The Centre for Health Protection is investigating a suspected case of botulism after a 25-year-old woman received botulinum toxin injections in mainland China.

The patient, who previously had a good health record, attended the accident and emergency room of the Queen Elizabeth Hospital on Sunday as she had been suffering from weakness, difficulty in swallowing and shortness of breath since October 3, according to a government release.

The clinical diagnosis was suspected iatrogenic botulism. The patient told the hospital staff that she had received botulinum toxin, or “botox” injections in mainland China on October 2. She did not reveal where she received the injections.

The woman was observed to be in a stable condition and subsequently left the hospital without informing hospital staff.

A spokesperson from the health authority reminded the public that botox injections should only be prescribed and performed by registered doctors.

Due to the weakening of associated muscles and the fact that botox may spread and affect other areas beyond the injection site, recipients of the injections may have drooping of the eyelids, vision problem, difficulties with with chewing, hoarseness and sometimes difficulties in swallowing, speaking or breathing. Such side-effects can appear hours, days or even weeks after the injection.

Since 2016, the health authority has recorded a total of 16 cases of suspected botulism, Sing Pao reported.

Eleven of the sixteen cases involved patients who received botox injections in Shenzhen, while two had the injections in Guangzhou. The remaining cases involved patients who had received the injections in Hong Kong.