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  • #31
    Re: UK: Several Addicts die as anthrax infects heroin users



    Scotland: Anthrax outbreak linked to contaminated heroin has caused 6 deaths, 12 infections
    By Maria Cheng (CP) – 2 hours ago

    LONDON — Contaminated heroin may have caused an anthrax outbreak among drug addicts in Scotland, killing six people and infecting 12 in total, health officials said Thursday.

    All of the people stricken with the bacterial disease were believed to be heroin users, said a spokesman at Scotland's Health Protection Agency, who spoke on condition of anonymity in line with government policy. The agency said other cases were under investigation, but would not specify how many.

    Experts say contaminated heroin or another powder-like substance used to dilute the drug may have spread the disease. Scottish officials warned that further cases might be detected beyond Glasgow, where 4 deaths have occurred. Another 2 people died near Dundee and Forth Valley.

    Anthrax is an animal disease and regularly infects people in Africa and Asia, as well as parts of southern Europe. It can be treated with antibiotics if caught early, and does not usually spread from person to person. Left untreated, anthrax can be fatal.

    "Heroin users all across Scotland need to be aware of the risks of a potentially contaminated supply," said Colin Ramsay, a consultant epidemiologist at Health Protection Scotland in a statement.

    Only a handful of anthrax cases have been reported in the United Kingdom in the past decade. The disease mostly affects people exposed to contaminated animal hides and other animal products.

    "It is highly probable that the contamination of heroin by anthrax is accidental," said Gordon Meldrum, director general of the Scottish Crime and Drug Enforcement Agency, in a statement. "Production processes (of heroin) can be basic and often be conducted in areas where there is contamination from animal carcasses or feces."

    Scottish police said investigations into the anthrax deaths were ongoing.

    "We are preparing reports for prosecutors," said David Steele, a spokesman for the Association of Chief Police Officers of Scotland. "Those who supplied the drugs are reluctant to talk, but we will investigate them fully."

    Agencies working to help heroin addicts, like Turning Point Scotland, said they were scanning more than 120 users a day for signs of anthrax infection.

    "We are checking everyone over," said Beverley Bell, a spokeswoman for the organization. "It usually reveals itself through little black dots or spots around the area of injection."

    She said the agency was also passing out leaflets about anthrax to heroin addicts and asking them to warn other users of the risks.

    Another bacteria outbreak struck Scottish heroin users in 2000, when an infected batch of the drug killed 60 people. In 2000, one person in Norway caught anthrax after injecting contaminated drugs.

    In Scotland, authorities said heroin users, rather than the general public, were most at risk.

    "Heroin users do need to be on their guard," said Ramsay. While anthrax spores can be spread in the air, officials said there was no evidence of that type of spread in this current outbreak.

    "I would advise heroin users to stop using heroin and seek advice," Ramsay said.

    He said any heroin users who noticed signs of infection - like redness or swelling around a needle injection site or a fever - should seek medical help immediately.

    The World Health Organization said it was monitoring the situation, but did not expect the outbreak to spill over into the general public.


    Associated Press Writer Ben McConville contributed to this report from Edinburgh.

    Comment


    • #32
      Re: UK: Several Addicts die as anthrax infects heroin users

      Hospitals, ambulance services and GPs warned to watch out for suspected cases as six more seriously ill in hospital


      Nationwide alert after anthrax-tainted heroin kills six addicts in ScotlandHospitals, ambulance services and GPs warned to watch out for suspected cases as six more seriously ill in hospital
      Buzz up!
      Digg it
      Severin Carrell, Scotland correspondent guardian.co.uk, Thursday 7 January 2010 19.01 GMT Article history
      Anthrax-tainted heroin has killed six addicts and left another six in hospital. Photograph: PA Photo/PA

      A nationwide alert has been issued to hospitals, ambulance services and GPs after a batch of heroin contaminated with anthrax killed six addicts in Scotland, raising fears for drug users across the UK.

      It is feared that the death toll will rise to at least 10 soon, the Guardian understands, after cases spread across Scotland from Glasgow to Lanarkshire, then to Dundee, Fife and now central Scotland.

      The first cases came to light before Christmas, when an addict died in hospital in Glasgow. It emerged today that the sixth addict died earlier this week in Stirling. A further six users with the lethal bacterial disease are in hospital, in the worst anthrax scare in recent times.

      Health ministers issued an alert to all primary care trusts in England tonight after the latest cases came to light, advising drugs workers, consultants and accidents and emergency units to watch out for suspected cases.

      A fresh alert has also been issued by the agency Health Protection Scotland, which has set up an outbreak control team to investigate the source of the contamination, while a parallel investigation has been launched by police. Heroin users are being urged to stop taking the drug immediately.

      Dr Colin Ramsay, the consultant epidemiologist at HPS who is leading the agency's inquiry, said contaminated heroin, or a contaminated cutting agent, could be responsible for the infections.

      "The death of this patient in NHS Forth Valley indicates further geographical spread of the cases, meaning that heroin users all across Scotland need to be aware of the risks of a potentially contaminated supply," he said. "If any heroin users do notice signs of infection, for example marked redness and swelling around an injection site, or other signs of serious infection such as a high fever, they should seek urgent medical advice."

      The Department of Health alert issued tonight states: "Investigations are continuing into the cause of these cases and into any heroin supply routes that may be affected. While cases remain confined to Scotland, you should be alert to the possibility of anthrax infection in injecting drug users presenting with severe soft tissue infections or sepsis."

      Dave Liddell, of the Scottish Drugs Forum voluntary organisation, said it was suspected that a large batch of heroin was to blame. "It was alarming when it was just centred on Glasgow; now it looks as if its following the drugs supply route," he said.

      Gordon Meldrum, director general of the Scottish Crime and Drug Enforcement Agency, said the spate of deaths was disturbing. "Illegal drugs are often prepared in unhygienic surroundings and can be vulnerable to contamination from various harmful agents.It is highly probable that the contamination of heroin by anthrax is accidental and there is a history of batches of heroin being contaminated in Afghanistan, Turkey and other countries key to the production and supply of heroin.

      "Production processes can be basic and often be conducted in areas where there is contamination from animal carcasses or faeces. Our priority remains to reduce the harm to drug users and the communities they live in and all cases will be investigated and reported where appropriate to the procurator fiscal."

      The sixth casualty was named locally as Colin McPhee, 49, who was well known for begging in Stirling city centre. A neighbour said: "Colin was a wee skinny guy with dark, straggly hair, who was a junkie and begged on the streets ? but he was a harmless wee guy. It's a shame."

      Comment


      • #33
        Re: UK: Several Addicts die as anthrax infects heroin users

        We now have a seventh death. It is not clear if one of the two new confirmed cases is the woman who fled the hospital, or whether she would be a 15th case (or whether she has been ruled out).



        Archive Number 20100111.0126
        Published Date 11-JAN-2010
        Subject PRO/AH/EDR> Anthrax - UK (05): (Scotland)


        ANTHRAX - UNITED KINGDOM (05): (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: 11 Jan 2010
        Source: BBC News [edited]
        <http://news.bbc.co.uk/2/hi/uk_news/scotland/tayside_and_central/8453174.stm>


        A 7th person with anthrax has died as infection among heroin users
        continues to spread around the country, health officials have
        confirmed. The latest person to die was from the NHS Tayside area,
        where one other person with anthrax has died.

        Another case has been confirmed in the NHS Fife area, bringing the
        total number of infected people to 14, Health Protection Scotland said
        .

        The outbreak, thought to be due to contaminated heroin, began in Glasgow.

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

        [The last release from Health Protection Scotland was dated 7 Jan
        2010, which reported 6 deaths among 12 cases:
        <http://www.hps.scot.nhs.uk/news/spdetail.aspx?id=322>, so it would
        seem that the 13th & 14th cases are since that date, and one of them
        promptly died. The CFR remains at 50 percent. A case presenting with a
        systemic anthrax infection is still extraordinarily difficult to save.

        It is clear that we are going to see a steady incidence of new cases
        over the coming weeks of the New Year. - Mod.MHJ]

        [see also:
        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/msp/jw
        *################################################# #########*

        Comment


        • #34
          Re: UK: Several Addicts die as anthrax infects heroin users

          It looks like the woman who fled is confirmed as the 14th case and is back under treatment, so there is not yet a 15th case.



          Another addict dies of anthrax
          By Marjory Inglis, health reporter
          A SECOND drug user from Tayside has died of anthrax infection, bringing the total number of deaths in Scotland caused by the bug to seven.

          The victim is understood to be a 41-year-old man from Dundee.

          Contaminated heroin is believed to have caused the death on Hogmanay of a 55-year-old Dundee drug user. His was the first anthrax death to be recorded on the east coast.

          Health chiefs believe a bad batch of heroin or a contaminated cutting agent which addicts mix with the substance may be responsible and are concerned about the increasing geographical spread of the infection.

          Health Protection Scotland announced the latest death yesterday. Tests confirmed the Dundee man did have anthrax infection.

          A Fife woman previously described as suspected of having anthrax is now confirmed and is continuing to receive treatment.

          Drug users with concerns can call Access Line (Angus) 08452 777778; Addaction (Dundee) 01382 206888; Drug and Alcohol Team (Perth and Kinross) 01738 474455.

          Comment


          • #35
            Re: UK: Several Addicts die as anthrax infects heroin users

            Note the red text - due to the illegal nature of heroin, at least some of these cases are dying without any treatment - this case was apparently found dead on the ground.



            Archive Number 20100113.0149
            Published Date 13-JAN-2010
            Subject PRO/AH/EDR> Anthrax - UK (06): (Scotland)


            ANTHRAX - UNITED KINGDOM (06): (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: 8 Jan 2010
            Source: Scotsman.com [edited]
            <http://news.scotsman.com/scotland/Heroin-contaminated-with-anthrax-could.5965853.jp>


            Heroin contaminated with anthrax could kill 50 addicts in Scotland
            ------------------------------------------------------------------
            Health officials fear that a deadly anthrax outbreak could kill up to
            50 heroin addicts across Scotland after the epidemic claimed its 6th
            victim. The outbreak began in Glasgow but doctors now believe
            contaminated heroin is circulating all over Scotland. They fear the
            death toll could match that of a similar case among Scottish heroin
            addicts in 2000 that claimed 43 lives.

            It was confirmed yesterday [7 Jan 2010] that the 6th person to die was
            a 49-year-old man whose body was found in Stirling city centre
            . He is
            the 1st fatality in the NHS Forth Valley area. There has also been a
            single death in Tayside, another in Lanarkshire, and 4 fatalities in
            Glasgow.

            Dr Colin Ramsay, consultant epidemiologist at Health Protection
            Scotland, which is leading a major inquiry to establish the source of
            the anthrax in the heroin, said contaminated drugs now appeared to be
            spreading all over the country. Dr Ramsay said: "The death of this
            patient in NHS Forth Valley indicates further geographical spread of
            the cases, meaning that heroin users all across Scotland need to be
            aware of the risks of a potentially contaminated supply."

            Dozens more people could be killed by the anthrax-contaminated heroin,
            drug experts warned last night. Andrew Horne, director of operations
            at drug and alcohol charity Addaction, said: "It is very worrying and
            I suppose it shows that we have no clear understanding of how the drug
            market works in terms of supply routes." Heroin contaminated with the
            flesh-eating bug necrotising fasciitis killed 43 addicts in Scotland
            in 2000.


            Mr Horne said the number of deaths caused by the anthrax-infected
            heroin could reach these numbers. He said: "The outbreak in 2000
            lasted about 6 weeks and then we never heard of it again, but because
            it is all illegal there is no way of knowing."

            Gordon Meldrum, Director General of the Scottish Crime and Drug
            Enforcement Agency, who leads on drugs for the Association of Chief
            Police Officers in Scotland, said: "The deaths associated with anthrax
            are disturbing and are being treated very seriously by all the
            relevant authorities. The Scottish Police Service is now coordinating
            the investigation into a number of drug related deaths across the
            country in order to gather as much information as possible about
            possible links and causes."

            [Byline: Mark Smith]

            --
            Communicated by:
            Milton Leitenberg
            <mleitenb@umd.edu>

            [We are getting notices of successful Scottish drug raids and highway
            recoveries. I will only list the news links as they are not strictly
            disease outbreaks:
            9 Oct 2009, Dundee, BPS 16 000
            <http://news.stv.tv/scotland/tayside/129169-man-held-over-dundee-heroin-seizure/>
            31 Oct 2009, A9 Sterling to Perth, BPS 175 000
            <http://news.stv.tv/scotland/133964-second-major-drugs-haul-on-same-road/>
            11 Jan 2010, Dundee, BPS 50 000
            <http://news.stv.tv/scotland/149597-police-make-50000-heroin-seizure/>
            The authorities believe that they are intercepting about 1 percent of
            the heroin.
            <http://files.stv.tv/pdf/heroin-seizure.pdf>

            The 28 Oct 2009 arrest involved 3 men from Liverpool; 29 Oct 2009, 2
            men from Aberdeenshire aged 36, 21; 10 Jan 2010, 4 people -- a
            27-year-old woman from Dundee, a 35-year-old man and a 35-year-old
            woman from Liverpool, and a 41-year-old man from Forfar. I think you
            can appreciate why this Scots situation casts a long shadow across the
            UK.

            Apropos contamination, there is an anecdote from a London drug worker
            about anthrax contaminated Iranian heroin in the 1960s from the
            dealers carrying the heroin around in animal skins. Has anyone any
            memories of this? That it is logical does not mean it is either
            correct or accurate. - Mod.MHJ
            ]

            Comment


            • #36
              Re: UK: Several Addicts die as anthrax infects heroin users

              And this is not confined to the UK.



              Archive Number 20100114.0170
              Published Date 14-JAN-2010
              Subject PRO/AH/EDR> Anthrax - Germany: (NW) fatal, heroin user


              ANTHRAX - GERMANY: (NORTH RHINE-WESTPHALIA) FATAL, HEROIN USER
              ************************************************** ************
              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: Thu 14 Jan 2010
              Source: Eurosurveillance edition 2010; 15(2) [edited]
              <http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19464>


              Preliminary case report of fatal anthrax in an injecting drug user in
              North-Rhine-Westphalia, Germany, December 2009
              ----------------------------------------
              [Rapid communications: D Radun et al]

              A fatal case of anthrax occurred in an injecting drug user in Germany,
              in December 2009. A potential link to similar cases in Scotland in the
              same time period is currently under investigation.

              The Robert Koch Institute, in collaboration with the Friedrich
              Loeffler Institute in Jena, the Federal Research Institute for Animal
              Health, and the respective local and regional health authorities in
              the Aachen district, North-Rhine-Westphalia, Germany, are currently
              investigating a fatal case of anthrax in a 42-year-old male injecting
              drug user.

              The individual was hospitalised on 6 Dec 2009, complaining of a
              swelling of his leg following drug injection into the popliteal fossa
              -- reportedly attempting to inject into a vein. He probably injected
              heroin, however, details are unknown. Following treatment with
              meropenem and surgical debridement of a subsequent necrotising
              fasciitis, the patient died with multiorgan failure on 13 Dec 2009.
              Anthrax had not been suspected clinically.

              Spore-forming bacteria from a wound swab specimen were identified, and
              on 18 Dec [2009], the diagnosis of anthrax was confirmed by PCR. The
              last case of human anthrax in Germany had been reported in 1994, at
              that time affecting a 66-year-old man (1).

              At this point in time, it is not clear whether there is a link between
              this case and the anthrax outbreak among injecting drug users in
              Scotland. As far as we know, the deceased had no travel history to
              Scotland. However, it can be assumed that other drug users in the same
              area in Germany, or perhaps elsewhere in the country, have been
              exposed. In case the hypothesis of a potential link to the Scottish
              cases proves true, it might well be that also other countries have
              been supplied with contaminated injectable drugs.

              We launched an epidemiological investigation and exchanged information
              with the colleagues in the United Kingdom and, in particular, Scotland
              to coordinate the approach.

              So far, the following measures have been taken:
              - we have distributed information to public health colleagues, medical
              care facilities, and low-threshold facilities in Germany to raise
              awareness of the event;
              - we are collecting information on the case and his contacts, and on
              the substances consumed;
              - we attempt further case finding;
              - we aim at a microbiological comparison of isolates to establish a
              potential epidemiological link with the Scottish cases.

              The success of the epidemiological investigation will rely on public
              health authorities' efforts, alertness amongst clinicians and medical
              microbiologists, but also on the degree to which drug users themselves
              can be reached. Therefore, it is of utmost importance to utilise
              existing communication channels to inform those who might be at risk.

              Reference
              ---------
              1. Robert Koch Institute: Ein Fall von Milzbrand im Land
              Niedersachsen. [A case of anthrax in Lower Saxony]. Epid Bull. 1994;
              1:10. German.

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

              [It will be interesting to see if there are any links with the
              Scottish cases. One may expect, if there are, that it would be an
              identical or very similar genotype. I fear that we can now expect more
              sick German heroin users. Prior to the 2009 bovine case -- see below
              -- there was a bovine infected in August 2000. Prior to that there
              were a scattering of bovine and human cases in the early 1990s. -
              Mod.MHJ]


              [An administrative map of Germany is available at
              <http://www.aboutromania.com/maps178.html>.
              Aachen can be located on the HealthMap/ProMED-mail interactive map of
              Germany at
              <http://healthmap.org/r/012E>. - Sr.Tech.Ed.MJ]

              [see also:
              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, bovine - Germany: (BY) 20090803.2730
              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
              2008
              ----
              Anthrax, human - Germany ex France (02) 20081213.3924
              Anthrax, human - Germany ex France 20081211.3897]
              ........................................arn/mhj/mj/jw
              *################################################# #########*

              Comment


              • #37
                Re: UK: Several Addicts die as anthrax infects heroin users

                Assuming the case in Germany in the previous post is confirmed, we know the contamination must have occurred upstream - outside of the UK. The red text necessitates a title change - the word "addict" needs to go.

                The latest headlines and breaking news from Scotland and beyond in The Herald - the longest running national newspaper in the world.


                Seven dead, 14 hospitalised... who is infecting Scotland?s heroin with anthrax?

                The shadowy nature of the heroin trade, and the desperation of addicts, makes tracking and tracing the anthrax doubly hard
                Special Report by Jasper Hamill and Arron Merat

                0 commentsPublished on 17 Jan 2010

                It is a health scare which has seen seven people die in Scotland so far with another 14 hospitalised, yet there is no panic in the streets, few headlines and little fearful talk in homes or in offices.

                The reason for the silence? The victims are all drug addicts, a faceless heroin-injecting underclass, who few care about. In the last month, anthrax-infected heroin has killed four people in the Greater Glasgow and Clyde area, two in Tayside and one in the Forth Valley.

                Although it?s likely that the heroin was infected with anthrax somewhere en route from the poppy fields of Afghanistan, there is no way that police and medics can rule out that the drug was deliberately infected once it arrived in the UK.

                The big problem facing police and doctors struggling to deal with the anthrax scare is that they just don?t know how, where, when, why or at whose hands the heroin became contaminated.

                Was it as a result of the heroin accidentally coming into contact with infected farm material while being stored or in transit from the Middle East to Britain? Was it because a middle man unwittingly used a contaminated bulking agent? Was it done maliciously? And if so, by whom? A callous dealer? Someone targeting Glasgow?s junkies? Even the most far-fetched theories can?t be ruled out.

                Users are concerned, but not concerned enough to stop using Patricia Tracey

                The country?s leading microbiologist, Professor Hugh Pennington, points to the distinct possibility of the anthrax coming into contact with the heroin in the country of origin, yet he also believes that it is possible that the anthrax could have been maliciously added to the heroin inside Britain.

                ?In the UK there used to be problem with anthrax-infected imports, particularly wool from areas east of Turkey,? he said. ?It is no great surprise that it would be prevalent around the areas in Afghanistan where heroin is processed. You can?t completely rule out maliciousness as theoretically ? people would be able to get hold of anthrax in the UK, although you?d need a specialist microbiological knowledge to do so.?

                Police are investigating the labyrinthine heroin supply chain, hoping that if they identify the source of the infection, they will be able to stop further deaths. Find the supplier, the theory goes, and you find and therefore save the customers. But the shadowy drug routes from Afghanistan to Scotland are difficult to trace and health officials are braced for more anthrax cases.

                Some of the main theories about how anthrax spores came to contaminate the heroin, include the possibility that bonemeal, which is sometimes used to cut ? ie, bulk up ? heroin batches came from diseased animals.

                Another theory suggests that the equipment used to manufacture the drug was contaminated. Some peasant producers mix raw opium with water and chemicals in an oil barrel before heating the mixture over a large fire. These barrels may have previously been used to carry diseased meat, cattle feed or even manure.

                Professor Graeme Pearson is a former director general of the Scottish Crime and Drug Enforcement Agency (SCDEA), the country?s leading crime-fighting unit, and is now with Glasgow University?s Unit for the Study of Serious Organised Crime. He has investigated the heroin production process and says he is surprised infections are so rare.

                He said: ?I?ve seen videos of heroin production and it?s a horrible and unhygienic process. It?s surprising that this doesn?t happen more often.?

                Anthrax exists as small, hardy spores that can lay dormant for up to 100 years. If these spores are breathed in, eaten or come into contact with skin, they cause an infection.

                Dr Colin Ramsay, consultant eEpidemiologist at Health Protection Scotland, has been following the anthrax infections ever since the first victim was identified.

                He said: ?The current hypothesis remains that the anthrax cases are linked to contamination of either heroin or a cutting agent.?

                While the police and medics remain temporarily at a loss, it may be thought that Scotland?s addicts themselves might be doing something to save themselves from infection. Sadly, that is far from the case.

                Heroin addicts, experts warn, are too in thrall to their next fix to heed the risks of shooting up with anthrax-infected heroin.

                Patricia Tracey, from Glasgow Drug Crisis Centre, claimed that it was ?unrealistic? to expect addicts to listen to public health warnings. ?Users are concerned, but not concerned enough to stop using,? she warned.

                The recent deaths have exposed the flaws in the Scottish Government?s drugs policy, Jolene Crawford, the head of pressure group Transform Drug Policy Foundation Scotland, claimed.

                She said: ?If it was contaminated beer that was killing these people there would be uproar. But there is no outrage.

                ?It is accepted that some heroin will be lethal because by prohibiting it we gift control to criminals. Were opium and heroin to be legally available via regulated pharmacies and doctors? surgeries, we would not have to see our children, mothers, fathers, brothers and sisters die unnecessarily in this way.?

                Comment


                • #38
                  Re: Europe - Several die as anthrax infects heroin users

                  And the German case in confirmed. Note that that death occurred a month ago - there may other cases that have been missed.



                  Anthrax death from heroin reported in Germany
                  by Ted Purlain on January 18, 2010
                  ShareThis

                  Anthrax
                  Following the deaths of seven heroin users and infections of 14 by anthrax in Scotland, fears have begin to rise in Germany following a fatal case of anthrax in a 24-year-old male injecting drug user.

                  The man, who has not been identified, was hospitalized on December 6, complaining of swelling in his leg following a drug injection. Details are unknown, but it is believed that the man was attempting to inject heroin into a vein.

                  The man was treated with meropenem and received surgical debridement following the subsequent necrotising fasciitis, eventually dying of multiorgan failure on December 13. At the time, anthrax was not suspected.

                  A wound swab specimen revealed spore-forming bacteria which, on December 18, was diagnosed as anthrax.
                  The last case of anthrax in Germany prior to this was reported in 1994, when a 66-year-old man suffered from an anthrax infection.

                  There is currently no known link between this death and the Scotland deaths and the man is not believed to have travelled to Scotland. It is assumed, however, that other drug users in the same area of Germany and even elsewhere in the country have been exposed.

                  If a link to the Scottish cases is shown, the hypothesis is that other countries have also been supplied with injectable drugs contaminated with anthrax.

                  To determine if there is a link, an epidemiological investigation was launched by the Robert Koch Institute in collaboration with the Friedrich Loeffler Institute in Jena, the Federal Research Institute for Animal Health, and local and regional health authorities in the Aachen District, North-Rhine-Wesphalia, Germany. Information was also exchanged with investigators in Scotland.

                  Comment


                  • #39
                    Re: Europe - Several die as anthrax infects heroin users

                    Two points here: One is the alarm this is now raising in France, despite the fact that as of yet, no suspected cases have been found there. Secondly, is the mention of smoking or inhaling heroin, which would result in inhalational anthrax, which in a situation like this, where anthrax might not even be suspect, would be almost 100% fatal.



                    Alarm over anthrax-tainted heroin
                    Posted 1 hour 58 minutes ago

                    The health ministry in France has issued a warning after eight people died and seven fell sick in two European countries from using heroin contaminated by anthrax.

                    "Since December 6, there have been 15 confirmed cases of anthrax among heroin users, 14 in Scotland and one in Germany," the ministry's General Directorate for Health (DGS) said in a statement.

                    "Eight people died," it said. "The likeliest source is heroin contaminated by anthrax spores."

                    Most of the casualties had injected the heroin, but others also inhaled it or smoked it.

                    Anthrax is a potentially lethal bacterium that exists naturally in the soil and can also occur among cattle. It is also, more notoriously, a potential bio-terror weapon.

                    The ministry said the contaminated drug may also be circulating in France and other European countries.

                    "There is no outward sign or colour enabling the user to tell whether the heroin has been contaminated by anthrax, and contaminated heroin dissolves or is used in the same way as uncontaminated heroin," it said.

                    Comment


                    • #40
                      Re: Europe - Several die as anthrax infects heroin users

                      Uh-oh. A 15th confirmed case in Scotland, but 9 suspicious deaths in Portugal. We have a large mess here.



                      Archive Number 20100122.0251
                      Published Date 22-JAN-2010
                      Subject PRO/AH/EDR> Anthrax - UK (08): (Scotland)


                      ANTHRAX - UNITED KINGDOM (08): (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: 22 Jan 2010
                      Source: BBC News [edited]
                      <http://news.bbc.co.uk/2/hi/uk_news/scotland/glasgow_and_west/8476088.stm>


                      Anthrax outbreak cases reach 15
                      -------------------------------
                      A further case of anthrax has been confirmed in a drug user in Scotland,
                      bringing the total number of cases in this outbreak to 15. The new case of
                      the potential killer was confirmed to have taken place in the National
                      Health Service (NHS) Ayrshire and Arran area. So far, the number of anthrax
                      related deaths stands at 7 with cases confirmed in 6 NHS boards.

                      Investigations are continuing into whether contaminated heroin or a cutting
                      agent may be responsible. Dr Colin Ramsay, consultant epidemiologist at
                      Health Protection Scotland, said: "Heroin users all across Scotland need to
                      be aware of the risk that their supply may be contaminated. They should
                      seek medical advice urgently if they experience signs of infection such as
                      redness and swelling of an infection site or high fever. I would urge all
                      drug users to stop using heroin immediately and contact local drug services
                      for support."

                      In addition, any users who continue to inject heroin are strongly
                      recommended not to re-use filters, but to use a fresh filter each time they
                      inject.

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

                      [This new case has been confirmed today, 22 Jan 2010, by Health Protection
                      Scotland: <http://www.hps.scot.nhs.uk/anthrax/index.aspx>

                      This is the 1st case in Ayrshire and Arran -- the affected area is
                      expanding. Previous cases have been in Fife (1), Forth Valley (1 died),
                      Greater Glasgow and Clyde (7 cases, 4 died), Lanarkshire (3), and Tayside
                      (2, both died).

                      At this time 9 suspicious heron-related deaths are being reported in
                      Coimbra, Portugal, but that means nothing until there is confirmation other
                      than there is widespread awareness of the risk in Europe
                      . As heroin in the
                      Americas does not come from Afghanistan the perception of risk in the
                      Americas is seen as minimal for the present.

                      Various related documents have been published, which members may read if
                      they wish. They are discussions on what is or might be going on. Remember
                      that if heroin-associated cases outside Scotland are or are not the same
                      genotype as the Scottish heroin infections the arguments change accordingly:
                      <http://www.heraldscotland.com/news/health/seven-dead-14-hospitalised-who-is-infecting-scotland-s-heroin-with-anthrax-1.999281>

                      <http://stopthedrugwar.org/chronicle/617/anthrax_heroin_deaths_scotland_germany>


                      Plus: Mark Beatty, et al. Gastrointestinal anthrax: review of the
                      literature. Arch Intern Med 2003; 163: 2527-31. - Mod.MHJ

                      The interactive HealthMap/ProMED map of Scotland is available at
                      <http://healthmap.org/r/00a8> - CopyEd.EJP]

                      [see also:
                      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
                      PRO/AH/EDR> Anthrax, human - UK: (Scotland) heroin users 20091217.4270]

                      .......................mhj/ejp/sh

                      Comment


                      • #41
                        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.

                        Os Diários de Coimbra, Aveiro, Viseu e Leiria são os jornais diários regionais mais lidos do país. Publicam notícias dos seus distritos e região das Beiras.


                        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.

                        Comment


                        • #42
                          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.



                          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.

                          Comment


                          • #43
                            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.
                            The salvage of human life ought to be placed above barter and exchange ~ Louis Harris, 1918

                            Comment


                            • #44
                              Re: Europe - Several die as anthrax infects heroin users

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

                              Os Diários de Coimbra, Aveiro, Viseu e Leiria são os jornais diários regionais mais lidos do país. Publicam notícias dos seus distritos e região das Beiras.


                              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."

                              Comment


                              • #45
                                Re: Europe - Several die as anthrax infects heroin users


                                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)

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