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  • Public Health Advisory: Adverse Effects Linked to Counterfeit or Mishandled Botulinum Toxin Injections

Public Health Advisory: Adverse Effects Linked to Counterfeit or Mishandled Botulinum Toxin Injections

Updated:
January 21, 2026
Published:
April 30, 2024

What You Need To Know 

The New Jersey Department of Health’s Communicable Disease Service is collaborating with the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and other authorities to investigate reports of adverse effects following botulinum toxin injections received from unlicensed or untrained individuals or in non-healthcare settings, such as homes and spas. As of April 18, 2024, 22 people from 11 states (including 1 from NJ) have reported adverse effects. No deaths have been reported. 

Action Items:

  • Clinicians should consider the possibility of adverse effects from botulinum toxin injections, including those administered for cosmetic reasons, when patients present with signs and symptoms consistent with botulism.
  • Clinicians should reach out to the Communicable Disease Service (CDS) at NJDOH immediately if clinical consultation supports systemic botulism. 
  • Clinicians should counsel patients who report using or being interested in using botulinum toxin about potential adverse events.
  • Clinicians should encourage patients to receive injections only from licensed providers in licensed settings.
  • Local Health Departments should collect clinical and epidemiological risk factors and immediately report suspect adult botulism cases to CDS.
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