Amarillo Globe-Mews reports that health officials are investigating a possible botulism outbreak in Amarillo and warn health professionals and the public to be aware there might be other cases.

The Amarillo Bi-City-County Health District announced Wednesday there are four probable cases of the rare, paralyzing and potentially fatal illness caused by a nerve toxin.

Paralysis starts in the head with symptoms like blurry vision, difficulty breathing, droopy eyelids and slurred speech and can spread downward to affect the diaphragm and even can stop a victim’s respiration, according to the CDC.

All the patients are adult residents of Amarillo, but one felt better and traveled to Georgia and is hospitalized there.

The incubation period for the bacteria that produces the toxin can be as short as 24 to 48 hours.