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Public health authorities in California have identified a second case of infant botulism, a bacterial infection that can lead to hospitalizations and deaths, as part of a small national outbreak linked to a brand of powdered baby formula that was sold at Target
A spokesperson for the California Department of Public Health confirmed the additional case on Wednesday, the latest associated with Nara Organics Whole Milk Organic Powdered Infant Formula. The brand was sold at Target stores, on its website and on Nara.com before authorities identified the bacteria last month. Nara Organics recalled all of its infant formula on June 13, according to the U.S. Food and Drug Administration

Along with the two cases in California, authorities have confirmed one in Washington and another in Pennsylvania. All four of the babies had been hospitalized, the federal agency said, but no deaths had been reported
Each of the infants was treated with an antitoxin produced and distributed by the state public health department, said spokesperson Beth Deines, which shortens hospital stays and reduces the need for breathing machines
The first three cases were in children between two and five months old, according to the Centers for Disease Control and Prevention. Infant botulism begins when a child swallows food containing bacterial spores, which produce toxins in the intestines
All four of the infants had consumed the Nara Organics baby formula, the FDA said. Parents should stop using the formula immediately and toss unopened cans or return then, it said
Symptoms of infant botulism include constipation, a floppy neck and trouble swallowing, the CDC says. Those evolve to paralysis and trouble breathing. Most infants recover fully with timely treatment, according to a Rutgers University research summary, but serious cases may require “prolonged mechanical ventilation.”
Parents who notice symptoms should seek immediate health care, the CDC says. Symptoms can take several weeks to kick in, the agency says, and parents who used the brand of formula should closely watch their child for a month
Parents also should consider putting away but keeping opened cans, which may be used for testing if their child gets sick, and washing surfaces that came into contact with open cans with hot, soapy water
In California, investigators with the department of public health detected bacteria in a can of Nara baby formula taken from the home of one of the sick children, according to the FDA. The federal agency said it is still working with the company to “determine the root cause of this outbreak and if any additional products are impacted.”
On its website, Nara Organics says its formula is produced with strict standards in Germany and regulated by both the FDA and the European Union. The company claims it manufacturers the first certified-organic formula that does not contain skim milk
“Stop using all Nara Organics infant formula immediately,” the company wrote online. “We are heartbroken for the concern and stress this may cause your family.”
This infant botulism outbreak is at least the second in the U.S. this year. The FDA in February announced the end of a separate outbreak including 48 infants in 17 states, which investigators linked to ByHeart Whole Nutrition Infant Formula. An FDA investigation into theitalized, but no deaths were reported to the CDC


