In an update yesterday, the European Centre for Disease Prevention and Control (ECDC) said 20 more cases of botulism linked to a weight loss procedure performed in Turkey have been reported in Germany, France, and Switzerland.
The 87 cases of the neuroparalytic illness reported since late February have all been tied to intragastric injection of the botulinum neurotoxin (BoNT) for the treatment of obesity at two private hospitals in Istanbul and Izmir from February 3 through March 1. Investigations by Turkish authorities have revealed that licensed BoNT products were used off-label for treatment of obesity at the two facilities. The relevant departments at both hospitals have had their activities suspended.
Of the confirmed cases, 53 have been reported in Turkey, 30 in Germany, 2 in Switzerland, and 1 each in France and Austria. Several of the case patients have been hospitalized, with a number reported to have been admitted to intensive care units and treated with botulinum anti-toxin.
BoNT products, such as Botox, are derived from the bacterium Clostridium botulinum and are commonly used for cosmetic purposes or for treatment of muscle spasticity. Excessive doses of BoNTs can cause botulism.
The ECDC is warning European Union/European Economic Area citizens to avoid intragastric treatments with BoNT for obesity in Turkey and is encouraging people who traveled to Istanbul or Izmir for the procedure in February to seek medical advice if they experience weakness or difficulty breathing and/or swallowing.