Forwarded by the Los Angeles County Department of Public Health
Forwarded by the Los Angeles County Department of Public Health
CDC Health Advisory:
Adverse Effects Linked to Counterfeit or Mishandled Botulinum Toxin Injections
April 23, 2024
The Centers for Disease Control and Prevention (CDC) have issued a Health Advisory to alert clinicians about risks of counterfeit or mishandled botulinum toxin injections. CDC, the U.S. Food and Drug Administration (FDA), and state and local partners are investigating clusters of 22 people in 11 U.S. states reporting adverse effects after receiving injections with counterfeit botulinum toxin or injections administered by unlicensed or untrained individuals or in non-healthcare settings, such as homes or spas. Per California Department of Public Health, two California residents are included in the investigation. Eleven patients were hospitalized and none have died.
Botulism is the disease caused by botulinum toxin circulating in the blood and producing effects remotely from the injection site. When botulinum toxin diffuses around the injection site, it can result in adverse effects. There may be symptom overlap between the presentation of localized adverse effects from injection of botulinum toxin, especially in the head and neck, and the early symptoms of botulism. Information about the botulinum toxin injection (e.g., dose) can help clinicians distinguish between botulism and localized adverse effects but is challenging to obtain for counterfeit products. Clinicians should consider the possibility of adverse effects from botulinum toxin injections in patients presenting with localized paralysis. 
Botulism is a medical emergency and requires immediate medical and public health response. Clinicians must immediately report any patients with suspected botulism to Public Health. Public Health is available 24/7 to provide consultation.
Los Angeles County DPH Acute Communicable Disease Control:
  • Weekdays 8:30 am–5:00 pm: call 213-240-7941.
  • After-hours: call 213-974-1234 and ask for the physician on call.
Long Beach Health and Human Services:
  • Weekdays 8:00 am-5:00 pm: call 562-570-4302.
  • After hours: call the duty officer at 562-500-5537.
Pasadena Public Health Department:
  • Weekdays 8:00 am-5:00 pm: call 626-744-6089.  
  • After hours: call 626-744-6043.
Click here to read the full CDC Advisory
You can also view the PDF or copy and paste this link into your browser: emergency.cdc.gov/han/2024/han00507.asp
To view this and other communications or to sign-up to receive LAHANs, please visit ph.lacounty.gov/lahan.
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