The Centers for Disease Control and Prevention (CDC) is widening its investigation into cases of botulism-like illness stemming from counterfeit cosmetic injections, commonly known as "Botox," administered in non-medical settings. Initially investigating cases in Illinois and Tennessee, the CDC has now received reports of 19 people in nine states experiencing adverse reactions after receiving these fake injections.

As of now, nine individuals have been hospitalized, with four of them receiving botulism anti-toxin due to their symptoms being "consistent with possible spread of toxins." However, no deaths linked to this counterfeit product have been reported. The CDC is urging caution, emphasizing that cosmetic injections should only be administered by licensed healthcare providers in licensed settings, using FDA-approved products. Currently, the sources of these botulinum toxin products remain unknown or unverified.

An ongoing investigation involving the CDC, the U.S. Food and Drug Administration (FDA), and multiple states suggests that the administered product was indeed counterfeit, according to the Tennessee Department of Health. Additionally, many of these injections were given in non-healthcare settings such as spas or homes, often by unlicensed or untrained individuals.

Botulism, a rare but severe illness caused by toxins released by bacteria attacking the nervous system, presents symptoms including blurred or double vision, droopy eyelids, difficulty breathing, fatigue, slurred speech, and hoarse voice. If left untreated, muscle paralysis can progress over time and prove fatal.

The Illinois Department of Public Health points out that the Clostridium botulinum bacteria, an ingredient in Botox and similar cosmetic substances, can cause systemic botulism when administered incorrectly. While laboratory-confirmed cases of such botulism after cosmetic or therapeutic injections are rare, the CDC highlights the concerning circumstances surrounding these cases.

The investigations in Illinois revealed that both patients received injections from a licensed nurse in LaSalle County who was performing work outside her authority. Similarly, Tennessee expressed concerns about injections given in non-medical settings like homes or cosmetic spas.

Dr. Sameer Vohra, the Director of the Illinois Department of Public Health, urges residents to be cautious when considering cosmetic treatments. Seeking such procedures in unlicensed and unapproved settings poses serious health risks. Dr. Vohra advises individuals to only receive cosmetic services from licensed professionals trained in these procedures and using FDA-approved products. If any health problems arise after a recent cosmetic treatment, individuals are urged to contact their healthcare provider immediately.

CNN reached out to the FDA for comment on the investigation, but the agency declined to provide any information.

As the investigation continues, the CDC, FDA, and state authorities are dedicated to identifying the source of these counterfeit products and holding accountable those involved in administering them. In the meantime, cautionary measures and adherence to proper healthcare protocols are strongly encouraged for all individuals seeking cosmetic treatments.