The North Carolina Department of Health and Human Services alerted parents and caregivers that a nationwide outbreak of infant botulism has hit the state.

The outbreak, which is linked to a countrywide recall of ByHeart Inc. Whole Nutrition Infant Formula, has affected 15 infants in the U.S. with suspected or confirmed infant botulism cases. Exposure to botulism in the contaminated products has occurred in 12 states, according to the U.S. Food and Drug Administration.

Now, there is a suspected case currently under investigation in North Carolina.

“Our Food and Drug Protection Division is working with counterparts at the Food and Drug Administration and NCDHHS on this recall. Our Food and Drug Protection Division is also working with retailers to make sure they have been notified about the recalled product and are removing it from store shelves,” said Agriculture Commissioner Steve Troxler in a news release from NCDHHS. “However, this product is readily available online and may be in home pantries, so parents need to check to be sure they are not feeding the product to their infants.”

Here’s everything North Carolina and people across the United States should know about the recall.

What baby formula was recalled?

According to the FDA notice, the recall was expanded to include all ByHeart Whole Nutrition Infant Formula products due to the number of ill infants reported to have consumed the products in the U.S. This includes all unexpired lots of formula cans and single-serve “anywhere” sticks.

The notice recommended the following:

  • Parents and caregivers should stop using any ByHeart infant formula products immediately

  • If your child consumed ByHeart formula and is experiencing symptoms, seek immediate medical attention.

  • If your child consumed ByHeart formula and is not currently showing symptoms, continue monitoring them and seek medical attention if symptoms develop.

  • If you still have the formula in your home, take a photo or record the information on the bottom of the package, keep the container in a safe spot and be sure to label that product as “do not use.”

  • If your child develops symptoms, your state health department may collect your formula container for testing. If your child does not develop symptoms after 30 days, throw your containers out.

Handout image of recalled ByHeart Whole Nutrition Infant Formula.

How many cases of botulism are there? Where was recalled baby formula sold?

The U.S. Centers for Disease Control provided the following map showing where botulism cases associated with the contaminated formula are in a total of 15 states, including one suspected case in North Carolina.

The CDC map of botulism cases associated with contaminated infant formula.

The CDC map of botulism cases associated with contaminated infant formula.

What causes botulism? What foods are high risk for botulism?

Botulism is caused by the botulinum toxin. There are several ways that the toxin can be introduced to the body, such as through wounds and contaminated food.

Though many foods have been linked to botulism, the CDC states that common sources of botulism are homemade foods that have been improperly canned, preserved or fermented.

The CDC adds that new sources of botulism have been found, including chopped garlic in oil, canned cheese sauce (such as nacho cheese), carrot juice and baked potatoes wrapped in foil.

What are the symptoms of botulism?

Mayo Clinic states that the symptoms of foodborne botulism generally begin 12-36 hours after toxins enter the body. Depending on how much of the toxin was consumed, this window can vary from a few hours to a few days.

Symptoms of foodborne botulism can include:

  • Trouble swallowing or speaking

  • Facial weakness on both sides of the face

  • Nausea, vomiting and stomach cramps

What are the symptoms of botulism in infants?

The CDC adds that symptoms of botulism in infants often include:

  • Difficulty feeding (sucking and swallowing)

Iris Seaton is the trending news reporter for the Asheville Citizen Times, part of the USA TODAY Network. Reach her at iseaton@citizentimes.com.

This article originally appeared on Asheville Citizen Times: What baby formula is recalled? Suspected case of infant botulism in NC

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