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Anthrax alert to Glasgow's injecting drug users
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18 December 2009
INJECTING drug users in Glasgow have been warned to seek urgent medical attention for site wound infection after the deadly bacterium anthrax had been linked to the death of one user and identified in another.
Blood tests from a drug injecting heroin user who died on Wednesday 16 December in the city’s Victoria Infirmary in Glasgow have shown the presence of anthrax.
Another patient being treated at the same hospital has also been positively tested for anthrax and NHS Greater Glasgow and Clyde’s Public Health Protection Unit are now working closely with the Procurator Fiscal’s Office and Strathclyde Police to identify the source of the anthrax.
A third patient, who is being treated at Glasgow Royal Infirmary, is being tested and doctors await the results early next week.
All three potentially linked cases presented at hospital with serious soft tissue infections in areas of the body injected with heroin.
One avenue being investigated by Public Health and Strathclyde Police is that contaminated heroin or a contaminated cutting agent mixed with the heroin may be responsible for the infections.
Dr Syed Ahmed, Consultant in Public Health Medicine, said: “I urge all drug injecting heroin users to be extremely alert and to seek urgent medical advice if they experienced an infection.
“While this section of the community need to be on their guard the risk to the rest of the population - including close family members of the infected cases - is negligible. It is extremely rare for anthrax to be spread from person to person and there is no significant risk of airborne transmission from one person to another.”
“As part of our ongoing inquiries any drug injecting heroin users who presents with serious soft tissue infections now or during the last four weeks will be investigated.”
In an interview featured on
BBC Scotland website, Dr Ahmed said that the first signs of infection would be just a pimple and soreness at the injecting site, developing into redness and swelling and then spread further into a “black scar”.
If not treated at this stage the infection could spread into blood and other organs, he said.
Twenty-three injecting drug users died in Glasgow between April and August 2000 in an outbreak of severe illness linked to heroin contaminated with the Clostridium Novyi bacterium.
Most suffered severe inflammation round injecting sites and/or multi-system failure, caused by spore-forming bacteria which produced toxic reactions.
A total of 60 cases were identified as definite or probable affected by the same outbreak – with the average age of users being 30 and 31 of them women. Most of the 60 had injected heroin/citric acid into muscles.
A subsequent
Fatal Accident Inquiry in 2001 led to Sheriff Edward Bowen criticising communications between public health and accident and emergency staff on information about the outbreak.
He commented that he was “not wholly convinced that the information was disseminated to the extent which it might have been”, adding “I stress that in no case did such an absence of knowledge affect the outcome; but it might have done…”
However, in the interview on BBC Scotland's website, Dr Ahmed said that as soon as NHS staff had found out about the anthrax cases, health professionals and all agencies working with drug users had been informed to advise drug injectors with injecting site infections to seek medical advice.
For more details on anthrax see the
website of NHS Greater Glasgow and Clyde.