Anthrax update

22 February 2010

A further case of anthrax has been confirmed in a heroin user in Scotland, bringing the total number of cases in Scotland to 24. This case occurred in the NHS Dumfries and Galloway board area and the individual is currently receiving hospital treatment. This is the first case in NHS Dumfries and Galloway, indicating that the outbreak is continuing to spread in Scotland.

In addition, one patient in the NHS Fife area who was previously confirmed as having anthrax has now died, bringing the total number of deaths in Scotland among confirmed anthrax cases in this outbreak to 10. A further two cases have been confirmed in England linked to the use of heroin, one in London and one fatal case in Blackpool. This makes the total number of cases in the UK 26 with 11 deaths.   

The spread of the outbreak to another new area of Scotland emphasises that contaminated heroin appears still to be in circulation and underlines the need for heroin users to understand the risks of continued use of heroin.

Dr Colin Ramsay, Consultant Epidemiologist at Health Protection Scotland and head of the national Outbreak Control Team, said:

"There is no way to tell if your heroin is contaminated and there is no way to prepare or take heroin that will make it safe if it has anthrax contamination. Drug users are advised to stop taking heroin if at all possible. While we appreciate that this may be extremely difficult advice to follow, it remains the only public health protection advice possible due to the nature of anthrax infection. Users are encouraged to find out more about support services in their area by calling Know the Score on 0800 587 5879 or visiting www.scottishdrugservices.com.

"It must be noted that filters will not make heroin safe or remove all traces of anthrax contamination, so the best advice remains not to use heroin by any method. Users should seek urgent medical attention in the event of symptoms such as redness or swelling at or near an injection site, or other symptoms of general illness such a fever, high temperature, chills or a severe headache, as early antibiotic treatment can be lifesaving. Marked swelling of a limb which has been used as an injection site is a particularly important sign of possible anthrax infection." 

The outbreak began with the identification of cases in NHS Greater Glasgow and Clyde in December, with cases now having been identified in seven NHS board areas across the country. Two cases have also been identified in England.

Another fatal case in a drug user in Germany in December also appears to be linked to the current outbreak. This outbreak represents the first known outbreak of anthrax to have occurred in conjunction with drug use. Advice and information continues to be issued to drug workers and vulnerable groups and will continue to be highlighted.

 Information for drug users, drug workers and members of the public is also available on www.hps.scot.nhs.uk/anthrax. All those who may have contact with drug users, including their families and friends, are reminded to familiarise themselves with this information and to share it with drug users themselves.

Image is courtesy of the US centers for Disease and Prevention.