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DH alerts public to health risks of inappropriate use of botulinum toxin injections

     The Department of Health (DH) today (June 3) alerted the public to health risks of inappropriate use of botulinum toxin injections following investigations by its Centre for Health Protection (CHP) into an additional case of suspected botulism after receiving such injections in the Mainland. The DH reiterated that 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.

     "We noted and draw the public's attention to the latest alert issued by the China Food and Drug Administration on possible health risks of inappropriate use of botulinum toxin injections following recent cases of patients being hospitalised in Beijing, Shanghai, Zhejiang and Guangdong after receiving such injections in non-healthcare settings for cosmetic purposes," a spokesman for the DH said.

     The female patient, aged 41 with good past health, has developed dizziness, slurring of speech, difficulty in chewing, facial swelling and numbness since May 27. She was admitted to Caritas Medical Centre for management yesterday (June 2) and was found to have left facial nerve palsy and neck weakness. She has been in stable condition all along.

     The patient visited a beauty premises in Luohu, Shenzhen, on May 24 where she received botulinum toxin injections to her forehead and the corners of her eyes. The preliminary clinical diagnosis was suspected iatrogenic botulism.

     "We have no evidence at this stage that patients of the four recent cases had received injections in the same premises. Epidemiological investigations are ongoing," the spokesman 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 while the Hospital Authority has also alerted healthcare professionals about the issue. All 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 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. Severe cases may result in death. 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 them 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/Friday, June 3, 2016
Issued at HKT 18:15


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