How is infant botulism transmitted?

• A. Ingestion of C. botulinum spores
• B. Ingestion of botulinum toxins
• C. Inhalation of spores
• D. Direct skin contact with spores

Answer: (A)

Infant botulism happens when a baby swallows spores of Clostridium botulinum. In the baby’s immature gut, those spores can germinate and produce botulinum toxin right there in the intestine. That in vivo toxin then gets absorbed and causes the characteristic paralysis. So the key idea is that the illness arises from spores being ingested and then forming toxin inside the gut, not from already-formed toxin in food. This distinguishes it from foodborne botulism, where the toxin is ingested as a preformed toxin. Inhalation of spores or direct skin contact do not typically cause infant botulism. Honey is a known source to avoid giving to infants under a year due to spore-containing dust and soil contamination.