Multnomah County, Ore. (June 18, 2025) — Public health authorities in Multnomah County, in collaboration with the Oregon Health Authority, are investigating a suspected case of iatrogenic botulism following injections of possibly counterfeit or improperly handled botulinum toxin (products similar to the brand name “Botox”).
As of June 18, 2025, one suspected case of botulism-like illness has been reported in a Multnomah County resident who was recently hospitalized. The patient improved after receiving botulism antitoxin and has been discharged.
This individual received a botulinum toxin injection for cosmetic purposes on June 6 from a person found to be unlicensed to administer the injections and who administered the injections in a non-clinical setting. The person who administered the injections is a resident of Clark County, and Multnomah County is working with Clark County Public Health on an investigation.
“We cannot stress enough the importance of receiving botulinum toxin injections only from licensed and trained medical professionals using FDA-approved products obtained from authorized suppliers. Purchasing these products online is a risky move,” said Multnomah County Health Officer Dr. Richard Bruno. “If in doubt, don’t get the injection.”
“If you or someone you know experiences symptoms such as blurry vision, drooping eyelids, difficulty swallowing, slurred speech, or difficulty breathing after an injection, seek immediate medical care.”
The investigation into the unlicensed individual and the product is ongoing. Last year, the Centers for Disease Control and Prevention reported 17 cases of harmful reactions linked to counterfeit Botox.
Due to concerns about additional potential cases, public health officials are advising medical personnel throughout the metro area to be vigilant for patients presenting with the following symptoms and to report suspected cases immediately to the local public health authority (for Multnomah County that’s 503-988-3406):
- Blurry or double vision
- Drooping eyelids
- Difficulty swallowing
- Slurred speech
- Difficulty breathing
- Muscle weakness