Almost 70 botulism cases have been linked to weight loss Botox injections in Turkey, prompting a warning from European health officials to medical tourists.
Of the 67 people who have developed botulism, a life-threatening condition that causes paralysis, a number have been admitted to intensive care, according to the European Centre for Disease Prevention and Control (ECDC).
Health officials have warned people against travelling to Turkey for stomach Botox injections, saying this comes with a “significant risk of developing botulism”.
While Botox is mostly associated with reducing wrinkles, it is also used as a weight loss treatment. Injections into the stomach wall relax the muscles and suppress the appetite.
Botox and botulism both originate from toxins produced by Clostridium botulinum bacteria.
Developing botulism as a result of Botox injections is rare, but can happen when patients are injected with an “excessive dose”, according to the ECDC.
In botulism cases, toxins attack the nervous system and cause paralysis. Blurred vision, drooping eyelids and difficulty swallowing are symptoms linked to cosmetic botulism.
Most people make a full recovery with treatment, but without fast treatment the paralysis can spread to the muscles that control breathing.
For food-borne botulism, 5 to 10% of cases are fatal, but there is not yet enough data to establish the mortality rate for cosmetic botulism.
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The ECDC said it is not yet clear whether the botulism is linked to the hospitals’ procedures or a problem with the product.
Among 63 cases with available information, 60 cases were linked to a private hospital in Istanbul and three were linked to a private hospital in Izmir.
Investigations carried out by Turkish authorities found that licensed products were used, but they were not approved for treating obesity.
The hospital departments have had their activities suspended and investigations have been launched.
The ECDC advised people who travelled to Istanbul and Izmir for stomach Botox between 22 February and 1 March 2023 to contact their doctor, particularly if they experience symptoms such as weakness, difficulty in breathing or swallowing.
The UK government advises British people thinking of travelling to Turkey for medical procedures to do their own research rather than rely on “private companies that have a financial interest in arranging your medical treatment abroad”.
At least 22 British nationals have died in Turkey since January 2019 following medical tourism visits.
Image: Liverpool’s captain Virgil van Dijk. Pic: Reuters
Image: Liverpool’s Ryan Gravenberch and Cody Gakpo (right) arrive at the funeral of Diogo Jota and Andre Silva. Pic: PA
Jota, 28, leaves behind his wife of only 11 days, Rute Cardoso, and three young children.
His younger brother, 25, was an attacking midfielder for Penafiel in the second tier of Portuguese football.
Liverpool manager Arne Slot, captain Virgil Van Dijk and teammates including Andy Robertson, Conor Bradley, Ryan Gravenberch, Cody Gakpo, Curtis Jones, Darwin Nunez and Joe Gomez were seen at the service.
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Former teammates Jordan Henderson, James Milner and Fabinho were also there.
Van Dijk carried a red wreath with Jota’s number 20, while Robertson had a wreath featuring number 30, Silva’s number at Penafiel.
Image: Manchester United and Portugal player Bruno Fernandes. Pic: PA
Image: Liverpool’s captain Virgil van Dijk and Liverpool’s player Andrew Robertson. Pic: Reuters
Some of Jota’s teammates in the Portuguese national side also attended, including Bruno Fernandes, of Manchester United, Ruben Dias and Bernardo Silva, of Manchester City, Joao Felix and Renato Veiga, of Chelsea, Nelson Semedo, from Wolves, Joao Moutinho and Rui Patricio.
Ruben Neves was one of the pallbearers after flying in from Florida where he played for Al Hilal in the Club World Cup quarter-final on Friday night.
‘More than a friend’
In a post published on Instagram before the service, he told Jota he had been “more than a friend, we’re family, and we won’t stop being that way just because you’ve decided to sign a contract a little further away from us!”
Jota’s fellow Liverpool midfielder, Alexis Mac Allister, said on Instagram: “I can’t believe it. I’ll always remember your smiles, your anger, your intelligence, your camaraderie, and everything that made you a person. It hurts so much; we’ll miss you. Rest in peace, dear Diogo.”
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Porto FC president Andre Villas-Boas and Portugal national team manager Roberto Martinez were also in attendance.
‘With us forever’
Speaking after the ceremony, Martinez said the period since their deaths had been “really, really sad days, as you can imagine, but today we showed we are a large, close family.
“Their spirit will be with us forever.”
The service was private, but the words spoken by the Bishop of Porto, Manuel Linda, were broadcast to those standing outside the church.
He told Jota’s children, who were not at the service, that he was praying for them specifically, as well as their mother and grandparents.
“There are no words, but there are feelings,” he said, adding: “We also suffer a lot and we are with you emotionally.”
The brothers died after a Lamborghini they were travelling in burst into flames following a suspected tyre blowout in the early hours of Thursday morning.
No other vehicles are said to have been involved in the incident.
Liverpool have delayed the return of their players for pre-season following Jota’s death and players past and present paid tribute to him and his brother on social media.
Rachel Reeves has hinted that taxes are likely to be raised this autumn after a major U-turn on the government’s controversial welfare bill.
Sir Keir Starmer’s Universal Credit and Personal Independent Payment Bill passed through the House of Commons on Tuesday after multiple concessions and threats of a major rebellion.
MPs ended up voting for only one part of the plan: a cut to universal credit (UC) sickness benefits for new claimants from £97 a week to £50 from 2026/7.
Initially aimed at saving £5.5bn, it now leaves the government with an estimated £5.5bn black hole – close to breaching Ms Reeves’s fiscal rules set out last year.
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6:36
Rachel Reeves’s fiscal dilemma
In an interview with The Guardian, the chancellor did not rule out tax rises later in the year, saying there were “costs” to watering down the welfare bill.
“I’m not going to [rule out tax rises], because it would be irresponsible for a chancellor to do that,” Ms Reeves told the outlet.
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“We took the decisions last year to draw a line under unfunded commitments and economic mismanagement.
“So we’ll never have to do something like that again. But there are costs to what happened.”
Meanwhile, The Times reported that, ahead of the Commons vote on the welfare bill, Ms Reeves told cabinet ministers the decision to offer concessions would mean taxes would have to be raised.
The outlet reported that the chancellor said the tax rises would be smaller than those announced in the 2024 budget, but that she is expected to have to raise tens of billions more.
Sir Keir did not explicitly say that she would, and Ms Badenoch interjected to say: “How awful for the chancellor that he couldn’t confirm that she would stay in place.”
In her first comments after the incident, Ms Reeves said she was having a “tough day” before adding: “People saw I was upset, but that was yesterday.
“Today’s a new day and I’m just cracking on with the job.”
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“In PMQs, it is bang, bang, bang,” he said. “That’s what it was yesterday.
“And therefore, I was probably the last to appreciate anything else going on in the chamber, and that’s just a straightforward human explanation, common sense explanation.”
The family and friends of Diogo Jota and his brother Andre Silva have been joined by Liverpool stars past and present and other Portuguese players at the pair’s funeral near Porto.
Pictures below show the funeral at the Igreja Matriz de Gondomar church in the town of Gondomar near Porto. Click here for our liveblog coverage of the day’s events.
Image: Diogo Jota’s wife Rute Cardoso arrives for the funeral of him and his brother Andre Silva. Pic: Reuters
Image: Liverpool players Virgil van Dijk and Andrew Robertson arrive for the funeral. Pic: Reuters
Image: Van Dijk carried a wreath with Jota’s number 20 while Andrew Robertson’s had a 30 for Andre Silva. Pic: Reuters
Image: Liverpool captain Virgil van Dijk. Pic: Reuters
Image: Portugal player Ruben Neves arrives at the funeral. Pic: PA
Image: Liverpool’s Joe Gomez and manager Arne Slot arrive at the funeral of Diogo Jota and Andre Silva. Pic; PA
Image: Liverpool’s Ryan Gravenberch and Cody Gakpo (right) arrive at the funeral of Diogo Jota and Andre Silva
Image: Manchester City and Portugal player Bernardo Silva arrives at the funeral. Pic: AP
Image: The coffins are carried to the church. Pic: PA
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2:27
Miguell Rocha played with Jota for around ten years with Gondomar Sport Clube in Portugal.
Image: People line up to enter the church. Pic: AP
Image: Pallbearers carry the coffins of Diogo Jota and his brother Andre Silva
Image: Pic: Reuters
Image: Pic: AP
Image: People gather outside the Chapel of the Resurrection. Pic: Reuters
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0:22
The former captain was seen wiping away tears as he read messages and laid his tribute down.
Image: Fans pay their respects outside Anfield in Liverpool. Pic: Reuters
Image: A board with a picture of Diogo Jota outside Anfield Stadium. Pic: PA
Image: The coffins are carried to the church. Pic: PA