Second case of anthrax confirmed in England

10 September 2012

The Health Protection Agency (HPA) is aware that a person who injected heroin has died from anthrax infection in Blackpool Victoria Hospital. This death has occurred three weeks after another person who injects drugs also died in Blackpool from confirmed anthrax infection.

The Health Protection Agency (HPA) is aware that a person who injected heroin has died from anthrax infection in Blackpool Victoria Hospital. This death has occurred three weeks after another person who injects drugs also died in Blackpool from confirmed anthrax infection.

There is an ongoing outbreak of anthrax among people who inject drugs (PWID) in a number of countries in Europe with ten cases identified since early June. The latest case in Blackpool brings the total number affected in the UK to four – two in England (both fatal), one in Scotland and one in Wales (both recovering).The source is presumed to be contaminated heroin. It is unclear as yet whether these recent cases are linked to the cases in Europe (three in Germany, two in Denmark and one in France) but the HPA is continuing to monitor the situation.

The European Centre for Disease Prevention and Control (ECDC) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) have concluded that heroin users in Europe are still at risk of exposure to anthrax.

Dr Fortune Ncube, an expert in blood-borne viruses with the HPA, said: “Anthrax can be cured with antibiotics, if treatment is started early. It is therefore important for medical professionals to know the signs and symptoms to look for, so that there will be no delays in providing treatment.

“It’s likely that further cases among people who inject heroin will be identified as part of the ongoing outbreak in EU countries. The Department of Health has alerted the NHS of the possibility of PWID presenting to Emergency Departments and Walk-in Clinics, with symptoms suggestive of anthrax.

“Local drug services throughout the country have also been alerted and the National Treatment Agency has circulated posters and leaflets about anthrax contamination, which are aimed at heroin users, to local treatment centres and to other organisations who are touch with drug users who might not be in contact with drug services, for example hostels, housing departments, needle exchanges, benefit offices, community pharmacies and social work departments.”

Drug users may become infected with anthrax when heroin is contaminated with anthrax spores. This could be a source of infection if injected, smoked or snorted. There is no safe route for consuming heroin or other drugs that may be contaminated with anthrax spores.

Dr Ncube, added: “The HPA is warning people who use heroin that they could be risking anthrax infection. We urge all heroin users 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, severe headaches or breathing difficulties. Early treatment with antibiotics is essential for a successful recovery.”

Ends

Notes to editors

1. The Rare and Imported Pathogens Laboratory at HPA Porton, is providing diagnostic support to clinical teams across the UK to assist them with the handling of anthrax incidents.
2. Further information on anthrax can be found on the anthrax page.
3.  More information on the European outbreak is available at the European Centre for Disease Prevention and Control (ECDC) website [external link].
4. More information about the 2009/2010 outbreak of anthrax in Scotland is available at the Health Protection Scotland website [external link].
5. The Health Protection Agency has produced advice for injecting drug users and guidelines on the clinical evaluation and management of people with possible cutaneous anthrax in England. These are available on the anthrax  page.
6. At the end of June 2012 in consultation with colleagues across the UK the HPA produced a one-page reminder for those who commission and provide services to drug users about severe infections among PWID caused by spore-forming bacteria. This has been cascaded to service providers in England by the National Treatment Agency. See the: Anthrax, botulism & tetanus among drug users - a reminder June 2012 (PDF, 65 KB)  for more details.
7. The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. In April 2013 the Health Protection Agency will become part of a new organisation called Public Health England, an executive agency of the Department of Health. To find out more, visit our website: www.hpa.org.uk or follow us on Twitter @HPAuk or ‘Like’ us on Facebook at www.facebook.com/HealthProtectionAgency [external link].
8. For more information please contact the national HPA press office at Colindale on 0208 327 7901 or email colindale-pressoffice@hpa.org.uk. Out of hours the duty press officer can be contacted on 0208 200 4400. Alternatively contact the communications team at HPA North West on 0844-2251295 and select option 2.

Last reviewed: 10 September 2012