The Centers for Disease Control and Prevention is warning consumers about fake or mishandled botulinum toxin, also known as Botox.

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The CDC said that so far 19 people in nine states have gotten sick from getting injections from unlicensed or untrained people in non-healthcare settings. Those locations included private homes and spas.

So far the cases have been found in Colorado, Florida, Illinois, Kentucky, Nebraska, New Jersey, New York, Tennessee and Washington.

The investigation is ongoing.

Some of the symptoms the people had experienced included:

• Blurry and double-vision
• Drooping eyelids
• Difficulty swallowing
• Dry mouth
• Slurred speech
• Difficulty breathing
• Fatigue
• Generalized weakness

Nine were hospitalized with four people treated with an antitoxin. Eighteen of the patients were getting the Botox treatment for cosmetic reasons, the CDC said.

The CDC says patients should receive Botox from licensed providers who are trained in using FDA-approved botulinum toxin.

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