The Pharmaceutical Journal
Vol 269 No 7224 p700
16 November 2002

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Public Health Laboratory Service (www.phls.org.uk)

Public laboratory warns risk of botulism in wounds of heroin users

A spate of wound botulism among heroin users has prompted the Public Health Laboratory Service to issue an alert for health care workers to be on the look out for symptoms.

Those infected may shows signs of blurred vision, drooping eyelids, slurred speech, difficulty swallowing, a dry mouth and muscle weakness.

Thirteen cases have been reported so far this year, six of which have occurred in the past three months and four of these in the south west of England. It is thought a batch of heroin contaminated with Clostridium botulinum is to blame.

Antimicrobial therapy and surgical removal of dead and infected tissue should reduce organism load and toxin production, although circulating toxin can only be neutralised by early administration of antitoxin. Further information is available on the PHLS website (www.phls.org.uk).