Between late February and March 10, 2023, the European Centre for Disease Prevention and Control (ECDC) reported 67 cases of botulism related with intragastric injection of botulinum neurotoxin (BoNT), with 12 cases in Germany, one each in Austria and Switzerland, and 53 cases in Turkey.

The symptoms ranged from mild to severe, and several people were admitted to the hospital. Some people are said to have been admitted to intensive care units and treated with botulinum antitoxin among those hospitalized.

BoNT injections are used to relax the stomach wall muscles, thereby slowing stomach emptying. As a result, the sensation of fullness arrives sooner and lasts longer.

The process can be repeated every six months and is recommended for people who want to reduce a moderate amount of weight (less than 5% of their body weight). The effects persist for approximately three months.

The ECDC strongly advises EU/EEA individuals to avoid intragastric BoNT treatments for obesity in Turkey, as these are currently related to a considerable risk of botulism. It is unknown whether this occurrence represents a therapeutic or procedural issue in the hospitals involved or if there is a problem with the product being provided.

Toxicities associated with cosmetic treatments include blurred vision, drooping eyelids, difficulty eating, and dry lips, but toxicities associated with therapeutic therapies include difficulty breathing, indicating an overdose.

According to the ECDC, there is little data on mortality in botulism cases caused by medical interventions. 5% to 10% of instances of food-borne botulism are severe causing fatality.

(Source: https://www.medscape.com/viewarticle/990094)