Posted by Hal Newman • December 23, 2009 • Printer-friendly
Glasgow--Greater Glasgow and Clyde (GGC) NHS Board is currently investigating an outbreak of anthrax affecting injecting drug users (IDUs) in Scotland. The source is suspected to be contaminated heroin or other drugs. Strathclyde Police are also involved in the investigation.
As at 18 December, two cases from Glasgow had been confirmed as having anthrax infections and three other possible cases were being investigated. The first patient presented with severe cellulitis which progressed to acute respiratory distress syndrome and disseminated intravascular coagulation, and died despite appropriate antibiotic treatment. By 21 December 2009, three confirmed cases (including the fatality) had been reported as well as one probable case, and four additional possible cases with clinical pictures compatible with anthrax infection. The cases are six males and two females, between 26 and 44 years of age. They developed symptoms between 7 and 20 December 2009, and originate from Glasgow and the surrounding areas. The only link so far between the cases is that they are all heroin users.
A further death has been announced on 22 December.
An urgent cascade of information has been sent out to UK hospitals, GPs, emergency departments, microbiologists, and drug teams to raise awareness and to request that cases of severe soft tissue infection or sepsis in an IDU, who has died or has been sufficiently unwell to require admission to hospital, are reported to their local public health authority.
The investigation is receiving assistance from Health Protection Scotland and the Health Protection Agency (HPA) and laboratory support from the HPA’s Special Pathogens Reference Laboratory at Porton Down. In addition, the US Centers for Disease Control and Prevention (CDC) have supported the outbreak response by supplying anthrax immunoglobulin for the treatment of confirmed cases. A team from CDC has been in attendance to monitor the use of the antitoxin supplies and assist the investigation.
If a contaminated batch of heroin or other drug is involved, it is possible that further cases will be seen. Further information on test results will be provided when available. HPS and the GGC NHS Board are also liaising with the European Centre for Disease Prevention and Control (ECDC).
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