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The BBC's Emma Simpson
"The spotlight has turned to Anthrax"
 real 28k

Public health consultant Dr Laurence Gruer
"We don't think it is likely anthrax is a factor in the cases"
 real 28k

Wednesday, 17 May, 2000, 17:23 GMT 18:23 UK
Anthrax 'link' in heroin deaths
Heroin injection
Addicts may be at risk
Anthrax is suspected of being responsible for a spate of deaths among heroin addicts in Europe.

New Scientist magazine reports that tests at Britain's biological defence lab at Porton Down have found signs of infection by the bacterium in two of the 10 addicts killed so far in Scotland.

But a public health expert in Glasgow is disputing the suggestion that anthrax caused the deaths.

Scientists conclude that these results are very unlikely to be due to anthrax infection

Dr Laurence Gruer, Glasgow Health Board

Nine more drug users in Scotland are ill, and doctors fear the disease - which is hard to monitor among drug users - may be far more widespread.

Les King, of the Forensic Science Service, which analyses seized heroin in Britain: "Heroin can contain almost anything in small amounts.

"There could be a long history of this, and we just haven't observed it till now."

Fluid leakage

The addicts initially developed a painless, pus-free wound after injecting into muscles rather than veins.

However, within hours they had died of symptoms including leakage of fluids around the heart and lungs and soaring white blood cell counts - indicating that the immune system was desperately battling a deadly invader.

Porton Down scientists have tested blood samples from five Scottish victims.

Lab tests
Lab tests revealed the presence of anthrax
Two tested positive for a poison produced by anthrax.

The scientists did not find any trace of anthrax itself - but the bacteria may have been wiped out by antibiotic treatment.

The circulating toxins can still kill patients, even though the bacteria have gone.

In addition, at least one surviving sufferer in Scotland has a tell-tale black scab typical of anthrax infection.

The fact that addicts were injecting into their muscles, rather than veins is also potentially significant.

The infection spreads far more effectively in muscle than blood.

Official denial

Dr Laurence Gruer, consultant in public health medicine at Greater Glasgow Health Board, said extensive blood and tissue microbiology tests had been carried out on all cases presented in Glasgow hospitals.

All these tests had proved entirely negative for anthrax infection.

Dr Laurence Gruer
Dr Laurence Gruer: "Negative results"
Dr Gruer said samples from seven patients were sent to the Centre for Applied Microbiology and Research (CAMRS) for anthrax exposure.

While two of the samples gave a "very weak positive reaction" this did not prove a link.

He said: "In the absence of any other positive results for anthrax, the CAMR scientists conclude that these results are very unlikely to be due to anthrax infection."

Dr Gruer said further tests had been carried out to establish if other toxic substances or citric acid used by addicts to dissolve the drug were present in the heroin

He said: "All the test results so far have been negative for traces of anthrax or any significant toxin."

Glasgow health officials believe the heroin mixture injected by the addicts was highly acidic, and that was what caused fatal tissue damage.

Norwegian connection

The possible connection to anthrax emerged after a doctor at the Norwegian Army Medical School posted details on ProMED, the internet forum for emerging diseases, of an Oslo addict who died in April after injecting heroin into a muscle.

Tests showed anthrax bacilli in his spinal fluid, which was confirmed by DNA analysis.

Anthrax is common in Pakistan, Afghanistan and Iran, where most of Europe's heroin originates.

It is possible that animal-derived material from the region, such as gelatin or bone meal, may well be contaminated with spores. Such material could have found its way into heroin.

Anthrax vaccines are available but if a victim has already breathed in the bug the only known treatment is massive doses of antibiotics. Even then mortality rates remain extremely high.

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See also:

11 May 00 | Scotland
'Bad' heroin inquiry stepped up
09 May 00 | Scotland
'Mystery illness' kills addicts
26 Sep 98 | World
Anthrax: a deadly bacterium
21 Jan 99 | Health
Genetic weapons alert
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