Anthrax confirmed in an injecting drug user in Kent

3 November 2010

The Health Protection Agency (HPA) can confirm that it is investigating a case of anthrax infection in a drug injecting heroin user, who is critically ill in Kent.

Dr Mathi Chandrakumar, Director of Kent Health Protection Unit said: „We are working closely with NHS and police colleagues to monitor the situation. I’d like to reassure people that there is no risk to the general population, including close family members of the patient. It is extremely unlikely that this form of anthrax can spread from person to person.

„We continue to see occasional cases of this serious infection among injecting drug users, following a cluster of cases earlier this year. Exposure to anthrax is now one of a number of risks that drug users are exposed to. All heroin users should 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 the fifth case of anthrax seen in an injecting drug user in England, the first being in London in February this year.  Similar cases have been seen in Scotland since December 2009 with 47 cases confirmed and one in Germany. 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 Chandrakumar added: „If friends and family are concerned about a family member or friend and their drug use there are a number of services, including their GP, Social Services and local drug teams who can help advise about where the most appropriate help can be found.“
ENDS

Summary of recent advice on infections due to spore-forming bacteria in drug users:
anthrax, botulism & tetanus

The Health Protection Agency (HPA) has confirmed that a heroin injector who was being treated for anthrax infection died on 3rd November 2010 in a Kent hospital. The HPA has issued a local press release in Kent.

Since December 2009, there have been a number of anthrax cases, including some deaths, among heroin users in Scotland and, to a much lesser extent, in England. There continue to be occasional cases of wound botulism among injecting drug users. In addition, injecting drug users are vulnerable to tetanus if they have not been appropriately vaccinated. Heroin – or perhaps a contaminated agent mixed with it – is the most likely source of these infections among English injectors.

We are drawing together, in this summary, the key sources of recent authoritative advice and information on infections due to spore-forming bacteria. This is to remind partnerships that, while there is no immediate increased cause for concern, the provision of relevant health advice to drug users continues to be an important activity for drug services.

Key points:

• It is important that all heroin users, and professionals working with heroin users, are familiar with the HPA’s advice about the risks of anthrax, wound botulism and tetanus. It is important that a person who is thought to have one of these infections or an unusual illness seeks urgent medical treatment. To help communicate these messages, the HPA and NTA developed specialist materials about anthrax in the form of detailed poster and leaflets designed so local areas can add the details of their treatment services. These, and information for healthcare professionals, are available from the HPA website. The HPA website also has information about wound botulism for both healthcare professionals and drug users. Information for healthcare professionals about tetanus immunisation can be found on the DH website.

• Local media campaigns are not recommended for raising awareness. Instead, effective local responses will involve targeted awareness-raising that is aimed at the key ‘at-risk’ group – heroin users. This will involve services and professionals using authoritative information and advice materials to inform their clients. Distribution should reach a wide range of organisations in touch with drug users including those focusing on those not in contact with drug treatment services, such as homeless hostels/housing departments, needle exchanges, and community pharmacies.

More information and links on the HPA website.

Notes to Editors
1. Heroin users in Kent are strongly encouraged to find out more about the support services in their area. They can find drug services or seek advice from Talk to Frank: 24-hour helpline: 0800 77 66 00 / website: www.talktofrank.com

2. For local drug treatment services visit DAAT website local services section at www.kdaat.co.uk

3. The Health Protection Agency has produced advice for injecting drug users and guidelines on the clinical evaluation and management of people with possible anthrax in England. These are available at: http://www.hpa.org.uk/HPA/Topics/InfectiousDiseases/InfectionsAZ/1191942145749/

Contact: SE Region Comms Manager Teresa Cash 07789 295454