Irish patients warned against weight-loss procedure in Turkey after rise in botulism cases

Sixty cases of the life-threatening illness have been linked to a private hospital in Istanbul, says ECDC

Patients from Ireland and other EU states have been warned against undergoing gastric Botox treatment in Turkey following a spike in life-threatening illnesses linked to clinics there.

Since late February, 67 cases of botulism linked to gastric Botox procedures have been reported, according to the European Centre for Disease Control (ECDC). All involved patients who had had weight-loss interventions.

The vast majority (53) were reported in Turkey, with further cases identified in Germany (12), Austria (1) and Switzerland (1).

Of the 63 cases where further information is available, 60 are linked to a private hospital in Istanbul and three to a private hospital in Turkey.


The symptoms have ranged from mild to severe and several cases have been hospitalised, according to the ECDC. Among those hospitalised, “a number” are reported to have been admitted to intensive care, where they were treated with botulinum antitoxin.

Anyone who travelled to Istanbul or Izmir for an intragastric injection of the botulism neurotoxin (BoNT) treatment between February 22nd and March 1st is encouraged to seek medical advice, particularly if they experience symptoms such as weakness, and difficulty in breathing and/or swallowing. The treatment limits stomach contractions and decreases appetite.

“ECDC strongly encourages EU/EEA citizens to avoid intragastric treatments with BoNT for obesity in Turkey as this is currently associated with a significant risk of developing botulism,” the Stockholm-based monitoring body said on Tuesday. “At this time, it is unclear whether this event represents a therapeutic or procedural issue in the involved hospitals, or whether there is a problem with the product administered.”

Investigations carried out by Turkish authorities have revealed that licensed BoNT products were administered in the treatments but that these products are not approved for the treatment of obesity by intragastric injection, the ECDC said. “Consequently, the relevant departments of both hospitals have had their activities suspended, and investigations have been launched against the parties involved.”

Botulism is a rare but life-threatening condition caused by toxins produced by Clostridium botulinum bacteria, which occur in soil and dust.

The toxins attack the nerves, brain and spinal cord and cause paralysis. Most people make a full recovery with treatment, but the paralysis can spread to the muscles that control breathing if it is not treated quickly. This is fatal in around five to 10 per cent of cases.

People who receive Botox injections for cosmetic reasons such as smoothing wrinkles, or to manage muscle tone, can develop botulism if the amount used to inject them is excessive.

A number of Irish people have died over the past year from complications of medical treatment in Turkey, according to the Department of Foreign Affairs.

If you are considering travelling abroad for surgical care, the RCSI has published guidance here.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.