COSMETIC treatments have landed 41 people in hospital with paralysing botulism infections – with symptoms sometimes taking weeks to develop.
Investigations suggest patients were injected with “unlicensed Botox-like products”, the UK Health Security Agency (UKHSA) said.
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Forty-one people were treated for serious reactions to ‘Botox‘ procedures between 4 June and 6 August, the health watchdog said.
Patients reported reactions such as difficulty swallowing, slurred speech and breathing difficulties, which meant they needed respiratory support.
This happens when the paralysis spreads to the muscles used for breathing, and can be lethal without treatment.
The UKHSA said the cases are linked to iatrogenic botulism – a rare but serious illness caused by exposure botulinum toxin, the main ingredient in Botox-like products.
It can happen if too much of the substance is injected or if the product is contaminated with bacteria – the risk of which is higher with unlicensed or untrained practitioners.
Dr Gauri Godbole, a consultant medical microbiologist at UKHSA, said: “Botulism related to aesthetic procedures is rare, but it can be serious.
“It is caused by toxins produced by the bacterium Clostridium botulinum.
“These toxins – but not the bacteria – are the active ingredient in ‘Botox’ and similar products.”
The toxins attack the nervous system, including the nerves, brain, and spinal cord, and cause paralysis.
It can take “up to four weeks” for symptoms to appear following a procedure, Dr Godbole added.
So far, cases have been reported in the:
- North East
- East Midlands
- East of England
- North West
- Yorkshire and Humber
Since the last update on July 18, the total of affected patients has increased by three.
UKHSA urged people to take precautions when booking aesthetic procedures like Botox injections.
Protecting yourself in cosmetic procedures
Take extra care when getting any cosmetic enhancements done.
Always book a consultation with the person who will do the procedure before making your final decision.
Ask them:
- How many of these procedures they’ve done
- What qualifications and training they have
- If they’re a member of a relevant professional association that shows they meet set standards in training and skill
- About the most common complications of the procedure
- What aftercare you can expect and who will look after you
- What to do if something goes wrong or you’re not happy with the result
- How much it’ll cost, and if it’ll cost extra to have further treatment if needed
The practitioner should tell you exactly what the procedure involves, including:
- How it’ll be done
- How long it’ll take
- Whether anaesthetic is needed
- What pain you can expect afterwards
- How long the recovery should be
- The potential risks and complications
- How long the results will last
- What you can expect to look like after the procedure
You can if someone is qualified by checking they’re registered with a suitable specialist association and trained in the right procedures.
You can check if professionals offering cosmetic procedures are on a voluntary register accredited by the Professional Standards Authority (PSA).
These registers show that practitioners meet set standards of training, insurance and skill:
Botox precautions
Botulinum toxin injections, such as Botox or Dysport, are prescription-only medicines.
They can only be prescribed after a consultation between you and a healthcare professional, such as a doctor or nurse.
The person giving the injections does not have to be the same person who gave you the prescription.
But the prescriber must ensure that the person giving you the injections is trained and safe to do so.
Source: NHS
This means checking if the product being used is licensed, and asking the practitioner about their qualifications, common complications of the procedure and aftercare tips.
Brits were also warned not to buy products from websites with the intention of injecting them themselves.
Dr Alison Cave, chief safety officer at the Medicines and Healthcare products Regulatory Agency (MHRA) – which is is also investigating the outbreak – said: “Botulinum toxin is a prescription-only medicine and should only be sold or supplied in accordance with a prescription given by an appropriate practitioner such as a doctor or other qualified healthcare professional.
“Buying botulinum toxin in any other circumstances significantly increases the risk of getting a product which is either falsified or not licensed for use in the UK.
“This means that there are no safeguards to ensure products meet the MHRA’s standards for quality and safety.
“As such, they can endanger the health of the people who take them.
“Our Criminal Enforcement Unit works hard to identify those involved in the illegal trade in medicines and takes robust enforcement action where necessary. This can include criminal prosecution.”
Meanwhile, UKHSA is warning medics to be on the lookout for botulism symptoms in people who’ve recently had cosmetic procedures, so they can be given anti-toxins promptly.
Dr Godbole told patients: “If you have had a recent Botox-like treatment and are having symptoms such as difficulty swallowing or breathing, contact NHS 111 for further advice and seek treatment.”
UKHSA previously reported that practitioners connected to the botulism outbreak have stopped offering the procedure and are cooperating with the investigation.
The new cases of Botox-induced botulism in the East Midlands and East of England are not thought to be linked to 28 cases reported in the North-East in June – most of them in Durham and Darlington.
Botulinum: Everything you need to know
Botulinum toxin, commonly known by the brand name Botox, is a powerful substance used for medical and cosmetic treatments.
While Botox is generally safe when administered by trained professionals, it carries a risk of botulism, a rare but serious condition caused by toxins produced by the bacterium Clostridium botulinum.
What is botulism?
Botulism is a life-threatening illness that causes muscle paralysis. It can occur when botulinum toxin spreads beyond the intended area during medical or cosmetic procedures.
This condition, called iatrogenic botulism, can affect breathing and swallowing and requires urgent medical treatment.
Common symptoms of botulism
Symptoms can appear within hours to weeks after exposure to the toxin. Watch out for:
- Difficulty swallowing or speaking
- Dry mouth
- Muscle weakness or paralysis
- Drooping eyelids
- Blurred or double vision
- Difficulty breathing
If you experience any of these symptoms after a botulinum toxin treatment, seek immediate medical advice.
Causes and risks
Botulinum toxin is used in small, controlled doses for conditions such as muscle spasms, excessive sweating, and cosmetic wrinkle flattening.
However, if the toxin spreads or is injected incorrectly, it can lead to serious complications.
The risk is higher when unlicensed or counterfeit products are used or when treatments are done by unqualified practitioners.
Treatment
Botulism requires urgent hospital care.
Doctors may give an antitoxin to stop the toxin from causing more harm.
Supportive treatments, including mechanical ventilation, may be needed if breathing muscles are affected.
Prevention
To stay safe, only get botulinum toxin injections from licensed healthcare professionals.
Make sure the product is approved and ask questions about the procedure beforehand.
If something feels wrong during or after your treatment, seek medical help immediately.
Source: NHS
