Hong Kong health officials reported an update on its investigations and follow-up on the seven cases of suspected botulism after receiving injections last month, and again advised the public that such injections should only be prescribed and performed by registered doctors.

Hong Kong/CIA
Hong Kong/CIA

Among the seven female patients aged 21 to 47, the woman aged 33 reported on June 22 was still hospitalized in Kwong Wah Hospital for management in stable condition, while the others have all been discharged. Antitoxin was used in two of the patients. All patients received the injections in May.

“Upon further inquiries, the woman aged 41 reported on June 3 clarified with us that she received botulinum toxin injections to her forehead and the corners of her eyes on May 24 by a suspected unregistered doctor in a beauty premises in Mong Kok, instead of Shenzhen. Both this case and that affecting a woman aged 39 reported on June 22 have been referred to the Police for suspected illegal practice of medicine and possession of Part 1 poison,” a spokesman for the Department of Health (DH) said.

The other five cases reported that they had received injections in the Mainland: four in Shenzhen and one in Guangzhou. No evidence has been detected at this stage that they had received injections in the same premises. Epidemiological investigations are ongoing.

“We have been maintaining close liaison with Mainland health and drug regulatory counterparts to identify if there are similar cases. We noted that follow-up measures have been taken by the relevant Mainland health authority,” the spokesman said.

“We are also concerned about a recent report of suspected illegal practice of medicine and possession of Part 1 poison involving botulinum toxin injection prescribed and performed by a suspected unregistered doctor in a non-healthcare setting. We appeal for more information for follow-up and investigations by law enforcement agencies,” the spokesman said.

Letters have been issued to doctors and hospitals to draw their attention to the latest information (www.hkpcn.org.hk/eng/ER.html) compiled by the multi-disciplinary Hong Kong Poison Control Network on the diagnosis and management of botulism following botulinum toxin injections. Clinicians should consult the Hong Kong Poison Information Centre in United Christian Hospital or the Poison Treatment Centre in Prince of Wales Hospital if necessary.

The Department of Health has stepped up publicity and public education on differentiating medical procedures from beauty services, including an Announcement in the Public Interest (API) entitled “Think twice and get the details before deciding on beauty procedures” (www.isd.gov.hk/eng/tvapi/13_md246.html). Fact sheets with health advice on various common cosmetic procedures are available on the DH’s dedicated page (www.dh.gov.hk/english/useful/useful_medical_beauty/useful_medical_beauty.html) to alert the public to potential risks and complications.

The hotline (2125 1133) set up on May 30 has so far received 11 calls with no abnormalities detected. The last call was received on June 20. It will be suspended after 6pm tomorrow (June 30).

“Patients with compatible symptoms following injections should promptly seek medical advice for diagnosis and management, while clinicians must report to the Centre for Health Protection in case of patients suspected of botulism,” the spokesman added.

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.