An outbreak of botulinum poisoning has been traced back to two private hospitals in Türkiye, where patients underwent a medical procedure intended to help them lose weight.
According to a report by the European Center for Disease Prevention and Control (ECDC), a total of 67 cases of botulism have so far been reported, mostly from Türkiye, with a dozen in Germany, one in Austria, and another in Switzerland.
No deaths have yet been reported, though some of the more severe cases have been admitted for intensive care treatment.
Botulism is a paralytic illness caused by the bacterium Clostridium botulinum, which commonly grows from spores in oxygen-free environments like that can of beans swelling up in the back of the pantry you've been avoiding since last summer.
In milder cases it can cause blurred or double vision, slurred speech, nausea, or diarrhea. More severe poisoning can prevent breathing, with death occurring in 5 to 10 percent of cases.
The offensive nerve-blocking toxin poison churned out by the tiny microbe has however found a use in recent years as a medication.
Injecting carefully measured doses of the neurotoxin into specific parts of the body can be a handy way for trained medical specialists to switch off targeted muscles responsible for pain or cosmetic problems.
Readily associated with cosmetic procedures that prevent skin from wrinkling, 'Botox' treatment has a variety of other applications, from easing chronic migraines to preventing excess sweating in areas like the armpits.
Following promising results in animal experiments in the early 2000s, botulinum toxin A (BTX-A) injections into the stomach wall via an endoscope have become a means of slowing digestion and holding onto that 'full' feeling for a little longer.
An increasing number of clinics around the world are providing the procedures – sometimes called 'stomach Botox' or 'gastric Botox' treatments – which so far appear to be a relatively safe option, though questionable in their long-term effectiveness as an aid in weight loss.
Of course, when you're dealing with one of the world's deadliest poisons, absolute safety can be difficult to guarantee. There isn't a lot of wiggle-room in calculating a safe and effective dose of BTX-A, which is considered to be lethal beyond a nanogram per kilogram of body mass.
Botulinum toxin is in fact made up of several different substances, each unique in its potency, so striking the right balance is important when cooking up a standardized medication. Needless to say, it's a recipe best left to approved manufacturers.
Even in trained hands, unlicensed 'Botox' products containing unknown mixes or unapproved counterfeit sources of the toxin present significant risks to patient health.
It's hard to know what went wrong to cause this latest outbreak. Among the 63 cases with sufficient details, 60 are known to have had the procedure at a private hospital in Istanbul.
A further three were linked with a second private hospital in the Turkish city of Izmir. They all received their treatments sometime between 22 February and 1 March this year.
Turkish authorities claim the products used in the treatment were licensed, though weren't approved for use on the stomach-paralyzing procedure. Investigations are currently underway on each of the clinics, which have meanwhile had their activities suspended.
The ECDC is encouraging anybody who traveled to Istanbul and Izmir for intragastric botulinum neurotoxin treatment to seek medical advice if they experience general weakness or difficulty breathing or swallowing.
Those suffering the effects of the paralyzing toxin could take months to fully recover. An outbreak of botulism caused by a counterfeit BTX-A medication in Egypt in 2017 left at least five people hospitalized. Even after being treated with antitoxins, the patients in that case still took up to 12 weeks to fully recover.