Europe - Several die as anthrax infects heroin users

[alert]

Re: Europe - Several die as anthrax infects heroin users

Here is an article out of Coimbra, Portugal. This one mentions the nine deaths, but makes no mention of anthrax, suspecting them as simply drung overdoses. The fact that one of the fatalities was found with a syringe still in his arm makes anthrax a bit less likely - anthrax takes time to kill.

This article seems to suspect a simple overdose.

http://www.diariocoimbra.pt/index.php?option=com_content&task=view&id=5839&Itemid=135

sections of drug trafficking and homicide

Judici?ria criou equipa mista Judicial created mixed team
para investigar mortes por to investigate deaths
alegada adultera??o de droga alleged adulteration of drugs

Toxicodependente de Barcou?o apareceu morto em Leiria no In Barcou?o addict found dead in Leiria
interior de uma viatura com uma seringa ainda espetada no bra?o inside a car with a syringe still stuck in the arm

A Pol?cia Judici?ria (PJ) decidiu criar uma equipa multidisciplinar para investigar a morte de v?rios toxicodependentes que morreram este m?s em Coimbra, alegadamente devido a adultera??o da droga que consumiam. The Judicial Police (PJ) decided to create a multidisciplinary team to investigate the death of several drug addicts who died this month in Coimbra, allegedly due to adulteration of the drug consumed. Segundo a Lusa, pelo menos nove pessoas morreram na cidade, desde 1 de Janeiro, na sequ?ncia do consumo de drogas. According to Lusa, at least nine people died in the city since January 1, following the consumption of drugs.

Um n?mero que at? pode ser maior j? que as mortes podem ocorrer fora da cidade sem que se estabele?a uma liga??o. A number that might be bigger since the deaths may occur outside the city without identifying a connection. Pode ser o caso, por exemplo, de um homem de 27 anos que na semana passada apareceu morto em Leiria e que residia em Barcou?o, Mealhada. May be the case, for example, a 27 year old man who last week was found dead in Leiria, and lived in Barcou?o, Aveiro. Trata-se de um toxicodependente conhecido das autoridades policiais de Coimbra e que era suspeito da pr?tica de alguns furtos na cidade. This is a known addict of police of Coimbra and was suspected of some thefts in the city. Apareceu morto, em Leiria, no interior de uma viatura, com uma seringa espetada no bra?o, pelo que se suspeita que tamb?m tenha morrido de overdose. Found dead in Leiria, inside a car with a syringe stuck in his arm, so if you think that too has died of an overdose. Ainda n?o h? qualquer certeza se teria comprado a droga em Coimbra mas ? uma hip?tese bastante plaus?vel. Although there is no certainty it would have bought the drug in Coimbra but one hypothesis is plausible.

O delegado regional do Centro do Instituto da Droga e da Toxicodepend?ncia (IDT), Carlos Ramalheira, estima, em declara??es ? Lusa, que ?apenas seis pessoas? ter?o sido v?timas de ?morte s?bita em meio de rua? relacionada com ?alguma anomalia dos produtos injectados?. The regional delegate of the Institute's Center for Drugs and Drug Addiction (IDT), Carlos Ramalheira estimated in a statement to Lusa, that 'only six people "have been victims of" sudden death in the middle of the street "related to" any anomaly of injected products. " Carlos Ramalheira disse ontem que estas mortes poder?o ter resultado de ?overdose? com subst?ncia em estado puro - ?n?o cortada? - ou com ?uma droga 'cortada' com produtos t?xicos?. Carlos Ramalheira said yesterday that these deaths may have resulted from drug overdoses with substance on its own - "not cut '- or' one drug 'cut' with toxic chemicals."

Ainda na semana passada, Cec?lia Escarameia, m?dica do Centro de Atendimento a Toxicodependentes (CAT) de Coimbra, revelava saber que num s? dia, na Urg?ncia dos Hospitais da Universidade de Coimbra, deram entrada 10 casos de princ?pio de overdose. Just last week, Cecilia Escarameia, Medical Care Center Drug Treatment (CAT) from Coimbra, revealed that out in one day, the urgency of the University Hospitals of Coimbra, lodged 10 cases of early overdose.

Face ao problema, a PJ de Coimbra j? constituiu uma equipa de investiga??o que inclui elementos das sec??es dos Homic?dios e do Tr?fico de Estupefacientes. With the problem, the PJ of Coimbra has involved a research team that includes elements of the sections of Homicides and Drug Trafficking.

?N?o sabemos ainda quais s?o as causas destas mortes. "We do not know yet what are the causes of these deaths. Estamos a recolher dados no sentido de encontrar algum elemento objectivo que indicie eventual adultera??o?, informou uma fonte policial. We are collecting data to find any objective evidence to suggest that any tampering, "a police source said.

No entanto, ?? muito prematuro falar em adultera??o? da droga, acrescentou, real?ando que o Inverno ?? um tempo mais depressivo? em que tende a verificar-se um maior consumo de estupefacientes. However, "it is very premature to talk about tampering" of the drug, he added, stressing that the winter "is a most depressing time" as it tends to occur a higher consumption of drugs.

Jorge Alves, presidente da associa??o Integrar, confirmou que, desde Novembro, a equipa de rua da institui??o, com sede na Baixa, ?tem notado um aumento do n?mero de toxicodependentes nas ruas? de Coimbra. Jorge Alves, president of Integrate, confirmed that since November, the street team of the institution, based in Lower, "has noticed an increase in the number of addicts on the streets' of Coimbra.

Carlos Ramalheira salientou que o IDT ?est? a trabalhar em coopera??o? com o Minist?rio P?blico, for?as de seguran?a eo Instituto Nacional de Medicina Legal (INML) no sentido de encontrar uma explica??o para estas mortes. Carlos Ramalheira stressed that the actions "is working in cooperation" with prosecutors, security forces and the National Institute of Legal Medicine (INML) to find an explanation for these deaths. Quatro dos corpos foram autopsiados em Coimbra pelo INML. Four of the bodies were autopsied in Coimbra by INML. ?Est?o ainda a ser realizados os exames de natureza toxicol?gica?, disse ? Lusa o presidente do instituto, Duarte Nuno Vieira. "They are still being carried out the toxicological tests," he told Lusa the president of the Institute, Duarte Nuno Vieira.

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

Note the mention of pink coloring. The anthrax is odorless and colorless. This sounds like a chemical contamination.

http://www.cmjornal.xl.pt/noticia.a...ntid=092631D6-3CE1-46E0-A1B9-8D0ADB521F69&h=8

January 17, 2010 - 00h30

Coimbra: S? num dia foram hospitalizados dez consumidores Coimbra: Only a day have been hospitalized ten consumers
Droga adulterada j? matou nove pessoas Adulterated drugs has killed nine people
Toxicodependentes dizem que andam a misturar gesso ou cal na hero?na traficada na Baixa. Drug users say they go to mix lime plaster or smuggled in Lower.


Ajuste de contas ou guerras entre traficantes de droga. Reckoning or wars between drug dealers. S?o as hip?teses que ganham mais consist?ncia entre os toxicodependentes de Coimbra para justificar as mortes por adultera??o da hero?na que consumiram. Are the assumptions that gain more consistency among addicts of Coimbra to justify the deaths by adulteration of the heroin consumed. "Desde a primeira semana de Janeiro j? morreram nove consumidores", quatro dos quais nos ?ltimos oito dias, afirmou ontem ao CM Ana Sim?es, respons?vel por uma equipa da C?ritas Diocesana de Coimbra que trabalha nos problem?ticos bairros do Ingote e da Rosa. "Since the first week of January are dead nine consumers," four of which in the past eight days, said yesterday the CM Ana Sim?es, responsible for a team of Caritas Diocesan Coimbra working on problematic neighborhoods ingot and Rose. As v?timas tinham idades compreendidas entre os 30 e os 41 anos. The victims were aged between 30 and 41 years.

Na quinta-feira foram assistidos nos hospitais da cidade mais dez toxicodependentes depois de terem consumido droga, revelou Cec?lia Escarameia, m?dica do Centro de Atendimento a Toxicodependentes, num debate sobre consumo de estupefacientes na sexta--feira ? noite. On Thursday, were attended in hospitals ten addicts after they consumed drugs, revealed Cecilia Escarameia, Medical Care Center for Drug Abusers in a debate about drug use on Friday night.

A Pol?cia Judici?ria est? j? em campo e quatro das v?timas foram submetidas a aut?psia, mas ainda n?o h? resultados que permitam concluir o que est? em causa. The Judicial Police is already in the field and four of the victims were subjected to autopsy, but still no results to suggest what is at stake. Os relatos dos toxicodependentes referem que "haver? algu?m que est? a 'tra?ar' [misturar] o produto com cal ou gesso", conta Ana Sim?es. The reports of addicts report that "there will be someone who is a 'draw' [mix] the product of lime or gypsum," says Ana Sim?es.

Tamb?m h? quem refira o uso de estricnina como subst?ncia de corte. Also some people mention the use of strychnine as a substance of the court. Ana Sim?es recorda que no ano passado houve uma situa??o em que foram detectados vest?gios desta subst?ncia. Ana Sim?es recalls that last year there was a situation where evidence was found that substance.

Os toxicodependentes contactados pelo CM apresentam duas justifica??es para o aparecimento da hero?na adulterada. Drug users contacted by CM have two reasons for the emergence of adulterated heroin. "Poder? ser uma tentativa de estragar o neg?cio a algu?m", comentavam ontem alguns consumidores que se foram reunindo na rua Direita, na Baixa da cidade. "It may be an attempt to ruin the business to someone," commented yesterday some consumers who were gathering in the street right in the downtown center. Mas h? quem avance com explica??es mais elaboradas. But there are those who come forward with more elaborate explanations. "Parece uma tentativa de eliminar os indesej?veis da sociedade", diz Carlos, 42 anos, consumidor de hero?na, ao garantir que "pelo menos tr?s dos que morreram tinham muitos inimigos porque assaltavam carros e lojas com muita frequ?ncia". "It seems an attempt to eliminate the undesirables in society," said Carlos, 42 years, heroin users, to ensure that "at least three of those killed had many enemies because robbing cars and shops very often."

HERO?NA ADQUIRIDA NA BAIXA HEROIN ACQUIRED IN LOWER

Os toxicodependentes que consumiram hero?na adulterada ter?o adquirido a droga na Baixa da cidade, segundo os dados de que Ana Sim?es disp?e. The heroin addicts who have purchased the adulterated drugs in the downtown, according to data that has Ana Sim?es. Uma situa??o que a t?cnica considera estranha, na medida em que o produto que ? comercializado nessa zona "vir? do mesmo s?tio do que aquele que ? vendido no Planalto do Ingote". A situation that the technique not unusual, in that the product is marketed in the area "will come from the same place than it is sold on the Plateau ingot. Isto significa, na opini?o dos consumidores, que anda "algu?m na Baixa a dar a 'banhada' [enganar consumidores com droga de m? qualidade]". This means, in the opinion of consumers walking "someone in the Lower to the 'washed' [deceive consumers with poor quality drugs]."

H? at? quem j? tenha suspeitos. There are those who already suspect. "Poder? ser um toxicodependente, que j? foi angariador de clientes para traficantes e que agora pretende estragar-lhes o neg?cio", comentam. "It may be a drug addict, a former salesman from customers to dealers and now want to spoil their business," comments. "Se assim for ? muita maldade", diz An a Sim?es, ao considerar a situa??o "muito preocupante". "If it is so much evil," says An Sim?es, considering the situation "very worrying". O modo de actua??o ser? simples: "Esse traficante faz uma encomenda, fica com a maior parte da dose boa e depois mistura o resto com uma subst?ncia de corte". The mode of action is simple: "This dealer makes an order, gets the most good dose and then mix the rest with a substance of the court." O problema estar? nesse produto adicionado ? hero?na. The problem is that product added to heroin. T?m verificado que depois de "prepararem o caldo" para consumir ficam res?duos "cor-de-rosa", o que n?o ? normal. They found that after "prepare the broth" to consume waste are "color pink," which is not normal.

TRAFICANTES "ESPANTADOS" TRAFFICKERS "AMAZED"

O medo j? h? muito se instalou entre os consumidores, mas ultimamente os pr?prios traficantes est?o a ficar preocupados. The fear has long been settled among consumers, but lately the traffickers themselves are worrying. "Anda tudo apreensivo e as pessoas que nos vendem e em quem temos confian?a demonstram tanto espanto como n?s", assegura Carlos. "Come all apprehensive and the people who sell and who have shown so much confidence as we wonder," says Carlos. "O que se est? a passar ? impens?vel e tamb?m n?o traz qualquer vantagem para o traficante", acrescenta outro consumidor. "What is happening is unthinkable and did not bring any advantage to the dealer," adds another consumer. Mas nem todos est?o assustados da mesma forma. But not everyone is scared the same way. "Eu tenho mais medo da ressaca", assegura um deles. "I'm more afraid of the surf," says one of them.

PORMENORES DETAILS

M? QUALIDADE POOR QUALITY

Os consumidores dizem que a droga vendida em Coimbra "? adulterada e com v?rios cortes". Consumers say the drug sold in Coimbra is adulterated and several cuts.

EXAMES ?S V?TIMAS EXAMINATION OF VICTIMS

Os exames laboratoriais toxicol?gicos para apurar o que aconteceu est?o a cargo do Instituto de Medicina Legal. The toxicology laboratory to find out what happened are borne by the Institute of Legal Medicine.

 

[mixin]

Re: Europe - Several die as anthrax infects heroin users

As heroin in the Americas does not come from Afghanistan the perception of risk in the Americas is seen as minimal for the present.

That's good thing. Levamisole-tainted cocaine has been circulating here, pretty much unnoticed, for almost 2 years.

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

And more deaths in Coimbra (although again, these don't sound like anthrax).

http://www.diariocoimbra.pt/index.php?option=com_content&task=view&id=5902&Itemid=135

Overdose

Instituto da Droga sem Institute for Drugs without
registo de novos registration of new
casos em Coimbra cases Coimbra

?N?o houve mais casos [de mortes por overdose] nos ?ltimos sete dias?, confirmou ao Di?rio de Coimbra o delegado do Centro do Instituto da Droga e Toxicodepend?ncia (IDT), sobre a sucess?o de epis?dios desta natureza que, s? este m?s, ter? vitimado nove pessoas em Coimbra. "There were more cases [of deaths by overdose] in the last seven days," confirmed the Di?rio de Coimbra delegate of the Institute's Center for Drugs and Drug Addiction (IDT), the succession of episodes of this nature, just this month, will victimized nine people in [Coimbra]. ?S?o infelizes acontecimentos, que admitimos possam estar ligados?, comentou Carlos Ramalheira, que desconhece, para j?, pormenores da investiga??o que juntou DIAP, Pol?cia Judici?ria, INEM e IDT. 'The unfortunate events, we admit may be connected, "commented Carlos Ramalheira, unaware that, for now, details of research that brought DIAP, Judicial Police, INEM and RTD.

O respons?vel explica que a participa??o da delega??o se ficou por alguns esclarecimentos ?dentro da ?tica a que estamos obrigados?. The officer explains that the participation of the delegation stayed for some clarification "within the ethics that are required." Ramalheira teme que as not?cias de colabora??o entre as entidades afastem alguns utentes das equipas de rua que prestam apoio aos toxicodependentes e prefere salientar que o trabalho dos t?cnicos passou, sobretudo, por dar alguns conselhos aos toxicodependentes. Ramalheira fears that the reports of collaboration between entities deviate from some users of outreach to offer support to addicts and prefers to emphasize that the technicians' work now, especially, for giving some advice to drug users. N?o consumir sozinho, n?o injectar a droga, optando antes por fumar, ou consumir doses menores, s?o alguns mas, real?a, ?o primeiro ? sempre aconselhar a integra??o num programa de desabitua??o?, aproveitando o receio que se instalou entre a comunidade para cativar os utentes neste sentido. Do not consume yourself, you do not inject drugs, opting instead for smoking or consuming smaller doses, but some are, emphasizes, "the first advice is always to integrate a program of withdrawal ', taking advantage of the fear that has developed between the community to engage users in this regard.

Carlos Ramalheira recorda que h? recursos, a n?vel nacional, ?para tratar todos os doentes que queiram, atrav?s de centros de acolhimento, comunidades terap?uticas e unidades de assist?ncia, que garantem 1500 camas em regime de longa dura??o?. Carlos Ramalheira remember that there are resources at the national level, "to treat all patients who wish, through reception centers, therapeutic communities and units of service, ensuring 1500 beds in long-term arrangements."

 

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Re: Europe - Several die as anthrax infects heroin users

http://uk.reuters.com/article/idUKTRE60M1Q720100123?pageNumber=2&virtualBrandChannel=0
Anthrax in heroin kills eight in Europe
Sat Jan 23, 2010 10:19pm GMT
Email | Print | Share| Single Page[-] Text [+]
1 of 1Full SizeBy Kate Kelland
LONDON (Reuters) - Eight people have died of anthrax infection from using suspected contaminated heroin, European health authorities said on Saturday, and one expert advised users to stop taking the narcotic immediately.

Authorities said they believed a batch of heroin is circulating in Europe that is contaminated with anthrax, a fairly common bacteria whose spores can be used as a biological weapon.

"I would urge all drug users to stop using heroin immediately and contact local drug services for support," Colin Ramsay, a consultant epidemiologist in Scotland, said in a statement.

A total of 15 heroin users in Scotland have been found to have anthrax infection since December. Seven of them have died.

The eighth victim was a 42-year-old man in Germany who died of anthrax infection in mid-December after injecting drugs, authorities said.

"It is now suspected that heroin with infectious anthrax spores (and possibly other psychoactive substances that can be injected) is in circulation in Europe," the health ministry in Berlin said in a statement.

Anthrax infection occurs most often in wild and domestic animals in Asia, Africa and parts of Europe.

Humans are rarely infected but touching contaminated hides or hair can cause skin lesions. If the bacillus is inhaled, it can take hold quickly and by the time symptoms show up, it usually is too late for successful treatment with antibiotics



The European Centre for Disease Prevention and Control (ECDC), which monitors health in the European Union, said on its website that further anthrax cases were possible.

"The occurrence of 15 confirmed cases, including 8 deaths in a 5-week period is unusual and unexpected," it said.

"Considering the complex international distribution chain of heroin, and the clustering in time of cases in Scotland and Germany, the exposure to a contaminated batch of heroin distributed in several EU Member States is possible."

England's chief medical officer Liam Donaldson issued an alert last week to doctors and hospital emergency rooms to be on the look out for anthrax poisoning.

The ECDC said investigations so far "strongly" suggested that all the cases had been infected by a common source, but said the heroin was unlikely to have been deliberately contaminated.

"Accidental contamination seems the most plausible explanation to these incidents," it said.

(Additional reporting by Brian Rohan in Berlin, editing by Michael Roddy)

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

So this brings Scotland to 17 cases with 8 deaths, Germany has one confirmed fatal case, and Portugal has 9 suspected (but IMO unlikely) deaths.

http://news.scotsman.com/scotland/Drug-user-becomes-eighth-victim.6011919.jp

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? Previous ? PreviousNext ? Next ?View GalleryPublished Date: 25 January 2010
THE number of drug addicts who have died after being infected with anthrax has risen to eight, officials said today.

? A contaminated batch of heroin is believed to be the cause of the outbreak


The latest death came in the Glasgow area, Health Protection Scotland said.

A second patient, also a drug user, was also confirmed to be infected with the deadly bacteria after using what is believed to be a contaminated batch of heroin.

Both new cases occurred in the NHS Greater Glasgow and Clyde area, which has seen the highest infection rate and also the most deaths since the outbreak of the infection in December.

The health board has now seen nine confirmed cases of anthrax and five deaths.

In total, eight people have now died out of 17 confirmed cases during the outbreak.

Anthrax is a deadly bacterial infection which occurs mostly in animals in Asia and Africa. Humans are seldom infected and it is extremely rare for anthrax to be spread from person to person.

A Health Protection Scotland spokesman said the outbreak was "ongoing" among heroin users.

Symptoms of infection include swelling, redness, abscesses or ulcers on skin where the needle has entered, often with septicaemia.

An investigation by health boards, the procurator fiscal and Strathclyde Police is trying to identify the source of the anthrax.

One possibility is that contaminated heroin, or a contaminated agent used to cut the drug, is to blame.

Heroin often comes from countries where anthrax is more prevalent in animals and bone meal, an animal product, is sometimes used as a cutting agent.

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

OK. The deaths in Portugal are now excluded as anthrax. I would wonder why anyone would put cement or lime in drugs that someone is going to inject, but that doesn't make any less sense than putting anthrax in them.

http://www.ionline.pt/conteudo/4354...acucar-amarelo-os-novos-ingredientes-da-droga

Rumors and suspicions of adulterated drugs circulating in Coimbra are scaring the community of drug addicts admitted to the Daily News (DN) a project leader to support the Caritas Diocesan toxicopendentes this city in the central region.

A droga estará cada vez menos pura e as equipas de rua "têm a convicção de que há uma cadeia de venda e revenda longa e complexa, na qual, para subir o lucro da droga, se junta cimento, gesso, cal, açúcar amarelo ", confirmou também ao jornal Carlos Ramalheira, director regional do Instituto da Droga e da Toxicodependência (IDT). The drug will be less and less pure and street teams "are convinced that there is a chain of sale and resale long and complex, in which to raise the profits of the drug, joins cement, gypsum, lime, brown sugar" , also confirmed to the newspaper Carlos Ramalheira, regional director of the Institute for Drugs and Drug Addiction (IDT).

Já Duarte Nuno Vieira, presidente do Instituto Nacional de Medicina Legal , confirmou que estão a ser investigadas quatro mortes, ocorridas este mês num curto espaço de tempo, Already Duarte Nuno Vieira, president of the National Institute of Forensic Medicine, confirmed that they are being investigated four deaths that occurred this month in a short space of time, que poderão estar ligadas a este fenómeno e aguardam-se os resultados dos exames toxicológicos. that may be linked to this phenomenon and are awaiting the results of drug tests.

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81067

Archive Number 20100125.0276
Published Date 25-JAN-2010
Subject PRO/AH/EDR> Anthrax - UK (09): (Scotland)


ANTHRAX - UNITED KINGDOM (09): (SCOTLAND)
*****************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Mon 25 Jan 2010
Source: Health Protection Scotland [edited]
<http://www.hps.scot.nhs.uk/anthrax/index.aspx>


Further cases confirmed
-----------------------
Two further cases of anthrax, one of whom has died, have been
confirmed in drug users in Scotland, bringing the total number of
confirmed cases in this outbreak to 17. The number of deaths is now
at 8. The 2 new cases occurred in the NHS Greater Glasgow and Clyde area.

--
Communicated by:
Louise Kelly
Communications Officer
Health Protection Scotland
Clifton House
Clifton Place
Glasgow G3 7LN
UK
Fax: 0141 300 1170
<nss.hpscommunications@nhs.net>
<http://www.hps.scot.nhs.uk/anthrax>

[This brings the total cases in Glasgow & Clyde to 9, of whom 5 have
died. As these 2 cases have only just been reported, it would seem
that one may have been found when moribund. - Mod.MHJ]

******
[2]
Date: Sun 24 Jan 2010
Source: Sunday Herald (Scotland) [edited]
<http://www.heraldscotland.com/news/health/international-alert-in-scottish-anthrax-probe-1.1000931>


International alert in Scottish anthrax probe
---------------------------------------------
An alert has gone out across Europe after a German heroin addict died
from an anthrax infection similar to the one that has killed 7 Scots.
Scottish police and health officials are assisting the German
authorities with their investigation into the man's death and are
also working with European agencies to share intelligence they've
gathered during the recent outbreak.

Detective superintendent Derek Robertson of Strathclyde Police is
leading the investigation in Scotland and has been liaising with his
European counterparts. He said: "An anthrax outbreak is a rare
occurrence, so when we heard of a case in Germany, we immediately
contacted the police." Since then, Strathclyde Police have shared
information ranging from risk-assessment advice to post-mortem
guidance aimed at making sure anthrax cases do not go undetected.

The German man died on [13 Dec 2009], which corresponds with the 1st
anthrax death in Scotland. Since then, Scottish police have
identified several "pulses" of deaths among drug users.

Scientists at Porton Down, a government-run testing facility, are
analysing the anthrax that killed the German man to determine whether
there is a link between the Scottish and central European strains of
the bacterium.

The rising death toll has prompted an intense investigation by
Strathclyde Police and other forces around Scotland. They are seeking
information from those familiar with the drugs market and urged
anyone with any information about contaminated heroin to get in touch
with police. Mr Robertson insisted: "It's not about locking them up,
it's about getting the key piece of evidence that will unlock where
the contaminant is."

Dr Colin Ramsay, consultant epidemiologist at Health Protection
Scotland, has led conferences with the European Centre for Disease
Control to make sure that countries know about the threat that could
be facing them. He said: "It has to be noted that this is the most
significant outbreak there has been for quite some time. In fact,
there has never been an anthrax infection of this scale among
intravenous drug users. "There is major interest in the Scottish
outbreak in both Europe and America, because of the unique nature of
this case."

[Byline: Jasper Hamill]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The key bits of news here are that there is now collaborative
surveillance across Europe for new cases and what that might aid in
the investigation. And secondly that the German government has
provided DSTL (Defence Science and Technology Laboratory) Porton with
a culture of their isolate for genomic analysis and comparison. This
is not to say that the Germans could not do it as they routinely use
the now standard 25 primer analysis.

The European Center for Disease Prevention and Control (ECDC), which
monitors health in the European Union, said investigations so far
"strongly" suggested that all the cases had been infected by a common
source, but said the heroin was unlikely to have been deliberately
contaminated. "Accidental contamination seems the most plausible
explanation to these incidents," it said. See
<http://news.yahoo.com/s/nm/20100123/wl_nm/us_anthrax_europe_1>. - Mod.MHJ]

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

And another fatal case in Scotland, bringing them to 18 cases with nine deaths.

http://news.bbc.co.uk/2/hi/uk_news/scotland/glasgow_and_west/8487857.stm

Anthrax drug deaths rise to nine

Experts are investigating if the bacteria contaminated a batch of heroin
The number of drug addicts who have died in Scotland after being infected with anthrax has risen to nine.

Health Protection Scotland said tests had confirmed the infection in a heroin user who had died in the NHS Greater Glasgow and Clyde area on 12 December.

This would make it the earliest death connected to anthrax although it is the latest to be diagnosed.

Investigations continue into whether contaminated heroin or a contaminated cutting agent may be to blame.

The outbreak began with the identification of cases in NHS Greater Glasgow and Clyde in December.

So far, the total number of confirmed cases is 18, across six Scottish health boards.


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

Dr Colin Ramsay
Health Protection Scotland
Health Protection Scotland said this represented the first known outbreak of anthrax to have occurred in the country in conjunction with drug use.

The head of the outbreak control team, Dr Colin Ramsay, said: "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 based on current evidence."

Dr Ramsay said filters would not make heroin safe for drug users.

Symptoms of infection include swelling, redness, abscesses or ulcers on skin where the needle has entered, often with septicaemia.

Anthrax is a deadly bacterial infection which occurs mostly in animals in Asia and Africa.

Humans are seldom infected and it is extremely rare for anthrax to be spread from person to person

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81113

Archive Number 20100129.0315
Published Date 29-JAN-2010
Subject PRO/AH/EDR> Anthrax - UK (10): (Scotland)


ANTHRAX - UNITED KINGDOM (10): (SCOTLAND)
*****************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 29 Jan 2010
Source: Health Protection Scotland news release [edited]
<http://www.documents.hps.scot.nhs.uk/news/anthrax-press-release-2010-01-29.pdf>


Investigations continue as further anthrax death announced
-----------------------------------------------------------
Laboratory results have confirmed a case of anthrax infection in a
deceased heroin user in the NHS Greater Glasgow & Clyde area. This
takes the number of confirmed cases of anthrax in the current
outbreak in Scotland to 18, of whom a total of 9 individuals have now died.

This patient died on 12 Dec [2009] and so represents the earliest
death linked to this outbreak chronologically, however due to the
complexity of the various methods of testing for anthrax it has only
been possible to confirm the presence of anthrax infection now. It is
important to note that there is no evidence of person-to-person
transmission in this outbreak.

This user died on 12 Dec [2009] and was therefore exposed to heroin
in the early stages of this outbreak, however evidence suggests that
contaminated heroin may still be in circulation, and drug users all
across Scotland must remain vigilant. The outbreak began with the
identification of cases in NHS Greater Glasgow & Clyde in December
[2009], with cases now having been identified in 6 NHS board areas
across the country, and represents the 1st known outbreak of anthrax
to have occurred in conjunction 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 based on current evidence.
Users are encouraged to find out more about support services in their
area by calling Know the Score on 0800 587 5879 or visiting
<http://www.scottishdrugservices.com>. Those who do continue to use
heroin should follow current harm reduction advice, which says that
fresh filters should be used on each occasion and that filters should
not be re-used. It must be noted however that filters will not make
heroin safe or remove all traces of anthrax contamination, so the
best advice remains not to use heroin by any method. Users should
seek urgent medical attention in the event of symptoms such as
redness or swelling at or near an injection site or other symptoms of
general illness such a high temperature, chills, or a severe
headache, as early antibiotic treatment can be lifesaving."

Police enquiries are also ongoing. Strathclyde Police are
coordinating the Scottish Police investigation in support of this
public health response. The police are using their experience of
major investigations to establish the circumstances of how each
individual acquired their anthrax infection and are working to trace
the source of the contamination. Detective superintendent Derek
Robertson, who is leading the police investigation, said, "Our
investigations are supporting the public health response to the
current outbreak and we are working hard to attempt to identify the
source of the contamination. Anyone with any information on the sale
or supply of drugs in their area can report this to Crimestoppers in
complete confidence on 0800 555 111 and help remove dealers from
their communities".

Details of the case breakdown by NHS board are as follows
Confirmed cases by NHS board area (total: 18)
- NHS Ayrshire and Arran: 1
- NHS Fife: 1
- NHS Forth Valley: 1
- NHS Greater Glasgow & Clyde: 10
- NHS Lanarkshire: 3
- NHS Tayside: 2
Deaths by NHS board area (total: 9)
- NHS Forth Valley: 1
- NHS Greater Glasgow & Clyde: 6
- NHS Tayside: 2

Contact:
Louise Kelly
Communications Officer
Health Protection Scotland
Clifton House
Clifton Place
Glasgow
G3 7LN
<nss.hpscommunications@nhs.net>
<http://www.hps.scot.nhs.uk/anthrax>

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Many people, professional medics and vets included, think that
_Bacillus anthracis_ infections are easy to diagnose. I wish that
were so. My late lamented Russian colleague Benyamin Cherkasskiy
claimed that they could only culture some 30 percent of the human
cases they saw. And the Russians see more than most, unfortunately.
We have found over the years of field investigations that it is not
unusual for a veterinary diagnostic lab to come up with negatives of
patently obvious cases with prior positives. PCR analyses are a great
help in this field. And remember that some 5-9 percent of all
cultures will be penicillin resistant and/or phage resistant. It is
only in textbooks that it is simple.

On Wed 27 Jan 2010 I received a message from Dr Nigel Silman
<Nigel.Silman@hpa.org.uk> pointing out that it is the Health
Protection Agency Laboratories at Porton Down (Centre for Emergency
Preparedness and Response; CEPR) and not Dstl (Defence Science and
Technology Laboratory) who are undertaking all of these analyses as
well as the genotyping work on the strain transferred from Germany. I
do apologise for my error. I am reliably informed that the German
culture should arrive at CEPR Porton today, Fri 29 Jan 2010. - Mod.MHJ]

[see also:
Anthrax - UK (09): (Scotland) 20100125.0276
Anthrax - UK (08): (Scotland) 20100122.0251
Anthrax - UK (07): (Scotland) 20100120.0231
Anthrax - UK (06): (Scotland) 20100113.0149
Anthrax - UK (05): (Scotland) 20100111.0126
Anthrax - UK (04): (Scotland) 20100108.0096
Anthrax - UK (03): Scotland 20100107.0068
Anthrax - UK (02): (Scotland) 20100106.0054
Anthrax - UK: (Scotland) 20100101.0011
2009
----
Anthrax, human - UK (04): (Scotland) 20091224.4333
Anthrax, human - United Kingdom (03): (Scotland) 20091222.4317
Anthrax, human - UK (02): (Scotland) 20091219.4288
Anthrax, human - UK: (Scotland) heroin users 20091217.4270]
...................................mhj/mj/dk

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

This report is less than an hour old, and may represent a new (19th) case in Scotland, although the mention of only 15 previous cases might indicate that this one is one of the 18 we already knew of.

http://www.irvinetimes.com/news/rou...96552-anthrax-heroin-user-in-local-hospital-/

ANTHRAX HEROIN USER IN LOCAL HOSPITAL
Print | Email
A HEROIN-USER in a local hospital has been confirmed as having anthrax, it can be revealed.

The new case of the potential killer is the first to have happened in NHS Ayrshire and Arran and now drug users in the area are being warned to be vigilant.

Investigations are talking place into whether the deadly outbreak has come from contaminated heroin or whether a cutting agent is responsible.

Of the 15 confirmed cases of anthrax, seven people have died so far.

Dr Colin Ramsay, consultant epidemiologist at Health Protection scotland said heroin users should stop using to avoid the danger.

He said: "Heroin users all across Scotland need to be aware of the risk that their supply may be contaminated."

See the Times for the full story

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

This source is an aggregator. I think he may have miscounted, or double counted. My count is 18 cases (9 fatal) in Scotland, and one fatal case in Germany.

http://www.bioprepwatch.com/news/211838-new-clue-in-scotland-anthrax-infections

The hunt for the source of heroin tainted with anthrax has been widened following the tenth reported death from the infection in Scotland.

This tenth death from an anthrax infection was confirmed by Health protection Scotland, which revealed that the newest revealed victim died in the Glasgow area on Dec. 12.
The first death reported in the anthrax infection outbreak prior to this, however, was on Dec. 16 in Glasgow's Victoria Infirmary, giving researchers a new lead in their search for the source.

A total of 18 drug users in Scotland and one in Germany have been infect to date during the outbreak, which is believed to stem from smoking or injecting heroin that has been contaminated by anthrax spores, either through a tainted cutting agent or some other means.

There is no evidence, Health Protection Scotland has said, of person-to-person transmission of the bacterium.

?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,? Colin Ramsay, an agency epidemiologist, said in the statement. ?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.?

Ramsay also added that the risk of infection for the general public is very low. Approximately 55,000 people in Scotland are thought to use illicit drugs.

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

As I suspected, the previous report is a duplicate, and the total for Scotland remains 19 cases with 9 deaths.

http://www.hps.scot.nhs.uk/anthrax/index.aspx

This site is to provide the latest information on the anthrax cases in drug users in Scotland and supporting materials developed for those involved in the outbreak management and the treatment and care of cases.

Latest situation■HPS Press Release 29 January 2010
View press release archive

Cumulative National Total Date Confirmed Cases Deaths
03 February 2010 19 9
02 February 2010 19 9

Cumulative Total by NHS Board, 03 February 2010 NHS board Confirmed Cases Deaths
Ayrshire and Arran 1 0
Fife 1 0
Forth Valley 1 1
Greater Glasgow and Clyde 10 6
Lanarkshire 3 0
Tayside 3 2

View data archive

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81170

Archive Number 20100202.0356
Published Date 02-FEB-2010
Subject PRO/AH/EDR> Anthrax - UK (11): (Scotland)


ANTHRAX - UNITED KINGDOM (11): (SCOTLAND)
*****************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 2 Feb 2010
From: Martin Hugh-Jones <mehj@vetmed.lsu.edu> [edited]


Re: anthrax heroin cases in Scotland
------------------------------------
Yesterday [1 Feb 2010] Health Protection Scotland (HPS) posted a new case; see
<http://www.hps.scot.nhs.uk/anthrax/index.aspx>.

This announces a new case in Tayside but without further details.

Dr Colin Ramsay, consultant epidemiologist, has kindly made available
a digital distribution map of the 18 cases as of Fri 29 Jan 2010, for
which we are very grateful. See
<https://filestogeaux.lsu.edu/public/download.php?FILE=mhughj1/48353PIEY6b>.

Using the following roadmap of Scotland you can connect the dots from
Glasgow to Kilmarnock in the south, and to Dundee in the northeast, or
for a minimum of 2 delivery routes:
<http://www.scotland.gov.uk/Resource/Img/47021/0031737.gif>.

Taking into account that there are some 50 000 heroin addicts in
Scotland and the majority are in the Glasgow <-> Edinburgh corridor,
Scotland clearly got off very lightly. The spatial distribution and
paucity of cases suggests a chunky contamination unevenly distributed
in the product, that is, the affected were not just getting a
collection of individual spores, occasionally acquiring too many, but
more likely there were small chunks of stuff with spores imbedded in
them, rather like the lanolin chunks with spores that you find in
contaminated wool. Most didn't get them but sometimes someone did, and
when they do there are a lot of spores.

The Scottish authorities have yet to identify any spore-positive
heroin samples. However they have had cases who had shared their
heroin with others but only the individual case was affected. The
apparently unaffected are being followed up.
--
Martin Hugh-Jones
ProMED-mail Animal Disease Moderator
Coordinator, Anthrax Research & Control Working Group
Louisiana State University
Baton Rouge, Louisiana, USA
<mehj@vetmed.lsu.edu>

 

[Shiloh]

Re: Europe - Several die as anthrax infects heroin users

Source: http://news.bbc.co.uk/2/hi/uk_news/scotland/glasgow_and_west/8500848.stm

Page last updated at 15:11 GMT, Friday, 5 February 2010

German death linked to Scots anthrax outbreak

The death of a drug user in Germany has been linked to the anthrax outbreak that has killed nine heroin users in Scotland.

Tests by the Health Protection Agency and German scientists show the strain of the infection is indistinguishable from cases in Scotland.

The results suggest the anthrax contamination in both countries could come from a common source.

In Scotland there have been 19 confirmed cases of anthrax infection.

The outbreak began with the identification of cases in NHS Greater Glasgow and Clyde in December.

Fourteen of the confirmed cases in Scotland had the same strain of anthrax while the others are being investigated.

Health Protection Scotland said typing on the sample isolated from the German patient, who died in mid-December, has confirmed it is also of the same strain.

A further case of anthrax in a patient living in London with a history of heroin use has also been confirmed by the agency.

This individual developed symptoms at the end of January 2010. Investigations are continuing but no obvious connections to Scotland have been identified.

Evidence suggested that contaminated heroin may still be in circulation, and drug users across Scotland have been warned to remain vigilant.

Head of the national outbreak control team, Dr Colin Ramsay, said: "Drug users are advised to cease taking heroin by any route if at all possible.

"While we appreciate that this may be extremely difficult advice to follow, it remains the only public health protection advice possible based on current evidence."

He said filters would not make heroin safe for drug users.

He added: "Users should seek urgent medical attention in the event of symptoms such as redness or swelling at or near an injection site or other symptoms of general illness such a high temperature, chills or a severe headache, as early antibiotic treatment can be lifesaving."

Anthrax is a deadly bacterial infection which occurs mostly in animals in Asia and Africa.

Humans are seldom infected and it is extremely rare for anthrax to be spread from person to person.

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81215

Archive Number 20100205.0394
Published Date 05-FEB-2010
Subject PRO/AH/EDR> Anthrax - UK (13): Scots & German strains identical, London


ANTHRAX - UNITED KINGDOM (13): SCOTS & GERMAN STRAINS IDENTICAL, LONDON
***********************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Fri 5 Feb 2010
Source: Health Protection Scotland news release [edited]
<http://www.documents.hps.scot.nhs.uk/news/anthrax-press-release-2010-02-05.pdf>


Fatal anthrax case in Germany same strain as Scottish cases
------------------------------------------------------------
Tests carried out at the Health Protection Agency (HPA) and Germany's
Robert Koch Institute (RKI) and Friedrich-Loeffler Institute (FLI) on
the strain of anthrax isolated from a heroin user who died in Germany
in mid December [2009] have shown it is indistinguishable from strains
isolated from anthrax cases in Scotland. This suggests that the
anthrax contamination in both countries, thought to originate in the
heroin supply, could share a common source. This could suggest that
the contamination of the heroin may have occurred prior to
distribution of the heroin in Scotland and Germany, however it does
not offer definitive proof.

Of 18 confirmed anthrax isolates from Scottish cases by the HPA's
Special Pathogens Reference Laboratory at Porton Down, 14 have so far
been confirmed as being of the same strain, with further isolates
awaiting confirmation. Typing on the isolate from the German patient
has now confirmed it is also of the same strain. These results suggest
that the outbreak may be associated with anthrax contamination from a
single source.

To date in Scotland there have been a total of 19 confirmed cases in
Scotland, of whom a total of 9 individuals have died. A further case
of anthrax in a patient living in London with a history of heroin use
has also been confirmed by the Health Protection Agency (HPA). This
individual developed symptoms at the end of January 2010.
Investigations are continuing but no obvious connections to Scotland
have been identified.

Evidence suggests that contaminated heroin may still be in
circulation, and drug users all across Scotland must remain vigilant.
The outbreak began with the identification of cases in NHS Greater
Glasgow & Clyde in December [2009], with cases now having been
identified in 6 NHS board areas across the country, and represents the
1st known outbreak of anthrax to have occurred in conjunction with
drug use.

Dr Colin Ramsay, consultant epidemiologist at Health Protection
Scotland and head of the national Outbreak Control Team, said: "Drug
users are advised to cease taking heroin by any route if at all
possible. While we appreciate that this may be extremely difficult
advice to follow, it remains the only public health protection advice
possible based on current evidence. Users are encouraged to find out
more about support services in their area by calling Know the Score on
0800 587 5879 or visiting <http://www.scottishdrugservices.com>. Those
who do continue to use heroin should follow current harm reduction
advice, which says that fresh filters should be used on each occasion
and that filters should not be re-used. It must be noted however that
filters will not make heroin safe or remove all traces of anthrax
contamination, so the best advice remains not to use heroin by any
method. Users should seek urgent medical attention in the event of
symptoms such as redness or swelling at or near an injection site or
other symptoms of general illness such a high temperature, chills or a
severe headache, as early antibiotic treatment can be lifesaving."

Details of the case breakdown by NHS board are as follows:
Confirmed cases by NHS board area (total: 19)
- NHS Ayrshire and Arran: 1
- NHS Fife: 1
- NHS Forth Valley: 1
- NHS Greater Glasgow & Clyde: 10
- NHS Lanarkshire: 3
- NHS Tayside: 3
Deaths by: NHS board area (total: 9)
- NHS Forth Valley: 1
- NHS Greater Glasgow & Clyde: 6
- NHS Tayside: 2

Contact:
Louise Kelly
Communications Officer
Health Protection Scotland
Clifton House
Clifton Place
Glasgow
G3 7LN
<nss.hpscommunications@nhs.net>
<http://www.hps.scot.nhs.uk/anthrax>

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[This confirms the suspicion existing for some time on the source for
the 2 strains being the same. Clearly the German case in Aachen scored
himself some heroin with or without the shipper knowing. Hopefully it
was just for him and not sufficient to be shared with others. In that
a month has passed without new German cases it would be logical to
think that the German case will be singular. - Mod.MHJ]

******
[2]
Date: Fri 5 Feb 2010
Source: UK Health Protection Agency (HPA) news release [edited]
<http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1265296975679?p=1259152466069>


Anthrax alert for heroin users in London
----------------------------------------
The Health Protection Agency (HPA) and NHS (National Health Service)
London can confirm that a drug injecting heroin user has tested
positive for anthrax and is being treated in a London hospital.

This is the 1st case of anthrax seen in an injecting drug user in
England since similar cases were first seen in Scotland in December
2009. 19 cases have so far been confirmed in Scotland. Similarities to
the cases in Scotland suggest that the heroin, or a contaminated
cutting agent mixed with the heroin, is the likely source of infection.

Dr Brian McCloskey, director of the Health Protection Agency in
London, said: "We are working closely with NHS London to monitor the
situation. There is no evidence of person-to-person transmission in
this case and I'd like to reassure people that the risk to the general
population, including close family members of the infected patient, is
negligible. It is extremely rare for anthrax to be spread from person
to person and there has been no evidence of a significant risk of
airborne transmission associated with the current situation in Scotland.

"While public health investigations are ongoing, it must be assumed
that all heroin in London carries the risk of anthrax contamination.
Heroin users are advised to cease taking heroin by any route, if at
all possible, and to seek help from their local drug treatment
services. Heroin users in London are strongly encouraged, as soon as
possible, to find out more about the support services in their area.
They can be put in touch with local drug services and receive advice
by contacting Talk to Frank."

Professor Lindsey Davies, regional director of public health from NHS
London, said: "I urge all heroin users in London to be extremely alert
to the risks and to seek urgent medical advice if they experience
signs of infection such as redness or excessive swelling at or near an
injection site, or other symptoms of general illness such a high
temperature, chills, or a severe headache or breathing difficulties,
as early antibiotic treatment can be lifesaving. This is a very
serious infection for drug users and prompt treatment is crucial.

"Drug injecting is an extremely risky and dangerous practice and users
are vulnerable to a wide range of infectious diseases, both from the
action of piercing the skin, as well as contaminants in the drugs that
they use.

"Health professionals and drug action teams in England had already
been alerted to the situation in Scotland in December [2009] and we
will continue to work closely with colleagues who work with drug users
to monitor probable cases and raise awareness of the risks."

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[We have already seen that Scottish heroin was being dumped. I gather
from contacts that there had been addict dissatisfaction with the
quality of the high being not "good". To keep their clients the
pushers would be pulling back that lot, and replacing it with a better
one in order to keep their clients. Then the inferior batch would be
remixed and/or shipped south, possibly at a bargain rate. This London
case indicates that the contaminated Scottish heroin is now in London.
Genomic confirmation of this London case is awaited. - Mod.MHJ]

******
[3]
Date: Fri 5 Feb 2010
From: Martin Hugh-Jones <mehj@vetmed.lsu.edu> [edited]


Re: Afghan heroin in Russia
---------------------------
In a previous posting (see archive no. 20100203.0368) we reported that
the heroin in the UK comes from Afghanistan via the Balkans where it
is processed and repackaged, before being shipped by road to a Channel
port. The identical genomic identity of the German case in Aachen to
the Scottish cases indicates that in this case they were using the
port of Antwerp.

Russia is severely afflicted with heroin, which the government hints
follows from the Western intervention in Afghanistan. Unfortunately
the Russian drug policy is counterproductive. Any addict who seeks
medical help for his or her addiction is immediately put on the state
"narcological register". This information is available to police, who
can have the drug user arrested and put in prison, and causes huge
problems for people if they kick their habit and want to reintegrate
into society.

But to date there are no reports of heroin related human anthrax in
Russia, which would reinforce the hypothesis that the anthrax
contamination problem is in the Balkans. The usual contamination
problems associated with heroin, however, are occurring.

There are a number of reports worth reading on the Russian heroin problem:
<http://news.bbc.co.uk/2/hi/7935527.stm>,
<http://www.independent.co.uk/news/world/europe/russia-finally-admits-to-its-
hidden-heroin-epidemic-1642103.html>,
<http://www.huffingtonpost.com/2009/03/11/russia-finally-admits-to_n_173924.html>,
<http://articles.latimes.com/2009/sep/25/world/fg-russia-heroin25>,
<http://news.sky.com/skynews/Home/World-News/Heroin-Russia-Blames-Coalition-Over-Afghanistan-Drug-Supply-Increase/Article/200912315500702>,
and
<http://www.tehrantimes.com/Index_view.asp?code=212477>.

--
Martin Hugh-Jones
ProMED-mail Animal Disease Moderator
Coordinator, Anthrax Research & Control Working Group
Louisiana State University
Baton Rouge, Louisiana, USA
<mehj@vetmed.lsu.edu>

[see also:
German case:
Anthrax - Germany: (NW) fatal, heroin user 20100114.0170
Scottish cases:
Anthrax - UK (12): heroin, background 20100203.0368
Anthrax - UK (11): (Scotland) 20100202.0356
Anthrax - UK (10): (Scotland) 20100129.0315
Anthrax - UK (09): (Scotland) 20100125.0276
Anthrax - UK (08): (Scotland) 20100122.0251
Anthrax - UK (07): (Scotland) 20100120.0231
Anthrax - UK (06): (Scotland) 20100113.0149
Anthrax - UK (05): (Scotland) 20100111.0126
Anthrax - UK (04): (Scotland) 20100108.0096
Anthrax - UK (03): Scotland 20100107.0068
Anthrax - UK (02): (Scotland) 20100106.0054
Anthrax - UK: (Scotland) 20100101.0011
2009
----
Anthrax, human - UK (05): (England) NOT 20091227.4363
Anthrax, human - UK (04): (Scotland) 20091224.4333
Anthrax, human - United Kingdom (03): (Scotland) 20091222.4317
Anthrax, human - UK (02): (Scotland) 20091219.4288
Anthrax, human - UK: (Scotland) heroin users 20091217.4270]

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

http://www.mirror.co.uk/news/top-st...r-tests-positive-for-anthrax-115875-22022320/

British heroin user tests positive for anthrax 6/02/2010


A heroin user in England has tested positive for antrax following 19 similar cases in Scotland, it was revealed yesterday.

The user is the first recorded case of anthrax transmission through drugs in England. Nine victims in Scotland have died.

Dr Brian McCloskey, Health Protection Agency director, said: "It must be assumed that all heroin in London carries the risk of anthrax contamination."

The latest victim, who injected the drug, is being treated in a London hospital.

Dr McCloskey added it was "extremely rare" for anthrax to spread from person to person.

Users suffering symptoms such as a high temperature should seek medical help.

 

[Shiloh]

Re: Europe - Several die as anthrax infects heroin users

Source: http://www.guardian.co.uk/society/2010/feb/10/anthrax-heroin-kills-drug-user


Anthrax-contaminated heroin kills drug user

Death in Blackpool follows nine fatalities in Scotland since the contaminated heroin emerged in December

* Severin Carrell
* guardian.co.uk, Wednesday 10 February 2010 16.08 GMT

A drug user has become the first person to die in England from a batch of anthrax-contaminated heroin which has now killed 11 addicts in the UK and Germany.

The unnamed user from Blackpool is the second case in England to emerge in the last week after it emerged five days ago that a female addict from London was being treated in hospital.

The death in Blackpool follows nine fatalities across central Scotland since the contaminated heroin emerged in early December in Glasgow. There have been 19 confirmed cases in Scotland, with deaths in Glasgow, Lanarkshire, Dundee, Fife and Stirling.

The German victim died in Aachen in December but the death was only officially linked to the batch found in the UK last week, after the strain was found to be "indistinguishable" from the type of anthrax found in Scotland.

The surge of cases ? the most serious anthrax outbreak in the UK in recent times ? has puzzled police and health experts, who remain uncertain how or where the heroin became infected. The frequently lethal bacteria is mostly found in animals in Asia and Africa, and very rarely occurs in Europe...

 

[alert]

Re: Europe - Several die as anthrax infects heroin users

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81300

Archive Number 20100210.0465
Published Date 10-FEB-2010
Subject PRO/AH/EDR> Anthrax - UK (14): (England, Scotland)

ANTHRAX - UK (14): (ENGLAND, SCOTLAND)
***************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: 10 Feb 2010
Source: The Guardian [edited]
<http://www.guardian.co.uk/society/2010/feb/10/anthrax-heroin-kills-drug-user>


A death in Blackpool follows 9 fatalities in Scotland since the
contaminated heroin emerged in December 2009. Health experts are
investigating whether the heroin was contaminated with anthrax at source.

A drug user has become the 1st person to die in England from a batch
of anthrax-contaminated heroin, which has now killed 11 addicts in
the UK and Germany. The unnamed user from Blackpool is the 2nd case
in England to emerge in the last week after it emerged 5 days ago
that a female addict from London was being treated in hospital. The
death in Blackpool follows 9 fatalities across central Scotland since
the contaminated heroin emerged in early December 2009 in Glasgow.
There have been 19 confirmed cases in Scotland [now 21 cases, see
below], with deaths in Glasgow, Lanarkshire, Dundee, Fife and Stirling.

The German victim died in Aachen in December 2009, but the death was
only officially linked to the batch found in the UK last week, after
the strain was found to be "indistinguishable" from the type of
anthrax found in Scotland. The surge of cases -- the most serious
anthrax outbreak in the UK in recent times -- has puzzled police and
health experts, who remain uncertain how or where the heroin became
infected. The frequently lethal bacteria is mostly found in animals
in Asia and Africa and very rarely occurs in Europe. They are
investigating whether the heroin was contaminated at its likely
source in Afghanistan, perhaps from contaminated soils or contact
with infected animal skins, or was infected by a cutting agent used
by drug dealers or traffickers closer to Europe.

The cases in London and Germany have no known link to the Scottish
outbreak [as of yet, the results of genomic analysis are awaited. -
Mod.MHJ], increasing anxieties that the contamination could be
widespread. There has been only one previous case of a heroin user
dying from anthrax, in Norway in 2000.

Dr Arif Rajpura, the director of public health with NHS Blackpool,
repeated warnings to heroin users to stop taking the drug or watch
closely for unusual symptoms, including rashes, swelling, severe
headaches or high temperatures. "Heroin users are strongly advised to
cease taking heroin by any route, if at all possible, and to seek
help from their local drug treatment services. This is a very serious
infection for drug users, and prompt treatment is crucial," he said.

[Byline: Severin Carrell]

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******
[2]
Date: 10 Feb 2010
Source: BBC News [edited]
<http://news.bbc.co.uk/2/hi/uk_news/england/lancashire/8508631.stm>


Health officials have confirmed a heroin user who tested positive for
anthrax has died. The 24-year-old from Blackpool was taken to the
town's Victoria Hospital on 28 Jan 2010 and died on 1 Feb 2010. The
Health Protection Agency (HPA), NHS Blackpool, and police are
investigating the circumstances surrounding the death and the source
or supply of the drugs.

A 36-year-old Blackpool woman arrested on suspicion of supplying or
offering drugs has been bailed until 2 Apr 2010, and a 35-year-old
man from Liverpool arrested on suspicion of possession with intent to
supply Class A drugs and a 21-year-old woman from Blackpool arrested
on suspicion of production or being concerned in the supply of Class
A drugs were released without charge.

This is the 2nd case of anthrax seen in an injecting drug user in
England, the 1st announced in London on 5 Feb 2010. Similar cases
have been seen in Scotland since December 2009.

A statement from NHS Blackpool said that while public health
investigations were ongoing, "it must be assumed that all heroin in
the northwest carries the risk of anthrax contamination." Heroin
users were warned to be alert to the risks and to seek urgent medical
advice if they experience signs of infection, as early antibiotic
treatment can be lifesaving.

Dependent on the dose and route of exposure, the symptoms may develop
within a week of taking heroin.

--
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[To find Blackpool, which is a coastal holiday town in Lancashire to
the north of Liverpool, go to: <http://www.fallingrain.com/icao/EGNH.html>.

From the ancillary information provided by the BBC, we might
speculate that the 24-year-old's dealer was the 36 year old Blackpool
woman, possibly on evidence provided by the other 2 individuals from
Liverpool and Blackpool respectively. Multiple deliveries of the
original contaminated material in Glasgow have been made, and on that
basis, other cases elsewhere in England can be expected. - Mod.MHJ]

******
[3]
Date: 10 Feb 2010
From: Martin Hugh-Jones <promed@promedmail.org>


Re: New cases in Scotland; see:
<http://www.hps.scot.nhs.uk/anthrax/index.aspx>. As of 10 Feb 2010, 2
new cases have been reported in Scotland in the Greater Glasgow and
Clyde NHS Board area. As the number of deaths remains at 9, we can
assume that these 2 individuals are hospital cases undergoing
treatment and may well survive.

As cases continue to occur in Glasgow and not in other Scottish
sites, maybe this pattern will continue.

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[alert]

Re: Europe - Several die as anthrax infects heroin users

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81383

Archive Number 20100215.0532
Published Date 15-FEB-2010
Subject PRO/AH/EDR> Anthrax - UK (15): (Scotland)


ANTHRAX - UNITED KINGDOM (15): SCOTLAND
******************************************
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International Society for Infectious Diseases
<http://www.isid.org>

Date: 15 Feb 2010
Source: Health Protection Scotland [edited]
<http://www.hps.scot.nhs.uk/anthrax/index.aspx>


A new case has been confirmed today [15 Feb 2010] for Lanarkshire,
bringing the total cases seen there to 4; to date, none have died there.

There is, at present, no other information.

Lanarkshire is southeast of Glasgow.

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[Map of Scotland showing Lanarkshire in sky blue:
<http://www.scotpho.org.uk/Web/MultimediaFiles/ProfileMap_Scotland.jpg>
- Mod.JW]