A 5-month-old baby who was taken to Hadassah Ein Kerem yesterday (Sunday) by his parents, showing signs of paralysis and extreme weakness, was diagnosed by a pediatric gastroenterologist with botulism - a disease that is very difficult to diagnose, and is considered rare in Israel.
"I noticed symptoms that were very consistent with the disease, and even though it hadn't been diagnosed in Israel for years and there had been no such cases, I immediately thought in that direction," says Dr. Mordechai Slay, director of the Pediatric Interventional Gastroenterology Unit at Hadassah.
"The baby was lying weak and crying quietly, barely able to swallow anything. When I checked his reflexes, I discovered that he had no reaction at all and could barely communicate.".
The symptoms, coupled with the baby's young age, aroused Dr. Slay's immediate suspicion, and he approached the parents to ask if their son had eaten honey.
"The answer was positive, and I realized that we had probably reached the correct diagnosis," he describes.
"Botulism is caused by a toxin from the botulinum bacterium, which is found in spores in soil and water, and can appear in foods that have not undergone appropriate heat treatment, such as canned food or untreated food. Most parents are familiar with the unequivocal instruction from pediatricians not to give honey to children under one year old, because it may also contain botulism spores," explains the doctor - who, although he had finished his shift, refused to leave the hospital until the case had been investigated more thoroughly.
Dr. Slay, along with Dr. Oren Gordon, a pediatric infectious disease specialist at Hadassah, began performing specialized tests to detect the bacteria. A stool sample was sent from Hadassah to the Biological Institute. At the same time, after the baby's condition deteriorated and the paralysis spread throughout his body, he was transferred to the pediatric intensive care unit, where he received an antidote and was monitored around the clock.
The lab results came back positive, confirming the suspicions - and the case was reported to the Ministry of Health.
"This is the first time I have encountered a botulism patient. Until now, I only knew the symptoms from the medical literature, and the case is very serious and painful," concludes Dr. Slay. "I urge all parents to follow the pediatricians' instructions and not give honey at all to babies under one year old. Not even a taste!
""Under the age of one, babies are more susceptible to this infection, and it is particularly aggressive and their bodies are unable to overcome it. The consequences can be extremely severe.".
Dr. Adi Aran, a senior physician in the pediatric intensive care unit at Hadassah Ein Kerem, says that this is not a short recovery process. "The muscle weakness can continue to progress and paralyze the airways, so in parallel with the administration of the antidote under close supervision, he is receiving respiratory support and is closely monitored. This morning his condition improved slightly, and we still have a long road ahead of us to recovery.".
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