Health officials in the UK are investigating reports of dozens of people suffering from a potentially life-threatening condition following Botox procedures in northeastern England, as well as allegations of the illegal sale of Botox-like products.
The local trust of the UK’s National Health Service (NHS) in the county of Durham put out an alert on June 13 about several people seeking medical attention after having adverse reactions to cosmetic procedures involving Botox.
Since the incident first came to light last week, 28 individuals have reported symptoms of botulism after receiving cosmetic procedures, the UK Health and Security Agency (UKHSA) told CNN in a statement Friday.
Botulism is a life-threatening condition caused by toxins made by Clostridium botulinum bacteria that attack the nervous system and cause paralysis.
“These toxins (but not the bacteria) are the active ingredient in Botox and similar products,” Dr. Joanne Darke, a consultant in health protection at the UKHSA, said in the statement, adding that it is “important to go to a licensed practitioner.”
Iatrogenic botulism is a type of botulism that occurs when too much of the cosmetic form, Botox, is injected into a muscle. Botox is a leading cosmetic treatment for wrinkles, as well as for medical conditions such as migraines and excessive sweating.
The UKHSA said the reactions reported have included symptoms of severe drooping of the upper eyelids, double vision, difficulty swallowing, slurred speech and lethargy.
Other symptoms of botulism can include facial muscle weakness.
Botulism requires immediate medical attention and is fatal in 5-10% of cases, according to the NHS website.
While most people make a full recovery with treatment, which typically involves getting injections with antitoxins, without quick care, paralysis can spread to muscles used to control breathing.
Evidence so far does not suggest contamination
While investigations into the cause of the cases are ongoing, the UKHSA said that “evidence so far does not suggest that the product used has been contaminated. Symptoms are being reported a few days up to four weeks after injection.”
“The practitioners associated with most of the reported cases are no longer carrying out these procedures,” said Dr. Simon Howard, a consultant in health protection at the UKHSA, in the statement.
“However, that does not mean that we may not see more cases as symptoms can take up to four weeks to develop although we are now seeing the number of cases coming forward decreasing which is encouraging news,” he continued.
Howard advised people to ensure they take precautions when seeking aesthetic procedures and advised anyone with symptoms to seek medical attention.
The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) told CNN Friday that it is investigating “allegations surrounding the illegal sale and supply of Botox-type products in the North-East, and want to reassure the public that we take such claims very seriously.”
The agency encouraged people in the UK who believe they have had side effects from medicine or received falsified stock to report it to its Yellow Card program.
“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,” Dr. Alison Cave, chief safety officer at MHRA, said in the statement.
“Botulinum toxin (Botox) is a prescription-only medicine and should only be available in the UK under the supervision of a doctor or other qualified healthcare professional,” she continued.
In the United States, a growing cluster of botulism cases linked to cosmetic injections was reported in Massachusetts earlier this month. The state’s Department of Health said it was investigating 10 cases of suspected iatrogenic botulism all associated with Botox procedures performed at one spa, Rodrigo Beauty.
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