IDPH Alerts Healthcare Providers to Cluster of Illnesses Resembling Botulism from Possibly Counterfeit Botox

State and local health departments & IDFPR investigate following hospitalization of two people who received injection of Botox-like substance in LaSalle County

CHICAGO - The Illinois Department of Public Health (IDPH) has alerted healthcare facilities and especially hospital emergency departments to be on a heightened lookout for patients who present with symptoms similar to botulism following a cluster of two cases reported in Illinois of people who received injections in LaSalle County of Botox or a similar possibly counterfeit product. IDPH is working with the LaSalle County Health Department and the Illinois Department of Professional Regulation (IDFPR) on the investigation of the cluster. A similar cluster was also reported by the Tennessee Department of Health and IDPH is in contact with the CDC and FDA regarding this investigation.

The two individuals in Illinois reported symptoms similar to botulism such as blurred/double vision, droopy face, fatigue, shortness of breath, difficulty breathing, hoarse voice following injection with either Botox or a possibly counterfeit version of the product. Both individuals in Illinois required hospitalization. Both had received injections from a licensed nurse in LaSalle County who was performing work outside her authority.

"Illinois residents should exercise caution when considering cosmetic treatment," said IDPH Director Dr. Sameer Vohra.  "Receiving these treatments in unlicensed, unapproved settings can put you or your loved ones at serious risk for health problems.  Please only seek cosmetic services under the care of licensed professionals trained to do these procedures and who use FDA approved products.  If you are experiencing any health problems after a recent cosmetic treatment, please contact your healthcare provider immediately for help and assistance."

In Illinois, the injection of botulinum toxin, the key ingredient in Botox, is a practice of medicine that may only be performed by certain licensed professionals who are licensed and regulated by IDFPR. Those professions include:

• Physicians: may perform practices intended to affect the living layers of the skin per the requirements of the Illinois Medical Practice Act.
• Nurses: may also perform such practices under the supervision of a physician.
• Advanced Practice Registered Nurses (APRNs): may perform practices consistent with their collaborative agreement with a physician.
• APRNs with Full Practice Authority: may perform such practices consistent with their national certification.
• Physician Assistants: may perform such practices consistent with their collaborative agreement with a physician.

Cosmetologists and estheticians are prohibited from performing this practice under their licenses (for more information, see IDPFR's Statement on Prohibited Practices).

"As the State of Illinois' head regulatory agency, IDFPR prioritizes protecting consumers and equipping them with the tools they need for safe, informed decision-making," said IDFPR Secretary Mario Treto, Jr. "We encourage everyone to use the resources on our website to ensure they receive services from trained, licensed professionals, as well as to inform us of the unlawful provision of medical services to maintain the highest quality of care throughout the State of Illinois."

Consumers and patients can check if a professional is licensed with IDFPR by using the Department's License Lookup Tool. In addition, the unlawful provision of medical services (and any suspected wrongdoing by professionals) should be reported to IDFPR by Filing a Complaint.

In the alert to healthcare providers issued April 3, IDPH urged providers and especially emergency department staff to be on the lookout for patients with symptoms that resemble botulism. Providers are also urged to record a thorough history on any recent receipt of botulinum toxin products, including purpose (e.g., cosmetic), name and address where the

 administration occurred, injection sites, number of doses administered, product used, date of administration and person who administered the injection.

Providers are also urged to immediately report any such cases to their local health department for further investigation. Cases of botulism should always be reported by local health departments to IDPH.

Health practitioners should check with Allergan, the FDA approved maker of Botox, to make sure that the distributor they purchase from is authorized to distribute Botox. To access a list of authorized Botox suppliers, visit Allergan's website.

Botulism is a rare, but potentially deadly illness characterized by muscle paralysis. Botulism is caused by a nerve toxin that is produced by a bacterium called Clostridium botulinum found in nature, which is an ingredient in Botox and other similar substances used for cosmetic reasons. The purified form of the botulinum toxin is approved by the FDA for use by licensed healthcare providers as a cosmetic treatment.

For information on botulism, click HERE.