at fda.gov. Or if they have any questions, they can always reach out to us at 1-833-796-8773, that's 1-800-SWNurse, to speak with an on-call epidemiologist.
KC Counts:
Sarah Shrum Davis, thank you so much for helping us understand this situation. Very nice to talk to you. Thank you.
Sarah Shrum Davis:
Great to talk to you as well.
