Baby botulism outbreak: FDA still doesn’t know cause—or how to prevent it

Post content hidden for low score. Show…

Oldmanalex

Ars Legatus Legionis
11,926
Subscriptor++
the cost of having your baby in NICU on a respirator for weeks is absolutely devastating
Not to mention that some adults actually care about their children, and kind of get bent out of shape when the kid spends a week at death's door. In my defense, I am simply observing this behavior; I would not want RFKJr, dope supplier to his closest younger relatives, to think that I am condoning it.
 
Upvote
17 (17 / 0)

Oldmanalex

Ars Legatus Legionis
11,926
Subscriptor++

"—or how to prevent it"​

Easy. Do what large number of PRC parents who preferred their offspring to consume as little melamine as possible – yep looks like you have arrived at the same dismal point just from the other side — buy your formula from nations who take care not to poison or otherwise harm their most valuable asset viz their children.

The quantity of formula purchased by PRC parents from AU and NZ manufacturers was prodigious. Definitely on every pre-covid PRC tourist's shopping list.

Your kids, your their funeral. Unfortunately.
And the melamine suppliers became organ donors; not voluntarily. Mercifully, we are not looking for that degree of accountability, but a smidge of repercussions might be optimal.
 
Upvote
0 (0 / 0)
Also I don't think most people realize how toxic botulism is. Like the lethal dose is so low that failing to detect it in a sample from a large vat of something wouldn't really mean much I don't think.
Slight confusion here ...

We're not talking about the botulinum toxin here, which is indeed almost unimaginably toxic, but rather spores of the underlying bacterium that can produce the toxin.

See also the above by Person_Man:

Typically botulism spore testing isn't needed because adult digestive systems aren't a suitable environment to grow and produce toxin. Infants on the other hand are, so any food going to infants should require botulism testing.
 
Upvote
12 (12 / 0)
Slight confusion here ...

We're not talking about the botulinum toxin here, which is indeed almost unimaginably toxic, but rather spores of the underlying bacterium that can produce the toxin.

See also the above by Person_Man:
Interesting, though that's probably worse I would assume? Like a couple of spores would also be extremely bad? Or does it take a lot of spores to make a little of the toxin?
 
Upvote
2 (2 / 0)

balthazarr

Ars Tribunus Angusticlavius
6,963
Subscriptor++
I didn't say it was a-okay. I'm just pointing out that when talking about outbreaks of disease in a large modern community, we generally tailor our adjectives according to a rough scale, and I felt 'devastating' was high on the scale for this case in this context, i.e. implications for public health. That's all.

Obviously very many lesser things can be devastating to individuals, and the word can also be used in contexts where the same implications are not present.

Anyway, I quibbled over the use of a word. If that implies something wrong with me, I am hardly alone in these forums.
Okay, sure, but this is not what you said in your original post.

If you're going to be a pedant, complaining about others' use of words, then don't be surprised when the community you're complaining in holds you to that same standard.
 
Upvote
20 (20 / 0)

MilanKraft

Ars Tribunus Angusticlavius
7,008
Well, I mean, RFK doesn't believe bacteria cause illness, so this result is no surprise. If babies get botulism, they should just crawl it off. [emphasis mine]

"Doz baby are sofff."
soff.jpg




(Note: A joke only hockey fans will understand. Apologies. It's the best I've got in a world where the Stanley Cup Finals are Las Vegas vs. Carolina. The end is nigh, but at least it's not TB or FLA.)
 
Upvote
-1 (1 / -2)
Interesting, though that's probably worse I would assume? Like a couple of spores would also be extremely bad? Or does it take a lot of spores to make a little of the toxin?
Not really.

The spores are notoriously difficult to kill, and are commonplace. But it takes just the right conditions for them to develop into the active bacterium, which then produces the botulinum toxin.
 
Upvote
7 (7 / 0)
Interesting, though that's probably worse I would assume? Like a couple of spores would also be extremely bad? Or does it take a lot of spores to make a little of the toxin?
In the case of food borne toxin the bacteria may have had a considerable time to build up a considerable amount of toxin. It commonly occurs with poorly preserved foods that are then stored for long periods. Consume enough at once and you may well die too fast to even realise you need to seek medical help.

In the case of infantile botulism the infant will slowly sicken, giving reasonably attentive parents living in a place with a modern health care system a good chance of getting treatment before it becomes lethal.
 
Upvote
7 (7 / 0)

Person_Man

Ars Tribunus Militum
1,544
Subscriptor
In the case of food borne toxin the bacteria may have had a considerable time to build up a considerable amount of toxin. It commonly occurs with poorly preserved foods that are then stored for long periods. Consume enough at once and you may well die too fast to even realise you need to seek medical help.
The important factor is lack of oxygen is a requirement. The spores won't grow in the presence of oxygen. This is why under processed low acid canned foods are known for it. That said, commercial canneries are well aware of this, and they instill the fear into everyone working there and there are redundant checks on everything to make sure this doesn't happen. Home canning is a far more likely source of botulism toxin.
 
Upvote
11 (11 / 0)

graylshaped

Ars Legatus Legionis
68,646
Subscriptor++
Yes. But isn’t that a consequence of our “health care” system, more than of botulism per se?
It's a cost of regulating agencies not being given the resources, mandate, and guidance to help identify risks in the supply chain, leaders of companies who see a few sick infants as a reasonable cost of business, and a public with a short span of attention.

For example, a Boar's Head commercial on TV will make me change the channel.
 
Upvote
13 (13 / 0)

Arstotzka

Ars Scholae Palatinae
1,261
Subscriptor++
I came down to make sarcastic references to the babies clearly being deficient in crossfit exercise and raw beef, but I see I've been beaten to the punchline many times over. Gotta be quick with this crowd.

(Also, how bleak are things that morbid humor is a common coping mechanism to deal with the malicious incompetence of American leadership.)
Morbid humor has been a common coping mechanism long before the current American leadership’s rise to power. It is left as an exercise for the reader to determine which era gallows humor dates from based on the name alone. If you need extra brain power to figure it out, try eating some gas station sandwiches in the hopes of contracting some good worms.
 
Upvote
-5 (0 / -5)

Readercathead

Ars Tribunus Militum
1,731
Subscriptor
The worst part is that many of these parents are probably going bankrupt from medical debt, and most of the babies are probably not getting the medical care and rehab etc that they need to grow up to be productive members of society. Some company needs to be at fault so it can be sued for damages; that money is badly needed in a country without universal health care and with high unemployment. This round-robin finger pointing is like being maimed by a hit-and-run driver. The executives should be in jail: companies pay them such exorbitant packages because of the enormous responsibilities they have, right?
 
Upvote
5 (5 / 0)
In the void, three companies at the center of the investigation are left pointing fingers at each other, with none publicly taking responsibility for the contamination.

Of course not. They'd immediately get sued if they did even if they had done the responsible thing and carried out a thorough internal investigation regardless of its findings. That's just the world we live in. Do the right thing, get sued. Do the wrong thing, get sued. Do nothing, get sued for doing nothing.

“Even though there are several hypotheses, investigational findings could not identify the source or root cause of contamination of the powdered infant formula,” the agency concluded.

Sometimes it's so simple as someone, despite following all proper procedures, still just tracked in a few spores off their clothes which fell somewhere that would eventually make it into the formula the infants drank. No one in the public, due to completely understandable cynical distrust of corporations, individuals, and institutions would believe it even if it were 100% factual and could be proven to be accidental and no way to actually prevent such a thing in the real world.

Reading through some of the comments tends to reinforce my point. "If only... not Trump... Jr. ..." So on. Yes, all that adds into the conspiracy theories about an incompetent system. Might even be true! But even if it weren't true, sometimes entirely transient phenomena can't be traced to a source, because they occur once and don't leave documentary evidence behind, despite the odds being against it. But partisans wouldn't believe it even if were in fact a transient event with or without evidence. Conspiracy theory isn't the sole purview of the hard right or left.
 
Upvote
3 (3 / 0)

graylshaped

Ars Legatus Legionis
68,646
Subscriptor++
The worst part is that many of these parents are probably going bankrupt from medical debt, and most of the babies are probably not getting the medical care and rehab etc that they need to grow up to be productive members of society. Some company needs to be at fault so it can be sued for damages; that money is badly needed in a country without universal health care and with high unemployment. This round-robin finger pointing is like being maimed by a hit-and-run driver. The executives should be in jail: companies pay them such exorbitant packages because of the enormous responsibilities they have, right?
You're way over-thinking this.

ByHeart holds this bag. It is welcome to pursue subrogation to its vendors for their failures. That mistakes and over-confidence led to injuries may or may not be a criminal violation is irrelevant to that notwithstanding consideration for changes to laws to address any deficiencies. Other companies using these suppliers should have already looked very hard at other options.

The arrogance and stonewalling by the company is disgusting and should result in their disappearance from all self-respecting stores until and unless there is a full accounting for their negligence at all stages of this process.
 
Upvote
11 (11 / 0)

Jupitor13

Ars Tribunus Militum
1,626
Subscriptor
It is infuriating we have the worst healthcare system in the civilized world. When I bring this up with my Mississippi workmates, they cry THAT'S SOCIALISM!

Mexico is rolling out Universal Healthcare, scheduled to go on line 2027.

And (while I'm bitching) I am so FN tired of hearing "The richest nation in th world...".
 
Upvote
8 (10 / -2)
It is infuriating we have the worst healthcare system in the civilized world. When I bring this up with my Mississippi workmates, they cry THAT'S SOCIALISM!
well actually, the US has the best healthcare in the world, if you can afford it. The rich mostly come to the US for care because they can. The best here are the best in the world. The rest can be spotty.

Of course, there are good docs all over the world. But there are more of them in the US, and the ones here are also better because they see lots of patients. That's the medical virtuous cycle at work.

And in general don't go to the hospital when the new residents come in (chaos) or around holidays (because the B-team is there).
 
Upvote
-11 (1 / -12)

Jupitor13

Ars Tribunus Militum
1,626
Subscriptor
well actually, the US has the best healthcare in the world, if you can afford it. The rich mostly come to the US for care because they can. The best here are the best in the world. The rest can be spotty.

Of course, there are good docs all over the world. But there are more of them in the US, and the ones here are also better because they see lots of patients. That's the medical virtuous cycle at work.

And in general don't go to the hospital when the new residents come in (chaos) or around holidays (because the B-team is there).
Actually the US doesn't have a healthcare system. We have health insurance which is a financial instrument. You buy it, use it and pay a deductable, and if the care is covered, the insurer will pay 80%. Damn this is just like auto insurance, or house insurance.
 
Upvote
12 (14 / -2)
People forget that the CDC, when they looked at the infant formula infections during the Biden administration, never were able to link the bacteria in the field to any part of the production process. They found a lot of issues, but no direct path.

This is good, because that means that whatever processes in place are hitting over 99%. The bad thing is that things that do get through can be incredibly difficult to hunt down.
 
Upvote
9 (9 / 0)
Actually the US doesn't have a healthcare system. We have health insurance which is a financial instrument. You buy it, use it and pay a deductable, and if the care is covered, the insurer will pay 80%. Damn this is just like auto insurance, or house insurance.

Well it's actually not insurance, it's cost sharing; it's not like auto or home insurance at all. They call it insurance because overloading the word "insurance" helps them sell it.

If you think single payer is great, WaPo just had a story about some dude in England who had penis worms for 40 years before the NIH diagnosed it. It sounds like Beth got scooped on this one.

https://www.washingtonpost.com/heal...doctor-visits-one-question-changed-everything
 
Upvote
-12 (1 / -13)

AdamM

Ars Praefectus
5,942
Subscriptor
I can't REALLY blame them. Even the tiniest crack the facade of perfection will open them up to tremendous legal liabilities, so there is very strong incentive NOT to look hard to find mistakes, because even an internal investigation can leak. This is a huge downside of the litigious and wildly unpredictable culture in the US and the ability for courts to grant absolutely devastating fines in some cases, while not taking any meaningful action in others.
In a regulatory system that doesn't regulate effectively and hands out the metaphorical equivalent of a stern look when companies don't follow the watered down rules we do have, it shouldn’t be surprising in the slightest that people run to the courts when they suffer injury. Especially when their medical bills may exceed the fine handed down by the “regulator”.

In the absence of an adequate regulatory system and universal healthcare, people are going to seek their pound of flesh through the courts.

In terms of internal investigations, we shouldn't be relying on the company to tell on itself in the first place.
 
Last edited:
Upvote
4 (4 / 0)

DarthSlack

Ars Legatus Legionis
23,494
Subscriptor++
Well it's actually not insurance, it's cost sharing; it's not like auto or home insurance at all. They call it insurance because overloading the word "insurance" helps them sell it.

If you think single payer is great, WaPo just had a story about some dude in England who had penis worms for 40 years before the NIH diagnosed it. It sounds like Beth got scooped on this one.

https://www.washingtonpost.com/heal...doctor-visits-one-question-changed-everything

Congratulations, you found one story where the healthcare system got it wrong. Now compare that to US outcomes, particularly for people who can't afford insurance.
 
Upvote
17 (17 / 0)
Well, I mean, RFK doesn't believe bacteria cause illness, so this result is no surprise. If babies get botulism, they should just crawl it off.
I have a suggestion: Let's make RFK Jr. eat this stuff, the known contaminated product, and then he can just crawl off...permanently.
 
Upvote
2 (2 / 0)

justsomebytes

Wise, Aged Ars Veteran
214
Subscriptor
Upvote
2 (3 / -1)

Shavano

Ars Legatus Legionis
69,446
Subscriptor
FWIW, my background is in canning and food processing and know a bunch about botulism. It sounds like the companies were probably doing everything they're supposed to, but the regulations need updating. Botulism spores are extremely hardy and drying alone isn't likely enough heat to inactivate them. Starting with just pasteurized milk wouldn't be good enough, but UHT milk would be. The UHT process goes well above the time/temp to inactivate the spores. Also, testing alone for spores doesn't guarantee they aren't there, it just guarantees they aren't in the test that you performed. So from my perspective, I think all the raw materials going in (If they aren't already) must go through some sort spore killing heat step and remain in a clean through packaging.
My hope is they bring in experts to look at the entire supply chain going into the formula and update requirements for each ingredient and the final mix. I'm certainly not that expert, but I know enough to see what is likely the problem.
Or decontaminate the end product either before or after it's packaged. After is safer but probably more expensive.
If it really was introduced in the last step of the process, then there really isn’t anything that the milk provider did wrong or could do to prevent it.
text of the story says otherwise.
"Strains of C. botulinum isolated from some of the sick infants were genetically linked to strains found in ByHeart’s formula, which were also linked to strains found in powdered whole milk used in the formula."
I think the lawyer has the right idea: go after ByHeart. The buck stops there. If they believe that their supplier provided milk contaminated with botulism, then ByHeart can go after their supplier to recoup some of their losses, but it doesn’t let ByHeart off the hook.
Sue all of them. The law is that if any of their negligence contributed to the harm, they're all liable.

The FDA also should be shutting them all down until they can demonstrate that they've taken action to prevent further harm.
Do what large number of PRC parents who preferred their offspring to consume as little melamine as possible – yep looks like you have arrived at the same dismal point just from the other side — buy your formula from nations who take care not to poison or otherwise harm their most valuable asset viz their children.
I thought the most valuable asset was measured in tokens these days.
 
Upvote
2 (2 / 0)

AliSard

Wise, Aged Ars Veteran
189
Subscriptor
I'm not sure I like the word "devastating" in "the devastating outbreak of botulism in babies" in that as far as I can see no babies died - and as I understand it botulism doesn't typically have major damaging sequelae for survivors (and none seem to be mentioned in the links I have seen).

That's not intended to be an argument for carelessness with infant formula - just an argument for precision with words.
Speaking as a parent:

Shove a flamethrower up your ass.
 
Upvote
3 (5 / -2)

Basil Wrathbone

Smack-Fu Master, in training
28
The current U.S. regime has slashed the budgets of the CDC and NIH and repurposed the FDA in much the same way it has the IRS. The welfare of the many, and their babies, is not on the current agenda, and never will be until Americans decide that changing that agenda is worth looking up from their screens. Until then, we'll have the leaders, government, and society we deserve: the worst we're willing to tolerate.

Ask a woman or any member of any minority: you get what you tolerate. Ultimately, if you submit to it, you're responsible for it.
 
Upvote
2 (2 / 0)

jhodge

Ars Tribunus Angusticlavius
8,743
Subscriptor++
FWIW, my background is in canning and food processing and know a bunch about botulism. It sounds like the companies were probably doing everything they're supposed to, but the regulations need updating. Botulism spores are extremely hardy and drying alone isn't likely enough heat to inactivate them. Starting with just pasteurized milk wouldn't be good enough, but UHT milk would be. The UHT process goes well above the time/temp to inactivate the spores. Also, testing alone for spores doesn't guarantee they aren't there, it just guarantees they aren't in the test that you performed. So from my perspective, I think all the raw materials going in (If they aren't already) must go through some sort spore killing heat step and remain in a clean through packaging.
My hope is they bring in experts to look at the entire supply chain going into the formula and update requirements for each ingredient and the final mix. I'm certainly not that expert, but I know enough to see what is likely the problem.
Sounds like an ideal case for irradiation.
 
Upvote
3 (3 / 0)
Congratulations, you found one story where the healthcare system got it wrong. Now compare that to US outcomes, particularly for people who can't afford insurance.
the recent medical drama "the pitt" brings up the cost issue multiple times including some super gross stuff where the patient tried to wait it out before finally going to ER because they don't have a regular doc or can't afford their copays

i broke my shoulder a few years ago and had to get multiple xrays and 2 MRI and 3 rounds of PT, it took two years to finally fix it and probably would have cost at least $20k out of pocket because insurance is garbage, but i was unemployed on medicaid so the only thing i had to pay for was renting the ice water sleeve thing for post-surgery recovery
 
Upvote
1 (1 / 0)

Person_Man

Ars Tribunus Militum
1,544
Subscriptor
Sounds like an ideal case for irradiation.
Indeed, it would work well. But when it comes to baby food, irradiation isn't going to be perceived as safe for babies regardless of the facts. The granola crowd will freak out that the big companies are making their babies radioactive. Same reason why GMOs aren't in baby food.
 
Upvote
1 (1 / 0)