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Two West Texas infants in the same neighborhood diagnosed with rare botulism

Ben Powell
The Texas Tribune
Downtown Midland is seen on Monday, April 27, 2020.

MIDLAND — Two newborns living with their families in the same West Texas neighborhood were earlier this year diagnosed with botulism, a rare — and in some cases, fatal — illness caused by a toxin that attacks the body’s nerves.

The families, who live within blocks of each other, learned of the diagnosis in mid-January and early February.

A third newborn in the same neighborhood was previously diagnosed with botulism, which can cause difficulty breathing and muscle paralysis, in August.

Hospitals in Lubbock treated the three infants.

Local and state health officials said the types of botulism were different in each case, eliminating the need to issue an alert to others in the area, a decision which left the three families alarmed about the well-being of neighboring households with newborns.

“This isn't a one-off, this isn't the flu,” said Jana Bowman, mom to one of the infants. “Families need to know what it looks like so that they don't have another baby sitting [at home] for eight hours when they could have been getting care.”

Two common ways infants contract botulism are through the environment and food. The Midland Health Department has not confirmed the cause of the exposure to the toxin that infected the three children, according to a spokesperson. However, the spokesperson ruled out food.

“For many infant botulism cases the specific source is never identified due to the fact that it can be environmental, usually via dust that is stirred up due to windy conditions, construction around the home, or through contact with parents who work outdoors,” the spokesperson said. “Based on our investigation we do not believe the source to be foodborne.”

Cases involving infant botulism can’t be prevented “because the bacteria that causes the disease is in soil and dust,” according to the Centers for Disease Control. There were 215 cases reported nationwide in 2019, the most recent year data was available. More than 70% were infants. Texas had the third-highest number of infections that year, reporting 12 cases. California reported 43 cases, followed by 17 in Pennsylvania.

In Texas, once a doctor suspects botulism, the hospital sends samples to Austin for laboratory testing, which can take two to 14 days to complete. The state notifies the local health department and in the case of infants, the Infant Botulism Center in California, the only agency in the country carrying an antidote.

In 2023, Texas documented 12 cases of infant botulism, about one a month — the highest in a four-year period — according to data obtained by The Texas Tribune. In the previous three years, the state averaged 10 cases, said Kenneth Davis, manager for food and water-borne diseases and high-consequence infections at the Texas Department of State Health Services.

By late February, Texas had already documented four cases in 2024, a spokesperson told the Tribune.

Two of those are the Midland cases. Jana and Foster Bowman’s 4-month-old contracted botulism at the end of January. Usually strong and sturdy, their baby went limp. He wouldn’t eat or move. While they bathed him one evening, they sat by the bathtub, feeling uneasy. Foster Bowman insisted on taking the baby to the hospital.

Jana, who was a pediatric nurse in Lubbock before moving to Midland, already had a hospital in mind. They drove up. The next day, the hospital intubated the baby.

Initially, Jana argued against the botulism diagnosis. It’s such a rare disease, she remembers saying, and she had only ever breastfed him. It didn’t make sense, she said. But before they began conducting tests, the hospital had already requested the antitoxin without a confirmed diagnosis. The next morning, doctors administered the medicine, and the baby began to recover.

Common cases of infant botulism include those spurred by ingesting honey or from an air-sealed can, said Salvador Baeza, a chemical toxicologist and director of the West Texas Poison Center, an agency serving 36 counties.

Once botulism toxins find their way into the human body, they shock the nervous system, working downward from the head, slowly paralyzing the infant’s ability to move, said Jennifer Zheng, a family physician at UT Health East Texas, who has treated cases of infant botulism.

“Children should get tested within hours,” she said.

Karen Mappolitano and Brandon Dyke spent 30 hours in and out of a Midland emergency room, searching for answers when their baby got sick in January. Their baby had stopped eating and his body was limp. After several rounds of additional testing, the hospital told the couple they could not handle their case. On the way to Lubbock, 119 miles north, Dyke drove. The ride was quiet.

“I was thinking every scenario you could think of,” Mappolitano said. Dyke tried to keep the worry at bay but peeled at his skin. At 10 days old, the baby had barely been home.

Once in Lubbock, the doctors recommended the botulism antitoxin without a diagnosis because of the baby’s symptoms. Two weeks later, the doctors confirmed the diagnosis: the baby had botulism. By then, the baby had recovered.

“It was definitely stressful,” said Dyke said. “We were just trying to figure out what was going on, just hoping everything was OK.”

Rebecca Lineham had gone through a similar ordeal months earlier. One August morning, Lineham’s newborn abruptly stopped eating, she said. The next morning, the family’s pediatrician referred them to the local hospital in Midland, where medical teams there hooked the baby to an IV to prevent dehydration. Hours later, a nurse held him up, noticing the body was limp. She alerted the doctor, who later arranged a transfer to a Lubbock hospital.

Her doctor suspected her weeks-old newborn had infant botulism. The diagnosis last August triggered a series of rapidly compounding events — there were no treatment options in Midland. That night, a thunderstorm forced the hospital to cancel an emergency helicopter and dispatch an ambulance instead, shuttling Lineham’s infant to Lubbock.

Doctors at a Lubbock hospital administered the antitoxin after intubating the baby for three days. They requested the medicine through an overnight delivery without a sure diagnosis. Lineham replays the night she sat in the back of the ambulance.

“I’m just sitting there holding my baby and praying that he doesn't die before the ambulance gets there,” Lineham said.

Before the infections, the families did not know each other, even though they frequented the same park and drove by the same elementary school, mall and football field. Sometimes they’d stroll through the same park.

They met after Lineham’s pediatrician told her another family had a newborn who was infected with infant botulism. The families now meet periodically to share their stories and brainstorm how to alert their neighbors.

Jana Bowman spends her free time raising awareness about her experience, heading from one doctor’s office to the next. She hopes other families won’t go through what she did. But she can only do so much, she said.

“I’m just a mom.”