At least 19 people in nine states have fallen ill after receiving botulinum toxin injections—commonly known by the brand name Botox—from unlicensed individuals or outside of a health care setting, according to the U.S. Centers for Disease Control and Prevention (CDC).
Some people received injections with counterfeit products or products with unverified sources, the agency said in an April 15 statement. The CDC said an investigation into the sources of these products is underway.
Of those 19 people, nine were hospitalized and four others were treated with botulism antitoxin due to concerns that botulinum toxin could have spread beyond the injection site, the CDC stated. Five people tested negative for botulism.
The cases were detected in Colorado, Florida, Illinois, Kentucky, Nebraska, New Jersey, New York, Tennessee, and Washington.
The CDC said that all 19 cases involved females between 25 and 59 years old, with a median age of 39 years. All but one reported receiving botulinum toxin injections for cosmetic purposes.
They reported experiencing symptoms such as blurred vision, droopy eyelids, difficulty swallowing, dry mouth, slurred speech, fatigue, difficulty breathing, and generalized weakness.
The CDC has advised people to exercise caution when considering cosmetic treatments and encouraged those who have experienced health issues after receiving such treatments to seek medical assistance.
Used for Cosmetic and Medicinal Purposes
Botulism is a rare but potentially deadly illness characterized by muscle paralysis.According to the CDC, those who receive botulinum toxin injections for cosmetic or medical purposes, such as migraine headaches, may face a higher risk of iatrogenic botulism if the dose they receive is too large or if they have underlying nerve or muscle conditions.
The two cases involved people who received injections of Botox or a similar counterfeit product from a licensed nurse in LaSalle County who was performing work outside her authority, the IDPH said.
The Tennessee Department of Health also reported similar cases.
In December 2023, the consumer advocacy group Public Citizen filed a petition with the Food and Drug Administration (FDA) seeking to require the makers of Botox and several similar injections to include stronger warnings about the risk of a potentially fatal muscle-paralyzing disease.
These injections, which use various versions of botulinum toxins to contract specific muscles by blocking certain nerve signals to erase wrinkles, already have a “black box” warning in their labels about the risks of the intended effect spreading to other areas.
The consumer group asked the FDA to clarify that these adverse effects could occur even at recommended dosages.
This request came after the group analyzed over 5,400 reports of deaths, life-threatening events, and other serious side effects related to Botox and rival toxin-based wrinkle treatments between January 1989 and March 2021 that were recorded in the FDA’s adverse events database.
