It's sad sometimes for one's skepticism to be so justified.
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Date: Mon, 29 Nov 2004 13:37:07 -0500 (EST)
From: ProMED-mail
Subject: PRO/EDR> Botulism, human - USA (FL): botox related?
BOTULISM, HUMAN - USA (FLORIDA): BOTOX RELATED?
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A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
[1]
Date: Mon 29 Nov 2004
From: ProMED-mail
Source: TheBostonChannel.com [edited]
2 botulism cases may be linked to botox
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Health officials are investigating whether a Florida man and woman got
botulism from botox injections. A spokesman for the Palm Beach County
Health Department said both patients got botox at the same clinic in
Broward County. They've since been hospitalized.
Botox is a derivative of the toxin that causes botulism. It's used as an
antiwrinkle drug [as well as treatment for strabismus, blepharospasm, and
cervical dystonia - Mod. LL]. A spokeswoman for the Centers for Disease
Control and Prevention said the agency is trying to learn whether the
Florida cases and 2 cases elsewhere are related to Botox.
Authorities are not releasing the name of the clinic and won't say when the
patients received the injections of Botox. A Florida woman died last year
after suffering an allergic reaction to Botox. But the company that makes
the drug stresses its safety record -- saying just 7 people had serious
side effects in the 1990s.
******
[2]
Date: Mon 29 Nov 2004
From: ProMED-mail
Source: Sun-Sentinel.com
Health officials are investigating whether a Palm Beach Gardens couple
hospitalized on life-support over the weekend are suffering complications
from a cosmetic treatment at a Fort Lauderdale clinic. The unidentified
couple in their 50s are being treated for botulism, a rare and potentially
fatal paralytic illness that affects muscles, eyes, limbs and respiratory
tract, said Dr Charles Schallop, a neurologist treating them at Palm Beach
Gardens Medical Center. They were both in critical condition Sunday night
and were breathing through ventilators and receiving intravenous feeding,
he said.
Schallop said the couple told him that they went to the Advanced Integrated
Medical Center last Wednesday and were injected with a cosmetic treatment
that was supposed to be Botox. By the next morning, they felt weak, had
trouble breathing and speaking and went to the hospital. Schallop said the
couple also told him that a doctor at the clinic and his girlfriend got the
same treatment last week and also had fallen ill. The couple are now
hospitalized in New Jersey, he said, but he knew no other details.
CDC is investigating the cause of the illness along with the health
departments in Florida and New Jersey and the Food and Drug Administration,
CDC spokeswoman Bonnie Hebert said. "It's too early to say anything yet,"
she said.
Schallop said he suspects both couples might have received the illness from
either contaminated doses of Botox or some other drug in their treatment.
"This is a severe adverse reaction most likely due to a contaminated vial,"
he said. "I just don't want anyone else coming down with this until we
figure this out."
Health officials are determining whether Botox or another chemical was used
in the injections. Stephanie Fagan, a spokeswoman for Allergan, which
produces Botox, said her company found out about the illnesses on Sunday
and was working with authorities to determine whether its products were
sent to Advanced Integrated Medical Center.
Tim O'Connor, spokesman for Palm Beach County Health Department, said his
department would determine definitively whether the Palm Beach Gardens
couple was diagnosed with botulism. Lab work at the hospital and antidotes
given to the couple will make the final determination, he said.
Officials will also examine where the couple have been in the past week and
what other doctors they may have visited and for what treatment. Hospitals
in Palm Beach and Broward counties were alerted Saturday night to be on the
lookout out for symptoms of botulism, O'Connor said. Symptoms include
weakness and troubles with breathing and speaking. An average of 110 cases
of botulism are reported each year in the United States, according to CDC.
Officials plan to examine Advanced Integrated's client list as well,
O'Connor said. "The first thing to figure out is where anyone else was
exposed to this," he said.
Botox is a sanitized derivative of botulinum toxin Type A, a bacterium
found in contaminated food. Types of botox are used to smooth wrinkles by
freezing muscles in areas where it is injected. Other types can be used for
treatment of crossed eyes, uncontrollable blinking and head and neck
spasms. On its website, Advanced Integrated Medical lists various services
including treatment of pain and injuries, increased strength and endurance
and a variety of cosmetic procedures.
(byline: Ted White, Leon Fooksman)
- --
ProMED-mail
[Each vial of Botox contains 100 units of _Clostridium botulinum_
neurotoxin A complex that is vacuum-dried to be reconstituted before use.
The purpose of the therapies is to actually produce "local" botulism of the
musculature injected. If the cases of "systemic" botulism are due to Botox
injections, it may be that the material was incorrectly diluted, too large
a volume of correctly diluted toxin was given, or a manufacturing error
occurred. If the latter occurred, more cases may be found. - Mod.LL]
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