Evidence map›Paper›PMID 25306863›Full record

ArticleEpidemiology and infection2015

Infant botulism due to C. butyricum type E toxin: a novel environmental association with pet terrapins.

E B Shelley, D O'Rourke, K Grant, E McArdle, L Capra, A Clarke, E McNamara, R Cunney, P McKeown, C F L Amar and 11 more

Open access · bronzeAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Epidemiology and infection, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 35 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 7 institutions in 3 countries.

E B ShelleyPublic Health Department,Health Service Executive,Dublin,Ireland.
D O'RourkeDepartment of Neurology,Children's University Hospital,Temple Street,Dublin,Ireland.
K GrantGastrointestinal Bacteria Reference Laboratory,Public Health England,Colindale,London,UK.
E McArdlePublic Health Department,Health Service Executive,Dublin,Ireland.
L CapraDepartment of General Paediatrics,Children's University Hospital,Temple Street,Dublin,Ireland.
A ClarkePublic Health Department,Health Service Executive,Dublin,Ireland.
E McNamaraPublic Health Laboratory, Cherry Orchard Hospital,Dublin,Ireland.
R CunneyDepartment of Microbiology,Children's University Hospital,Temple Street,Dublin,Ireland.
P McKeownHealth Protection Surveillance Centre,Dublin,Ireland.
C F L AmarGastrointestinal Bacteria Reference Laboratory,Public Health England,Colindale,London,UK.
C CosgroveEnvironmental Health, Health Service Executive,Dublin,Ireland.
M FitzgeraldPublic Health Department,Health Service Executive,Dublin,Ireland.
P HarringtonEnvironmental Health, Health Service Executive,Wicklow,Ireland.
P GarveyHealth Protection Surveillance Centre,Dublin,Ireland.
F GraingerEnvironmental Health, Health Service Executive,Wicklow,Ireland.
J GriffinDepartment of Agriculture,Food and the Marine,Dublin,Ireland.
B J LynchDepartment of Neurology,Children's University Hospital,Temple Street,Dublin,Ireland.
G McGraneEnvironmental Health, Health Service Executive,Dublin,Ireland.
J MurphySouth Dublin County Council,Ireland.
N Ni ShuibhneDepartment of Neurology,Children's University Hospital,Temple Street,Dublin,Ireland.
J ProsserEnvironmental Health, Health Service Executive,Dublin,Ireland.
Health Service Executive · IEHealth Protection Surveillance Centre · IEPublic Health England · GBTemple Street Children's University Hospital · IETemple University · USDepartment of Agriculture Food and the Marine · IEDublin City Council · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We describe two cases of infant botulism due to Clostridium butyricum producing botulinum type E neurotoxin (BoNT/E) and a previously unreported environmental source. The infants presented at age 11 days with poor feeding and lethargy, hypotonia, dilated pupils and absent reflexes. Faecal samples were positive for C. butyricum BoNT/E. The infants recovered after treatment including botulism immune globulin intravenous (BIG-IV). C. butyricum BoNT/E was isolated from water from tanks housing pet 'yellow-bellied' terrapins (Trachemys scripta scripta): in case A the terrapins were in the infant's home; in case B a relative fed the terrapin prior to holding and feeding the infant when both visited another relative. C. butyricum isolates from the infants and the respective terrapin tank waters were indistinguishable by molecular typing. Review of a case of C. butyricum BoNT/E botulism in the UK found that there was a pet terrapin where the infant was living. It is concluded that the C. butyricum-producing BoNT type E in these cases of infant botulism most likely originated from pet terrapins. These findings reinforce public health advice that reptiles, including terrapins, are not suitable pets for children aged <5 years, and highlight the importance of hand washing after handling these pets.

Indexed as

AnimalsBotulinum AntitoxinBotulinum ToxinsBotulismClostridium butyricumFecesHumansInfant, NewbornMaleMolecular TypingPetsReptilesTreatment OutcomeUnited KingdomWater MicrobiologyBotulinum AntitoxinBotulinum Toxinsbotulinum toxin type EBotulismClostridiumpublic healthtoxinszoonoses

Identifiers

PMID25306863
PMCPMC9507071
OpenAlexW2070084762

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.