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Anthrax - Multistate - Outbreak among people who inject drugs (ECDC/CDTR, March 18 2013)

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  • Anthrax - Multistate - Outbreak among people who inject drugs (ECDC/CDTR, March 18 2013)

    [Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]


    Week 11, 10-16 March 2013


    Anthrax - Multistate - Outbreak among people who inject drugs

    Opening date: 18 December 2009 Latest update: 8 March 2013

    Epidemiological summary

    Since July 2012, there have been 15 cases of anthrax reported in intravenous drug users due to contaminated heroin including seven fatalities in: Germany (four cases, one fatal), Denmark (two cases, one fatal), France (one case), and UK (eight cases, five fatal).

    The latest case was reported on 14 March by Health Protection Scotland in a middle aged drug user.

    The 2012 outbreak has been linked to the 2009-2010 outbreak of anthrax among IDUs with 127 cases in the UK (England - five, Scotland - 119) and three cases in Germany. Of seven B. anthracis isolates tested so far, two isolates from the United Kingdom were indistinguishable from the 2009-2010 strain and three isolates from Germany and two from Denmark were identical and almost identical to the 2009-2010 strain.


    ECDC assessment

    This additional case is not unexpected and does not change the conclusions of the rapid risk assessment published by ECDC and EMCDDA on 16 July 2012. The reporting on cases of anthrax in IDUs in several countries over a long period of time suggests that contaminated heroin is still circulating in Europe. People who inject heroin in Europe are still at risk of exposure to anthrax.


    ECDC and EMCDDA updated their joint rapid risk assessment (RRA) on 13 July 2012. The two organisations are working together to produce a joint guidance document on the prevention of anthrax among IDUs.