Five heroin users die from anthrax, six more infected in Scotland

A major police investigation is under way after the number of heroin users across Scotland infected with anthrax rose to 11, including five who are now dead.

The 11 confirmed cases are in the Greater Glasgow, Lanarkshire and Tayside areas. Test results are also awaited from another suspected case in Fife.

The rising toll has prompted Health Protection Scotland, the national agency for protecting the public from infectious and environmental hazards, to issue a warning to all heroin users to stop using the drug, regardless of whether they inject it or take it by other means.

Officials stressed that the risk to others, including immediately family members of those infected, remained low.

Police and doctors believe contaminated heroin or heroin mixed with a contaminated cutting agent could be responsible for the cases.

Anthrax is an acute bacterial infection most commonly found in hoofed animals such as cattle, sheep and goats. It usually infects humans when they inhale or ingest anthrax spores, but cannot be passed from person to person.

The current outbreak in Scotland was discovered three weeks ago when tests carried out on a drug user who died in a Glasgow hospital confirmed the presence of anthrax.

It was the first anthrax death in Britain since Fernando Gomez, a 34-year-old drum-maker from London, died in October 2008 after inhaling the spores while handling untreated animal hides.

Colin Ramsay, consultant epidemiologist at Health Protection Scotland, said: "Evidence now suggests that potentially contaminated heroin may be in circulation in other parts of Scotland, not just the Glasgow area.

"All heroin users need to be aware of the risks – contaminated heroin is potentially dangerous taken by any route, not just injection. I would advise heroin users to stop using heroin and seek advice from local harm reduction and drug services for support.

"If any heroin users do notice signs of infection, for example marked redness and swelling around an injection site or other signs of serious infection such as a high fever, they should seek urgent medical advice."

Signs of infection include soreness at the injecting site, developing into redness and then spreading into a black "scar". If not treated at this stage the infection can spread into the blood and other organs.

Dr Ramsay also sought to reassure the public, saying that the risk to non-drug users is neglible. "While heroin users do need to be on their guard, the risk to the general public, including close family members of the confirmed cases, is very low indeed," he said.

"It is extremely rare for anthrax to be passed from person to person and there is no evidence of a significant risk of airborne transmission associated with the current situation."

The present spread of anthrax poses one of the greatest dangers to addicts since 23 injecting users in Glasgow died ten years ago during an outbreak linked to heroin contaminated with the Clostridium novyi bacterium. A fatal accident Inquiry in 2001 led to Sheriff Edward Bowen criticising communications between public health and accident and emergency staff on information about the outbreak.

Gordon Meldrum, director general of the Scottish Crime and Drug Enforcement Agency, and drugs spokesman for the Association of Chief Police Officers in Scotland, said a major national investigation had been launched into the latest deaths.

He said: "The deaths associated with anthrax are disturbing and are being treated very seriously by all the relevant authorities.

"The Scottish Police Service is now co-ordinating the investigation into a number of drug-related deaths across the country in order to gather as much information as possible about possible links and causes."

"Illegal drugs are often prepared in unhygienic surroundings and can be vulnerable to contamination from various harmful agents.

"Those involved in the trafficking of drugs are driven by profit and have no care for the harm they can cause or the health of those who take these potentially lethal drugs."

It was highly probable that the contamination had occurred by accident, he added.

Mr Meldrum advised drug users who feel ill to contact the NHS.

@'The Times'