JOURNAL REVIEW
FOOD SAFETY & SANITATION

INFANT BOTULISM IN HONEY

By:
Angela Indryana (03420100086)
Zefanya Tjokrodiredjo (03420100087)

FOOD TECHNOLOGY DEPARTMENT
FACULTY OF INDUSTRIAL TECHNOLOGY
UNIVERSITAS PELITA HARAPAN
KARAWACI
2012

CHAPTER I
INTRODUCTION

Honey is a natural food, mainly composed of a complex mixture of carbohydrates and other minor substances, such as organic acids, amino acids, proteins, minerals, vitamins, and lipids. It has two sources of contamination with microorganisms: primary sources include pollen, the digestive tracts of honey bees, dust, air, soil and nectar; secondary sources are those arising from honey manipulation by people, they include air, food handlers, cross-contamination, equipment and buildings.
Spores of Clostridium botulinum may be found in honey, usually at low levels. C. botulinum spores are found in soil and dust and hence, can contaminate different agricultural products. Honey is a recognized vehicle for C. botulinum spores. The presence of spores of Clostridium is especially dangerous for infants and small children. Although the high sugar content, low pH, low protein concentration, and the existence of different oxidases and other antimicrobial substances in honey may cause the spores unable to germinate and grow in the product, the microenvironment may remain anaerobic as a consequence of high viscosity. Yet existing spores may not be removed from honey or destroyed without spoiling the product, thus they may be present indefinitely. Therefore, infant botulism is mainly caused by the consumption of honey contaminated with C. botulinum.
Foodborne botulism is a severe type of food poisoning caused by the ingestion of foods containing the potent neurotoxin formed during the growth of the microorganism. Infant botulism is common form of botulism and honey has been identified as a potential source of infection. Immature infantile intestinal flora allows ingested spores to germinate, multiply and produce botulinal neurotoxins in the intestinal lumen. Children aged between 2 weeks and 1 year is most susceptible. Honey has been identified both as a dietary risk factor for infant botulism and as a natural reservoir of C. botulinum type A and type B spores.
Approximately 30% of the infant botulism caused by honey was reported in California, while in a French study 6.7% of honey samples were found to be contaminated with C. botulinum while in Cordoba, 7% were positive. Meanwhile, there are some studies reporting lower contamination levels in honey, such as in Washington DC and Argentina where only 2% and 2.3% of contamination levels were reported respectively.

CHAPTER II
DISCUSSION

Supernatant filtration was used in the main journal (Saraiva et. al., 2012) to identify the types of botulinum toxin in order to detect the Clostridum botulinum strain in the honey sample which causes infant botulism. Meanwhile, the medium enrichment broths used for cultivation were Cooked Meat Medium (CMM) and Rosenow cysteine medium. The identification result of honey sample from Portugal showed that the toxin present was the type B botulinum toxin. In one of the supporting journal (Kuplulu et. al., 2004), different methods of sample preparation were used and compared. The methods were direct addition (DA), dilution centrifugation (DC), and supernatant filtration (SF). The CMM enrichment media was also used, yet there was also another type of media used which was Trypticase Peptone Glucose Yeast broth (TPGY). This supporting journal’s result showed that the DC method was more efficient than DA and SF method as false negative results were observed with the DA method and negative results were obtained from the SF method. The CMM enrichment broth was also more preferable than TPGY and was more commonly used in studies concerning isolation of C. botulinum in honey. Nevertheless, there is also another method of isolation for C. botulinum being used by the other supporting journal (Nevas et. al., 2005) which is the PCR (Polymerase Chain Reaction) method.
Moreover, according to Nevas et. al. (2005), as the supporting journals, there are actually 6 types of toxin caused by different strains: A, B, C, E, F and G. Types A and B, together with types C and G are the majority cause of infant botulism. C. botulinum spores type B was also frequently found in Denmark and Norway honey samples, although there were many cases of botulism found in other countries without the specification type of C. botulinum. One of the factors that caused honey to be contaminated with the C. botulinum, which explained by Kupulu et. al. (2004), as the supporting journal, is the behavior of honeybees (Apis mellifera). Honeybees tend to prefer a dirty source of water to a cleaner one, which may be due to its odor and salt content. It is likely that honeybees collect water from areas contaminated with animal feces, thus lead to the transfer of C. botulinum spores through water in honey. It is because honeybees tend to use water not only for a nutritive substance, but water is spread over the combs to regulate the temperature and the humidity inside the beehive.
According to the supporting journal (Kuplulu et. al., 2004), honey sold in retail markets in Ankara are significantly (12.5%) contaminated with C. botulinum. Honey, as a food product which being commonly consumed by all age groups of consumers and being potential infantile botulism agents for the children younger than 1 year old, should be considered by the pediatricians and need a further investigation. It needs more studies to determine not only the prevalence of C. botulinum in honey, but also how this microorganism is incorporated into it.
The advantage of the main journal (Saraiva et. al., 2012) is that the information from the journal is easy to understand as it did not use much scientific wordings. Moreover, it also provided some prevention details to avoid the further occurrence of infant botulism. As this was the first case of infant botulism in Portugal, the presence of this journal becomes quite important in educating the rest of Portugal citizens about the danger of infant botulism. Lastly, the short length of journal makes it more preferable to read than a lengthy journal.
On the other hand, the main journal (Saraiva et. al., 2012) still has some disadvantages. The main disadvantage is the lack of information and further explanation provided in the journal, such as the lack of information and explanation about the laboratory assay, the result of the assay that lead to the conclusion provided, and the conclusion itself. If it is compared to the supporting journal, which is rich in information and explanation, this journal become weaker in terms of its use of scientific words. Moreover, the main journal lacks of tables, graphs, or any other details that are needed to support the result and disscusion. It can be seen from the supporting journals that each of them has at least one table that can help the reader to understand more about the topic discussed. Furthermore, the main journal does not explain about the type of Botulinum or making a comparison to the case of botulinum from other country, as it was explained and disscused in the supporting journal. There is also no discussion of the result gained from the experiment. The writer only provided a short elaboration of result but did not explain more about the importance of the result and further discussion. Lastly, there is no conclusion in this journal. Although the writer has provided how to prevent infant botulism, there is no sufficient conclusion, thus making it difficult for a reader who just want to have a quick review about the journal.

CHAPTER III
CONCLUSION

The better way to isolate and identify the Clostridium botulinum is by using DC (Dilute Centrifugation) method compared to SF (Supernatant Filtration) method, which was used in the main journal. On the other hand, the usage of CMM (Cooked Meat Medium) is one of the best medium to culture and identify the C. botulinum in honey. The C. botulinum type B was the main cause of infant botulism found in many countries, though type A, C and G was also identified in the honey sample. As the C. botulinum is identified in the honey sample, it is agreeable that honey and other high-risk in C. botulinum food product not be given to children, especially infant. Furthermore, it is important to make a further studies and investigation of the presence and the prevention of the C. botulinum in honey.

BIBLIOGRAPHY

Kuplulu, Ozlem, Muammer Goncuoglu, Haydar Ozdemir and Ahmet Koluman. 2004. Incidence of Clostridium botulinum spores in honey in Turkey. Food Control, 17, 222-224.
Nevas, Mari, Miia Lindstrom, Kirsi Hautamaki, Satu Puoskari and Hannu Korkeala. 2005. Prevalence and Diversity of Clostridium botulinum types A, B, E and F in Honey Produced in The Nordic Countries. International Journal of Food Microbiology, 105, 145– 151.
Saraiva, Margarida, Isabel Campos Cunha, Conceicao Costa Bonito, Claudia Pena, M. Manuel Toscano, Teresa Teixeira Lopes, Isabel Sousa and M. Antonia Calhau. 2012. First case of infant botulism in Portugal. Food control, 26, 79-80.