Infant botulism is commonly caused by ingestion of spores from honey.

• A. Ingestion of preformed toxin in foods
• B. Ingestion of spores from honey
• C. Inhalation
• D. Wound infection

Answer: (B)

Infant botulism happens when botulinum spores are swallowed and then colonize the infant’s immature gut, producing toxin in the gut itself. Honey is a common vehicle because it can contain these spores, and in infants under one year the gut flora isn’t fully developed to suppress such colonization. The illness is driven by in vivo toxin production from these germinated spores, not by preformed toxin that was ingested with food.

This differs from ingestion of preformed toxin in foods, which is foodborne botulism and occurs when toxin is already present in the food and absorbed after consumption. Inhalation and wound infection describe other, less typical routes of botulism (inhalational or wound botulism), not the classical mechanism of infant botulism.