State public health officials are now reporting 14 cases of botulism connected to Botox injection procedures performed at a Milton, Massachusetts spa that is under investigation, up from four cases last week.

The Massachusetts Department of Public Health (DPH) first reported the growing cluster of cases last Friday, announcing that the cases were tied to cosmetic botulinum toxin injections on the South Shore.

DPH then announced 10 confirmed cases associated with procedures performed at Rodrigo Beauty, which is located on Granite Avenue in Milton. A spokesperson for the department confirmed Tuesday that 14 reported cases are under investigation, but declined to comment further.

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