The Centre for Health Protection (CHP) of the Department of Health (DH) is today (June 14) investigating a probable case of botulism after receiving injections of botulinum toxin in Zhuhai. The CHP again reminded the public that botulinum toxin injections should only be prescribed and performed by registered doctors.
The case involves a female patient aged 57 with good past health. She has presented with symptoms including slurred speech and swallowing difficulty since May 18, and ptosis since May 19. She attended the Accident and Emergency Department of Queen Mary Hospital and was admitted for treatment on May 22, but was discharged against medical advice on the same day. She was admitted to Queen Mary Hospital again on May 23 due to increased slurred speech and swallowing difficulties and was discharged after treatment on May 25. The patient attended the Accident and Emergency Department of Tseung Kwan O Hospital on June 2 due to shortness of breath, choking and limb weakness. She was admitted on the same day and transferred to the Intensive Care Unit for further management on June 5. She is now in critical condition. The clinical diagnosis was suspected iatrogenic botulism.
Initial investigations revealed that the patient received botulinum toxin injections at a beauty parlour in Zhuhai on April 27 and May 15. The CHP has reported the case to the relevant authority of the Mainland. Epidemiological investigations are ongoing.
"In Hong Kong, Botulinum toxin injections should only be performed by a locally registered doctor. Customers should verify the doctor's full name against the list of registered doctors of the Medical Council of Hong Kong as well as their professional qualifications and relevant experience. When receiving injections outside Hong Kong, pay special attention to ensure the provider is qualified or registered with relevant jurisdictions for practice. In case of injections obtained from suspicious sources, refrain from receiving them. If feeling unwell, seek medical advice from eligible medical professionals as soon as possible," a spokesman for the DH said.
Due to the weakening of associated muscles and the fact that botulinum toxin may spread and affect other areas beyond the injection site, affected patients may have drooping of the eyelids, double vision or blurred vision, problems with chewing, hoarseness or even difficulties in swallowing, speaking or breathing, which may happen hours, days or weeks after the injection.
The DH urged the public to observe the health advice below before receiving botulinum toxin injections:
- Injections in Hong Kong should only be performed by locally registered doctors;
- Understand the procedure, potential risks and complications before receiving injections. Consult a doctor for an informed decision;
- Do not receive injections obtained from suspicious sources;
- Do not receive an injection in the 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.
​The public may visit the DH's webpage on the differentiation between medical procedures and beauty services, the Drug Database of the Drug Office and the CHP's botulism page for more information.​
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