Health chiefs have urged people to be aware of the symptoms of botulism after more people suffered reactions following cosmetic procedures involving botulinum toxin, also known as Botox.
New cases in the east of England and East Midlands suggest the use of an unlicensed Botox-like product, the UK Health Security Agency (UKHSA) said.
Reactions have included severe eyelid drooping, double vision, trouble swallowing, slurred speech and lethargy, which can happen weeks after the procedure.
They are not thought to be linked to the cases reported in the north east of England last month.
There have been 38 cases of iatrogenic botulism – a rare form of the illness that happens as a result of medical treatment – reported between June 4 and July 14, according to UKHSA data.
Dr Gauri Godbole, consultant medical microbiologist at UKHSA, said: “Botulism related to aesthetic procedures is rare, but it can be serious.
“It is caused by toxins produced by the bacterium clostridium botulinum.
“These toxins, but not the bacteria, are the active ingredient in Botox and similar products.
“Symptoms of botulism can take up to four weeks to develop and if you have had a recent botulinum toxin (Botox-like) treatment and are having symptoms such as difficulty swallowing or breathing, contact NHS 111 for further advice and seek treatment.”
Dr Godbole also urged anyone considering having cosmetic procedures to check that their practitioner is licensed.
Professor Meghana Pandit, co-national medical director secondary care at NHS England, added: “When these procedures go wrong, there is a risk of serious infections and permanent scarring, which is why only registered professionals like a doctor, a nurse or pharmacy prescriber should be prescribing these treatments.”
Dr Alison Cave, chief safety officer at the Medicines and Healthcare products Regulatory Agency, warned that “botulinum toxin is a prescription-only medicine and should only be sold or supplied in accordance with a prescription given by an appropriate practitioner such as a doctor or other qualified healthcare professional”.
She said: “Buying botulinum toxin in any other circumstances significantly increases the risk of getting a product which is either falsified or not licensed for use in the UK.
“This means that there are no safeguards to ensure products meet the MHRA’s standards for quality and safety. As such, they can endanger the health of the people who take them.
“Our criminal enforcement unit works hard to identify those involved in the illegal trade in medicines and takes robust enforcement action where necessary. This can include criminal prosecution.”
The practitioners involved with the latest cases have ceased the procedure and are co-operating with the investigation, the UKHSA said.
The agency is advising healthcare staff to ensure they look out for botulism in people who may have had a recent aesthetic procedures.
Treatment for the symptoms includes an anti-toxin.
