UKHSA Warns of Botulism Threat
UKHSA warns public to be alert to botulism following adverse reactions to cosmetic procedures involving botulinum toxin.
UK Health Security Agency (UKHSA) is warning people to be aware of the signs and symptoms of botulism after a small number of individuals presented to NHS healthcare settings following adverse reactions after receiving cosmetic procedures involving botulinum toxin.
The cases are in addition to those recently diagnosed in the North East region and relate to procedures carried out in the East of England and East Midlands. To date, 38 cases of iatrogenic botulism have been reported between 4 June and 14 July 2025.
As yet there are no known links between the newly diagnosed cases and those in the North East.
Investigations are ongoing but evidence so far suggests the use of an unlicensed Botox-like product. It is understood that those practitioners involved in this latest incident have ceased the procedure and are co-operating with the ongoing investigation.
Reactions have included:
- difficulty swallowing
- slurred speech
- breathing difficulty requiring respiratory support
UKHSA has issued national advice to clinicians to ensure that they look out for botulism in people who may have had a recent aesthetic procedure, in order to provide them appropriate treatment which includes giving anti-toxin.
UKHSA is also advising people to take precautions when seeking aesthetic procedures, including checking if the product being used is licensed.
Dr Gauri Godbole, Consultant Medical Microbiologist at UKHSA, said:
We are working closely with our partners to reduce the public health risk and would advise people to make sure they take precautions when seeking aesthetic procedures.
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 4 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.
If you are considering having a cosmetic procedure, please make sure to check that your practitioner is using a licensed product. On the NHS website there is
https://www.gov.uk/government/news/ukhsa-issues-warning-over-botulism