Published Date: 2012-07-31 16:08:31
Subject: PRO/AH> Anthrax, human - UK (03): (Scotland) HPS briefing docs.
Archive Number: 20120731.1223145

ANTHRAX, HUMAN - UK (03): (SCOTLAND), BRIEFING DOCUMENTS
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International Society for Infectious Diseases
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Date: 30 Jul 2012
Source: Health Protection Scotland [edited]
http://www.hps.scot.nhs.uk/news/spdetail.aspx?id=495


Anthrax contaminated heroin: resources for drug users and drug workers:

The Scottish Drugs Forum has published revised resources following the recent case of anthrax in Scotland, and these are available from their website; the resources include:

- Anthrax and Heroin Users: What Workers Need to Know (283 Kb Adobe PDF Icon).
- Anthrax Alert information for drug users - Poster (738 Kb Adobe PDF Icon)
- Anthrax Alert information for drug users - Leaflet (977 Kb Adobe PDF Icon)

These resources have been updated since they were 1st used during the 2009-2010 outbreak of anthrax associated with drug use.

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

[These are very valuable resources for those faced by this recent drug challenge.

I recently had a query concerning how the anthrax spores survived the flame heating prior to injection. I asked Colin Ramsay <colin.ramsay@nhs.net>, Consultant Epidemiologist, Health Protection Scotland, who replied as follows: "The evidence from the anthrax and preceding _Clostridium novii_ outbreaks, together with other occasional clostridia cases in injecting drug users, suggests that conventional flame heating is unreliable as a means of eliminating spores. Heating using a flame is apparently unlikely to achieve consistent temperatures sufficient to destroy the spores, and prolonged heating is generally avoided, since it may result in degradation of the solution, the aim being to avoid ending up with a black, sticky residue from prolonged heating. Drug users also conventionally use citric acid or lemon juice to help dissolve the heroin, yet spores apparently resist this acidic solution as well as heating. A variety of filters are also used by injectors, e.g. filters from cigarettes, but these apparently do not prevent spore exposure either."

There were some references in the OCT report on this aspect: http://www.documents.hps.scot.nhs.uk/giz/anthrax-outbreak/anthrax-outbreak-report-2011-12.pdf. The OCT report goes into it with marginally more information as well as other topics such as the possible origin of the earlier contamination. - Mod.MHJ

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1h2A.]

See Also

Anthrax, human - UK (02): (Scotland) new heroin related case, alert 20120725.1214623
Anthrax, human - UK: (Scotland) heroin users case control study 20120525.1143693
Anthrax - France: (RA) conf. heroin case 20120714.1201908
Anthrax - Germany (08): (Berlin) ongoing investigations 20120713.1200646
Anthrax - Germany (07): (Berlin) early self treatment 20120710.1196322
Anthrax - Germany (06): (Berlin) new case 20120705.1191168
Anthrax - Germany (05) 20120705.1190288
Anthrax - Germany (03): strain identified 20120624.1179225
Anthrax - Germany (02): (BY) 2nd heroin case, RFI 20120621.1175326
Anthrax - Germany: (BY) fatal, heroin user 20120612.1165823
Anthrax, human - Denmark (03): fatal conf. heroin case 20120709.1195198
2011
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Anthrax, human - UK, Germany 2010: heroin users, final report 20111231.3712
...and there are a number relating to the UK outbreaks in 2009-2010
.................................................mhj/msp/dk