foot and mouth With the increased interest in home canning and "natural" foods (those without preservatives), botulism is threatening a comeback. Adults and children past infancy can be poisoned by botulism only if they eat food in which the botulism germ has already formed the toxin. Recent cases of fatal botulism among infants, however suggest that the botulism germ can grow in an infants immature intestines to form the dangerous toxin within the infant's body. The only natural food so far identified as a source of botulism germs for infants is honey Therefore, you should not give honey to an infant. Other raw or improperly cooked foods may eventually be identified as potential sources of the germ. Pari»nmn9 and Preserving food at home, follow directions for ynng and sterilizing exactly. SIGNS AND SYMPTOMS Symptoms of botulism are nausea, vomiting, diarrhea, abdominal pain followed in 12 to 48 hours by double vision, dilated pupils, and difficulty in speaking, swallowing, and breathing. There is no fever and no loss of awareness or alertness. Death may result. Suspect botulism if your infant has symptoms within a week of eating raw or homeprepared foods. Suspect the disease if more than one member of your family develops similar symptoms after eating the same food. If symptoms of stomach or intestinal upset are followed bv paralysis that starts at the eyes and moves downward, botulism may be the cause. Home diagnosis, however, is totally unreliable. Consult your doctor immediately if symptoms of botulism occur. HOME CARE None. Call your doctor immediately if you suspect botulism PRECAUTIONS • Do not give babies unwashed, unpeeled raw foods or improperly cooked foods. • Do not give honey to infants. • Do not use foods that come in damaged or dented storebought cans. Damaged cans may have leaks through which the botulism germ can enter the food. • Certain homepreserved foods (for example, vegetables and meats) should be reheated for ten minutes at a temperature of at least 180°F before eating because of the danger of botulism. • When canning or preserving foods at home, follow preparation and sterilization directions carefully. MEDICAL TREATMENT Diagnosis is made by identifying the toxin in samples of the food eaten and in the patient's stomach contents, stools, and blood. Treatment includes injection of the antitoxin (a substance that counteracts the effects of the poison). Stomach washing, laxatives and enemas, antibiotic therapy, and hospitalization may be necessary. Immunization to prevent botulism is available, but only for persons at high risk RELATED TOPICS: Dehydration; Diarrhea in older children: Diarrhea in young children; Dysentery; Food poisoning; Vomiting guick Reference Bowlegs and knockknees SYMPTOMS • Legs bent outward at knees (bowlegs) • Legs bent inward at knees (knockknees) HOME CARE • Usually no home care is needed. • If you think your child has bowlegs or knockknees, consult your doctor. pox