NEW YORK -- Is it real or a clever look-alike?

The question could be asked about everything from your toothpaste to your TV set, and counterfeiting has become a billion dollar headache for manufacturers and consumers, NewsChannel 4's Asa Aarons reported.

When people think of counterfeiting, the usual suspects are fake CDs, movies or clothing, but product counterfeiting can leave you with more than cheap stitching and a faded label.

Caroline Joiner, who investigates counterfeits for the U.S. Chamber Of Commerce, said some can make you sick.

"Like the shampoo the Chicago Police Department confiscated. The shampoo they went back into the labs to test it and they found bacteria that was laced with fecal matter," Joiner said.

It can even threaten your life in some extreme circumstances. One safety label from the nonprofit Organization Underwriter's Laboratory certifies that its products are safe -- however, its counterfeit counterparts could potentially spark and catch fire within minutes.

Joiner said she wants to change the perception of product counterfeiting as a victimless crime.

"This is organized crime. Bottom line, these are sophisticated criminal networks operating internationally," Joiner said. "What most people don't understand is that it's the same guy that's selling the handbag the next day he could be selling pharmaceuticals or batteries or extension cords."

Although spotting counterfeit products can be difficult, it is not impossible.

"You are looking at the quality of the packaging. Also, looking to see if their is a country of origin listed. If its not then its then its probably fake," Joiner said.

"Be suspicious of products that come from deep discount stores or from the Internet; also from flea markets," she added.

The U.S. Chamber of Commerce estimated product counterfeiting costs the U.S. economy $250 billion a year.

In real world terms, that is nearly a million American jobs lost to product piracy.