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Confirmed case of Anthrax in injecting drug user in England

Doctors told to be on the alert for symptoms of anthrax in other users

Ingrid Torjesen

Friday, 17 August 2012

A drug user has died in hospital with a confirmed anthrax infection, the Health Protection Agency says.

There is an ongoing outbreak of anthrax amongst people who inject drugs affecting a number of countries in Europe. Seven cases have been identified since early June: one in Scotland, three in Germany, two in Denmark, and one in France. The source is presumed to be contaminated heroin.

It is unclear as yet whether this case and a case in Scotland at the end of July are linked to the outbreak in Europe.

These are the first cases of anthrax among injecting drug users in Europe since an outbreak during 2009/2010 which principally affected Scotland (119 cases), but with cases also reported from England (five cases) and Germany (two cases).

Dr Dilys Morgan, an expert in zoonotic infections at the HPA, said: “It’s likely that further cases among people who inject drugs will be identified as part of the ongoing outbreak in EU countries. The Department of Health has alerted the NHS of the possibility of people who inject drugs presenting to emergency departments and walk-in clinics, with symptoms suggestive of anthrax.

 “Anthrax can be cured with antibiotics, if treatment is started early. It is therefore important for medical professionals to know the signs and symptoms to look for, so that there are no delays in providing the necessary treatment.

As part of the response to the 2009/10 outbreak, the HPA developed an algorithm for the clinical evaluation and management of people who inject drugs with possible anthrax. This algorithm specifies the kinds of presentations where anthrax should be considered, and outlines the actions to take.

Drug users may become infected with anthrax when heroin is contaminated with anthrax spores. This could be a source of infection if injected, smoked or snorted – there is no safe route for consuming heroin or other drugs that may be contaminated with anthrax spores.

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