Pubdate: Fri,  2 Jun 2000
Source: Independent, The (UK)
Copyright: 2000 Independent Newspapers (UK) Ltd.
Contact:  1 Canada Square, Canary Wharf, London E14 5DL
Author: Cahal Milmo


US team of specialists is asked to work round the clock to try to trace 
cause of fatal disease that has now killed 20 addicts By Cahal Milmo

The Drugs Tsar urged heroin addicts yesterday to smoke rather than inject 
the drug as a precaution against a mystery infection that has contaminated 
batches of the drug and killed 20 users in Scotland and Ireland.

The Government's anti-drugs co-ordinator, Keith Hellawell, said the illness 
was restricted to drug users who inject. "At the moment, when you are in a 
crisis ... receive medical advice. Smoke it rather than inject it," he said.

Doctors attempting to trace the source of the illness admitted they faced a 
race against time to prevent the outbreak spreading to users in other parts 
of the country.

A specialist team, including a senior American epidemiologist, has been 
told to work around the clock to track down the mystery bug as the death 
toll mounted in the worst affected areas, Glasgow and Dublin. Last night 
health authorities confirmed they were linking two deaths in Aberdeen and a 
number of cases of severe illness among addicts in Wicklow and Kildare in 
the Irish Republic to the outbreak.

Medical experts are concerned at the ability of the bacterium to spread 
rapidly through the body via large abscesses before attacking the vital 
organs, in particular the heart, causing death.

Dr Laurence Gruer, public health consultant for the Greater Glasgow Health 
Board, said: "The infection is resistant to antibiotics and produces a 
toxin which quickly leaches into the blood and attacks the heart, liver and 
kidneys. Once that happens, it's curtains.

"There is a good chance of the bacteria spreading to addicts anywhere on 
the routes where this batch originated, from Glasgow and Dublin to 
elsewhere in Scotland and Ireland. The risk of further cases cannot be 
ruled out."

Health officials in Britain have warned other European countries to look 
out for further tainted consignments of brown heroin originating from the 
Indian sub-continent.

The death toll from the infected drugs continued to rise as the authorities 
in Dublin confirmed they were investigating 16 deaths linked to the bug. 
Eight fatalities from the illness have been confirmed in the Irish Republic.

In Glasgow, 12 addicts, most from the Govan Hill area, have been killed by 
the disease, which causes large abscesses that spread from injection areas 
and results in multiple organ failure. Fourteen heroin users in the city 
have also been infected. Glasgow has one of the worst heroin problems in 
the British Isles.

The death in Aberdeen on Sunday of Rachael Wilson, 25, who had one child, 
is one of two fatalities being investigated in the Grampian region. There 
are several seriously ill addicts in Wicklow and Kildare.

Adding to fears that the outbreak may claim more lives, drug workers in 
Glasgow said addicts were preferring to risk infection rather than seek 
alternative supplies of heroin.

George Hunter, manager of the Turning Point drug crisis centre, said: 
"There is a fatalistic attitude. Users inject three or four times a day and 
most would rather not know what the drug has been cut with - even if that 
includes the risk of a horrible death."

In recent days officials in Scotland and the Irish Republic have increased 
their efforts to pinpoint the bacterium and contain the outbreak.

Tissue samples have been sent to the Centre for Disease Control and 
Prevention in Atlanta, Georgia, while one of its leading infection experts, 
Dr Jai Lingappa, is in Glasgow to help with laboratory tests.

Health experts in Dublin are assisting the international effort, which is 
focusing on the possibility that a hitherto untraceable bacterium may be to 
blame for the illness.

A close link between the outbreaks in Dublin and Glasgow has been 
established by the teams - but the fact that most common bacteria have been 
eliminated as the cause has left scientists puzzled.

Dr Gruer said: "We are now concentrating on testing for rare or difficult 
to trace organisms that may be present in dust or other matter when the 
heroin was cut or diluted.

"Given the localised nature of the outbreaks, the contamination probably 
happened at a stage close to distribution in Britain and Ireland. It is 
unlikely the bacteria comes from the country of origin."

Earlier suggestions, caused by an addict's death in Norway, that anthrax 
may have been to blame have been ruled out, and biologists are now 
investigating the possibility of whether a botulism-type bug may have been 
mixed with the heroin in the form of spores.

One theory is that citric acid may be providing the oxygen-free conditions 
necessary for a bacterium similar to clostridium to multiply and attack the 
weakened muscle-tissue of addicts once injected.

A clostridium bug was blamed for an outbreak of illness in San Francisco 
last year that killed five heroin addicts in three weeks.
- ---
MAP posted-by: Keith Brilhart