In a follow-up to a report Friday concerning a botulism case in Hong Kong linked to receiving botulinum toxin injection in China, Hong Kong health officials report an additional suspected case of botulism after receiving injections of botulinum toxin in the Mainland, prompting officials to urge the public that such injections should only be prescribed and performed by registered doctors.

The Centre for Health Protection (CHP) was notified by Caritas Medical Centre (CMC) Sunday 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 traveled 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.
This follows the first case in a female patient aged 47 reported on May 27. It was revealed that she had traveled to Shenzhen on May 15 and visited a beauty premises where she received botulinum toxin injections to each leg.
“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 Department of Health (DH) said.
Concerning the investigation into the cases, a DH spokesman said, “As the first patient refused to provide further information and the second patient cannot recall the exact location, we have no evidence at this stage that both patients received injections at the same premises. Epidemiological investigations are ongoing.”
“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.
The DH has informed the National Health and Family Planning Commission and the Health and Family Planning Commission of Guangdong Province as well as the China Food and Drug Administration, the Guangdong Food and Drug Administration and the Food and Drug Administration of Shenzhen Municipality of both cases to alert them to the patients’ exposure history in the Mainland,” the spokesman said.
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