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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 today (June 2) investigating an additional suspected case of botulism after receiving injections of botulinum toxin in the Mainland. Procedures involving injection should only be prescribed and performed by registered doctors, and the public should hence prudently consider whether to undergo such procedures outside Hong Kong.

     The female patient, aged 21 with good past health, has developed blurred vision, neck weakness and difficulty in swallowing since May 26. She attended the Accident and Emergency Department of North District Hospital today and was admitted for management with stable condition all along.

     The patient visited a beauty premises in Buji, Shenzhen, on May 24 where she received botulinum toxin injections to her both calves. The preliminary clinical diagnosis was suspected iatrogenic botulism.

     "We have no evidence at this stage that patients of the three recent cases had received injections in the same premises. Epidemiological investigations are ongoing," a spokesman for the DH said.

     Anyone who develops compatible symptoms following botulinum toxin injections is urged to immediately seek medical attention for prompt management, and call the DH's hotline (2125 1133), operating from 9am to 6pm from Monday to Friday, to provide details for epidemiological investigations. No abnormalities have been detected so far.

     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 histories of suspected botulism.

     "We are very concerned about recent cases and 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, relevant medical professionals, and Mainland health and drug regulatory counterparts to identify if there are similar cases," 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 in hours, days or weeks. Botulinum toxin may spread and affect other areas beyond the injection site, resulting in 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;
* 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 for the procedure, as well as the professional qualifications and relevant experience; and
* If symptoms develop, such as fever or feeling unwell, seek medical attention immediately.

     "Those who must receive injections outside Hong Kong should pay special attention to ensure that practitioners are qualified or registered with relevant jurisdictions. If in doubt, stop using or receiving the injection immediately. Promptly consult qualified healthcare professionals if feeling unwell," the spokesman added.

     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/Thursday, June 2, 2016
Issued at HKT 16:14


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