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. - --- MAP posted-by: Derek