Fake Botox Is Causing Botulism-Like Illness

The U.S. Centers for Disease Control and Prevention (CDC) is looking into an outbreak of symptoms resembling botulism, a rare but serious illness, due to fake botox injections.

Illinois and Tennesee’s state health departments have acknowledged cases of botulism-like symptoms in their states. The CDC and the FDA are conducting a multistate investigation to learn more about the outbreak.

Botulinum toxin (Botox) is an FDA-approved treatment for reducing facial lines and wrinkles to maintain that younger look. Botox injections are the most common nonsurgical cosmetic procedure in the United States, with more than 3.9 million treatments in 2022.

Botox is made from a toxin produced by the bacterium Clostridium botulinum, the identical toxin that causes botulism — a potentially fatal food poisoning illness. The CDC says botulism is an illness caused by a toxin that attacks the body’s nerves and causes difficulty breathing, muscle paralysis, and even death.

On April 5, the Tennessee Department of Health (TDP) announced it had identified four individuals experiencing botulism-like symptoms following cosmetic procedures. All four sick patients received medical care, with two being hospitalized.

Three days later, the Illinois Department of Public Health (IDPH) followed suit with a statement noting two individuals in LaSalle County were exhibiting botulism symptoms. The IDPH says these symptoms included “blurred/double vision, droopy face, fatigue, shortness of breath, difficulty breathing, hoarse voice following injection with either Botox or a possibly counterfeit version of the product.”

Like in Tennessee, both patients required hospitalization. Also, the IDPH highlights both individuals received injections from a licensed nurse who was working outside of her allowed authority. Individuals seeking nonsurgical cosmetic treatments should be cautious when selecting a provider.

An NBC News article on Thursday revealed Kentucky had confirmed four botulism cases, with two being hospitalized. Additionally, Washington state is investigating a suspected case and Denver health officials have identified a botulism-like illness due to an unlicensed provider.

The TDP and IPHD recommend healthcare providers to speak with patients about recent cosmetic procedures and examine if experiencing any botulism-like symptoms.

What is botulism?

The bacteria that forms botulinum toxin can naturally be found in many places, however, the CDC says it is rare in making people sick. In 2019, the CDC received 215 botulism cases of which only 201 were laboratory confirmed.

The five main kinds of botulism include infant botulism, wound botulism, foodborne botulism, adult intestinal toxemia, and iatrogenic botulism. Individuals who get Botox injections are more likely to receive iatrogenic botulism if they weigh less than a typical adult, receive too large a dose, or if they have an underlying nerve/muscle issue.

Botulism symptoms include:

  • Trouble swallowing
  • Muscle Weakness
  • Double vision
  • Drooping eyelids
  • Blurry vision
  • Slurred speech
  • Difficulty moving eyes

The CDC advises those displaying signs of botulism to immediately visit a doctor or go to an emergency room. Individuals may require a brain scan, spinal fluid examination, nerve and muscle function tests, and Tensilon test for myasthenia gravis — a chronic autoimmune disease that causes muscle weakness.

Botulism is treated with an antitoxin that prevents the toxin from causing additional harm. The CDC emphasizes that antitoxin does not heal the damage done. Depending on the severity of symptoms, one with the illness may be hospitalized from weeks to months.

The CDC says fewer than five of every 100 diagnosed with botulism die. Some patients who survive the disease may have fatigue along with shortness of breath for years after the illness and require long-term therapy for recovery.

For now, be wary of fake botox on the market and only see a certified individual for injections.

“Receiving these treatments in unlicensed, unapproved settings can put you or your loved ones at serious risk for health problems,” IDPH Director Dr. Sameer Vohra said in a release. “Please only seek cosmetic services under the care of licensed professionals trained to do these procedures and who use FDA-approved products. If you are experiencing any health problems after a recent cosmetic treatment, please contact your healthcare provider immediately for help and assistance.”

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