Deaths linked to heroin contaminated by anthrax have risen to nine, tests revealed.
The laboratory tests confirmed anthrax infection in a heroin user who died in the NHS Greater Glasgow and Clyde area in December.
This takes the number of confirmed cases of anthrax in the current outbreak in Scotland to 18, with nine people dead.The latest confirmed case was a drug user who died on 12 December – the earliest death linked to the outbreak, although the connection has only just been proven.
Experts said evidence suggested that contaminated heroin may still be in circulation and urged all drug users across Scotland to remain vigilant.
The outbreak began with the identification of cases in NHS Greater Glasgow and Clyde in December, with cases now having been identified in six NHS boards across the country.
It is the first known outbreak of anthrax linked with drug use.
Dr Colin Ramsay, consultant epidemiologist at Health Protection Scotland and head of the national Outbreak Control Team, said: "While public health investigations are continuing to attempt to identify the source of the contamination, no drug samples tested to date have shown anthrax contamination, although a number of other types of potentially harmful bacteria have been found.
"It must therefore be assumed that all heroin in Scotland carries the risk of anthrax contamination and users are advised to cease taking heroin by any route if at all possible.
"While we appreciate that this may be extremely difficult advice for users to follow, it remains the only public health protection advice possible."
Detective Superintendent Derek Robertson, who is leading the police investigation, said: "We are working hard to attempt to identify the source of the contamination."
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