A local outbreak of iatrogenic botulism associated with cosmetic injections of botulinum neurotoxin-containing products, England, 2025

In June 2025, 25 botulism cases were identified among recipients of botulinum neurotoxin-containing cosmetic injections in North East England. A case-control study indicated that cases were more likely to have attended two specific practitioners and received an unlicensed product (p < 0.001). Testing of seized product detected a potency (370 units/vial) that was higher than listed on its labelling (200 units/vial). Strengthened regulation of cosmetic procedures is necessary for mitigating public health risks, which are exacerbated by the availability of unlicensed products.