A New York State Health Department advisory reports 10 severe illnesses tied to unlicensed botulinum toxin products purchased online.
Ten people across the United States developed severe illness and suspected botulism between May and August 2025 after injecting—or being injected with—botulinum toxin products purchased from unlicensed sources, according to a memo from the New York State Health Department citing a Morbidity and Mortality Weekly Report published last week.
“Some of the symptomatic individuals reported seeing advertisements for vendors selling botulinum toxin products on social media, including TikTok,” the memo states. “They reported contacting the vendors and purchasing the products through messaging platforms such as WhatsApp.”
Many of the products were described as unlabeled vials of white powder, lacking essential information such as dosage, manufacturer, expiration date, or warnings.
According to the New York State Health Department, symptoms began a median of three days after injection (range: 0–9 days) among the nine individuals who provided information. Reported symptoms included dysarthria, dysphagia, diplopia, ptosis, shortness of breath, and proximal extremity weakness. All 10 individuals were hospitalized and received botulism antitoxin to treat suspected botulism.
Three required intubation and mechanical ventilation. No deaths were reported. All were tested for circulating botulinum toxin, and results were negative for all—though negative testing does not rule out botulism.
The department advises individuals to receive injections only from licensed providers trained in administering FDA-approved botulinum toxin products and operating in accordance with state requirements.
The Nov 27 Morbidity and Mortality Weekly Report provides clinical details on three cases, involving women in New York, Texas, and Wisconsin who self-injected botulinum neurotoxin purchased online and required hospitalization.
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