Pubdate: Wed, 06 Nov 2002
Source: Reuters (Wire)
Copyright: 2002 Reuters Limited
Author: Richard Woodman

BRITAIN WARNS OF BOTULISM RISK IN HEROIN USERS

LONDON - Britain's Public Health Laboratory Service
(PHLS) has alerted clinics, drug services and coroners to a spate of
botulism in heroin users.

It said six cases of potentially fatal wound botulism had been
reported in injecting drug users in the UK since August, possibly
because their drugs were contaminated with the anaerobic bacterium
Clostridium botulinum.

"Injecting drug users are susceptible to wound botulism when anaerobic
conditions exist at injection sites," the PHLS added in a statement on
its Web site. It advised drug users to avoid injecting the drug, and
smoke heroin if necessary.

"The injection of substances that increase tissue damage may
facilitate the growth of anaerobic bacteria and therefore injecting
drug users should try to use as little citric acid as possible to
dissolve heroin and should avoid the injection of mixtures of heroin
and cocaine.

"They should also be advised to seek urgent medical attention if they
develop swelling, redness or pain at injecting sites," the statement
said.

Reports of wound botulism in injecting drug users are a relatively new
phenomenon with no clinically diagnosed cases in the UK or Ireland up
to the end of 1999. There were, however, six reports in 2000, four in
2001, and five in February 2002.

Symptoms of botulism include blurred vision, drooping eyelids, slurred
speech, difficulty swallowing, dry mouth and muscle weakness. If
untreated, paralysis may progress to the arms, legs, trunk and
respiratory muscles, which can be fatal.
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