CDC investigating reports of counterfeit, mishandled botulinum toxin injections

Key takeaways:

• The CDC is investigating 19 reports in nine states.
• Nine individuals have been hospitalized, and four were treated with botulism antitoxin.

The CDC, state and local health departments, and the FDA are investigating 19 reports of “harmful reactions” following counterfeit or mishandled botulinum toxin injections, the CDC announced in an investigation summary.

While previous reports documented the hospitalization of at least four individuals with botulism-like illnesses in two states, the CDC has now confirmed that, as of April 12, 19 people in nine states have reported harmful reactions after receiving botulinum toxin injections, more commonly referred to as Botox.

According to the CDC, these reactions occurred after these individuals received botulinum toxin injections from unlicensed or untrained professionals in a non-health care setting in Colorado, Florida, Illinois, Kentucky, Nebraska, New Jersey, New York, Tennessee and Washington.

These individuals reported experiencing blurry vision and double vision, drooping eyelids, difficulty swallowing, dry mouth, slurred speech, difficulty breathing, fatigue and generalized weakness.

Nine people have been hospitalized, and four were treated with botulism antitoxin due to concerns that the botulinum toxin spread beyond the injection site. Results were negative in five people who were tested for botulism.

The reports were from people identifying as female aged 25 to 59 years, with 18 reporting they received the injections for cosmetic purposes.

The CDC recommended that health care providers consider the possibility of adverse effects from botulinum toxin injections in patients who present with signs and symptoms consistent with botulism near the injection site. If botulism is suspected, call the local health department for consultation and antitoxin release or the CDC clinical botulism service at 770-488-7100.

The CDC also recommended that providers practice preventive care including counseling patients on the risks of botulism and encouraging them to go to licensed providers in a licensed or accredited health care setting for injections.