Welcome to the Infant Botulism Treatment and Prevention Program

Laboratory Diagnosis

The disease infant botulism is first suspected based on clinical features of the infant patient (12 months of age or younger). Symptoms such as poor feeding, droopy eyelids, constipation and lethargy, together with hypotonia and loss of head control, should prompt physicians to consider botulinum toxin as the causative agent. Accordingly, laboratory testing needs to be performed without delay to establish the diagnosis. Prompt laboratory diagnosis of infant botulism is helpful for patient management and excludes the possibility of fatal degenerative neuromuscular diseases.

The laboratory diagnosis of infant botulism is a two-step process. The first step is to perform a direct toxin analysis. This requires the extraction of toxin directly from the fecal specimen and the use of specialized techniques to identify and type the toxin. The second step varies between laboratories, some laboratories use PCR techniques to identify Clostridium botulinum in the feces, while others culture the feces using specialized media and techniques in order to isolate C. botulinum.

Stool, enema or rectal wash specimens for diagnostic testing (serum not needed) from California in-patients and out-patients with suspected infant botulism may be submitted to the IBTPP laboratory only after consulting with the IBTPP physician-on-call. California physicians seeking such testing for their patients should contact the IBTPP at (510) 231-7600. For non-California physicians, please contact your State public health department for instructions. All state health departments now have 24/7 telephone numbers.

California health care providers click here for current lab send out instructions.

For more information on specimen collection, please visit our specimen collection page for laboratory scientists at /laboratorian/collection.php.

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