Q: I've read that honey can cause botulism in infants. I wondered if using honey in cooking can still cause a problem, or if high temperatures would kill the botulism toxin. Also, would boiling honey in a jar kill the botulism spores?
A: It's unlikely that honey used in cooking would cause botulism in infants, but because the exact risk, though low, is unknown, it's probably safest to avoid using honey in infants under 1 year of age.
Botulism is a severe illness caused by a deadly toxin produced by one type of bacteria. (The disease got its name from its association with eating spoiled sausage -- botulus is the Latin word for sausage.) You get botulism from eating foods contaminated with the toxin, usually improperly canned, home-preserved food.
Heat destroys the botulism toxin at temperatures, for example, of 176 degrees Fahrenheit for 30 minutes or 212 degrees, the boiling temperature, for 10 minutes. But spores -- a dormant, long-lasting form of the botulism germ -- can withstand boiling for several hours and survive to release their toxin in the infant's intestines. It takes higher temperatures to destroy botulism spores, 248 degrees for 30 minutes.
The botulism toxin acts as a nerve poison to produce its symptoms of constipation, weakness, limpness, dry mouth, enlarged pupils and an inability to move the eyes normally. Paralysis of the breathing muscles can be rapidly fatal.
Botulism spores are commonly present in soil, on unwashed fruits and vegetables, and in as much as 10 to 15 percent of all honey produced. (Commercial processing does not destroy spores in honey.) Yet it seems that only infants are susceptible to getting botulism from eating spore-contaminated honey.
Even at that, infant botulism is a very rare disease -- just over 100 cases have been reported in the world, and in only about a third of these was honey a possible source. The other exposures seem to have come from something other than foods.
To be on the safe side, honey manfuacturers and the federal Centers for Disease Control recommend that honey not be fed to infants under 1 year of age.
Q: I'm a federal employe and my office supervisor contends that unless one has a fever, one is not ill and must come into work. My supervisor also says that coughing and sneezing in the office do not contribute to the spread of illness because a person is no longer contagious by the time those symptoms appear. I think these ideas fly in the face of reality. I hope your opinion will carry more weight than mine.
A: People have differing notions about health and illness. A medical student I once taught told our class that when he was growing up, no matter how sick he was, his parents wouldn't keep him out of school unless he threw up. In his family, at least, that was the mark of true illness.
In your case, however, it's not up to your supervisor to decide whether you're sick or not. That's a matter between you and your doctor. In the federal government and many private companies, it's common practice for employers to ask for a sick slip from your doctor for unexcused absences. Unless you abuse this procedure, or use up all of your sick leave, I don't see how your supervisor would have a say in the matter.
Although coughs and sneezes are not necessarily signs of a contagious disease, they can spread respiratory infection if that's what's causing them. Cold viruses are even more readily spread by hand-to-hand contact. In any event, I don't think coughing or sneezing in themselves are sufficient reasons for staying out of work.
Federal workers with questions about sick leave may talk with their department supervisor or call the Office of Personnel Management, 632-4634.