{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:22:42Z","timestamp":1791253362234,"version":"4.1.0"},"reference-count":51,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Infant Botulism Treatment & Prevention Fund at the California Department of Public Health"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Appl Environ Microbiol"],"published-print":{"date-parts":[[2024,11,20]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              We sought to identify counties in the northeastern United States where the incidence of infant botulism (IB) is elevated compared to the nationwide incidence and to assess associations with soil type at the case residence. IB cases were identified through the distribution of the orphan drug Human Botulism Immune Globulin Intravenous for treatment of IB by state and national surveillance systems and were subsequently confirmed by laboratory testing. IB incidence by county was calculated as the number of IB cases divided by the number of live births in the county from 2000 to 2019. Cases were spatially mapped and assigned to soil types using the US Department of Agriculture\u2019s online soils database. Possible association with soil type was evaluated with the Chi-squared test. We identified a rectangular area consisting of 17 contiguous counties in Delaware, Maryland, New Jersey, New York, and Pennsylvania, approximately 80 km by 250 km, in which the 20-year incidence of IB was nearly seven times greater than that of the remaining counties in those five states. Within this area, case residences were strongly associated with certain soil types (\n              <jats:italic>P<\/jats:italic>\n              \u2264 0.003). From 2000 to 2019, IB occurred with disproportionate incidence in a rectangular area encompassing the lower Delaware and Raritan River Valley and parts of five adjacent states. Further investigation of the soils in counties from this area could assess whether\n              <jats:italic>C. botulinum<\/jats:italic>\n              is more prevalent in certain soil types and whether isolation of\n              <jats:italic>C. botulinum<\/jats:italic>\n              is more common in counties with higher IB incidence.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>Infant botulism occurs more frequently in 17 counties within and adjacent to the Delaware and Raritan River watersheds. This study should alert physicians and pediatricians in the area to the higher likelihood of encountering cases of this otherwise rare disease that manifests with constipation, poor feeding, loss of head control, weak suck\/cry, generalized weakness, and descending bilateral paralysis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/aem.01063-24","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T13:00:23Z","timestamp":1730379623000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":3,"title":["Elevated incidence of infant botulism in a 17-county area of the Mid-Atlantic region in the United States, 2000\u20132019, including association with soil types"],"prefix":"10.1128","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3243-5733","authenticated-orcid":true,"given":"Haydee A.","family":"Dabritz","sequence":"first","affiliation":[{"name":"Infant Botulism Treatment and Prevention Program (IBTPP), Center for Laboratory Sciences, Infectious Diseases Laboratories Division, California Department of Public Health, Richmond, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid K.","family":"Friberg","sequence":"additional","affiliation":[{"name":"Infant Botulism Treatment and Prevention Program (IBTPP), Center for Laboratory Sciences, Infectious Diseases Laboratories Division, California Department of Public Health, Richmond, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica R.","family":"Payne","sequence":"additional","affiliation":[{"name":"Infant Botulism Treatment and Prevention Program (IBTPP), Center for Laboratory Sciences, Infectious Diseases Laboratories Division, California Department of Public Health, Richmond, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Moreno-Gorrin","sequence":"additional","affiliation":[{"name":"Office of Infectious Disease Epidemiology, Delaware Department of Health and Social Services, Dover, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristy","family":"Lunquest","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Surveillance, Prevention and Health Promotion Administration, Maryland Department of Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepam","family":"Thomas","sequence":"additional","affiliation":[{"name":"Communicable Disease Service, Infectious Disease Epidemiology, New Jersey Department of Health, Trenton, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra P.","family":"Newman","sequence":"additional","affiliation":[{"name":"Regional Epidemiology and Investigations Program, New York State Department of Health, Albany, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Negr\u00f3n","sequence":"additional","affiliation":[{"name":"Bureau of Epidemiology, Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"Drohan","sequence":"additional","affiliation":[{"name":"Department of Ecosystems Science and Management, Pennsylvania State University, University Park, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.75.5.928"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.75.5.935"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.26.10.2191-2192.1988"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.60.2.518-522.1992"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199510000-00022"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.6.2260-2262.2002"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.8.4280-4282.2005"},{"key":"e_1_3_3_9_2","article-title":"Notes from the field: infant botulism caused by Clostridium baratii type F - Iowa, 2013","volume":"64","author":"Moodley A","year":"2015","unstructured":"Moodley A, Quinlisk P, Garvey A, Kalas N, Barash JR, Khouri JM, Centers for Disease Control and Prevention (CDC). 2015. 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