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CHP investigates additional case of suspected botulism following botulinum toxin injections

     The Centre for Health Protection (CHP) of the Department of Health (DH) is tonight (May 29) investigating an additional suspected case of botulism after receiving injections of botulinum toxin in the Mainland, and again urged the public that such injections should only be prescribed and performed by registered doctors.

     The CHP was notified by Caritas Medical Centre (CMC) tonight that a female patient, aged 41 with good past health, had developed difficulty in swallowing and breathing as well as weakness of neck muscle since May 11. She attended the Accident and Emergency Department of CMC today and was admitted for management. She has been in stable condition all along.

     The patient travelled to Shenzhen this month during which she received at least three injections of botulinum toxin to her forehead, face and neck. The preliminary clinical diagnosis was suspected iatrogenic botulism.

     "We are very concerned about this additional case and recent reports of consultations following botulinum toxin injections in the Mainland. We are maintaining close liaison with the Hong Kong Poison Information Centre of the Hospital Authority and relevant medical professionals for more information to identify if there are similar cases," a spokesman for the DH said.

     "We urge those who developed compatible symptoms upon botulinum toxin injections to immediately seek medical attention for prompt management and their information is key to our epidemiological investigations. A hotline (2125 1133) will be set up tomorrow (May 30) operating from 10am to 6pm to appeal for cases and information," the spokesman added.

     The CHP has issued letters to doctors and hospitals to remind them of the statutory notification of botulism. Clinicians must report to the CHP in case of patients with symptoms or history suspected of botulism.

     In Hong Kong, botulinum toxin is a pharmaceutical product and must be registered with the Pharmacy and Poisons Board of Hong Kong before it can be supplied in the market. All registered pharmaceutical products must carry a Hong Kong registration number in the format of "HK-XXXXX". Unregistered pharmaceutical products should not be used as their safety, quality and efficacy are not guaranteed.

     "Botulinum toxin can be used for medical purposes, such as treatment of overactive bladder, and cosmetic purposes. Injections should only be performed by registered doctors," the spokesman said.

     "Due to the weakening of associated muscles, patients receiving the injection may have problems with chewing or even swallowing, speaking or breathing. These problems may happen hours, days or weeks after an injection. In some cases, botulinum toxin may spread and affect other areas away from the injection site, resulting in symptoms including hoarseness, drooping of the eyelids, double vision or blurred vision," the spokesman said.

     The DH urged the public to observe the health advice below before receiving botulinum toxin injections:

* Injections should only be performed by locally registered doctors;
* The cosmetic effects of botulinum toxin after injections are temporary and will gradually disappear;
* Understand the procedure, potential risks and complications before receiving botulinum toxin injections. Consult a doctor for an informed decision;
* Do not receive an injection in case of a history of allergy to botulinum toxin or infection or inflammation on the injection site;
* Request the full name of the doctor in writing if referred by a beauty service provider to a doctor for the procedure, as well as the professional qualifications and relevant experience of the doctor; and
* If symptoms develop, such as fever or feeling unwell, seek medical attention immediately.

     The public may visit the DH's pages below for more information:

* The differentiation between medical procedures and beauty services (;
* The Drug Database of the Drug Office (; and
* The CHP's botulism page (

Ends/Sunday, May 29, 2016
Issued at HKT 23:11


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