Pubdate: Thu, 18 May 2000
Source: Guardian, The (UK)
Copyright: 2000 Guardian Newspapers Limited
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Author: James Meek, Science Correspondent

ANTHRAX LINK TO DEATHS OF 11 SCOTTISH HEROIN ADDICTS

Government analysts said yesterday that evidence of anthrax had been found 
in victims of a mysterious disease that has killed 11 Scottish heroin 
addicts in recent weeks and left 15 more in hospital.

Scientists at Porton Down, Wiltshire, confirmed a report in the forthcoming 
issue of New Scientist magazine that antibodies against anthrax spores have 
been found in blood samples from two of the victims. The anthrax theory is 
expected to be confirmed or ruled out by the end of the week after further 
tests.

If confirmed, the deaths suggest that a consignment of heroin contaminated 
with the deadly bacterium is loose on the streets of Europe.

However, Glasgow health officials yesterday played down the theory, saying 
the Porton Down findings were only weak, indirect evidence.

"I'm very sceptical," said Laurence Gruer, consultant in public health 
medicine on Greater Glasgow health board. "I can't 100% rule it out, but I 
would have expected a lot more evidence for anthrax."

Cases of dead and dying heroin users with similar and unusual symptoms 
began to pile up on Dr Gruer's desk at the end of last month. The 11th 
victim died on Tuesday.

All had injected the drug into their muscles, rather than their veins, 
either by accident or because scars from overuse of a needle meant that 
free-flowing blood could no longer be found in surface veins. Many of the 
victims have been women, whose veins tend to be less accessible than men's.

The anthrax connection was first mooted by scientists at the centre for 
applied microbiology and research, which is alongside the Ministry of 
Defence's biological warfare lab at Porton Down but is run by the 
Department of Health.

They noticed a report from Norway, posted on the internet, of an Oslo 
addict who died in April after injecting heroin into his muscle. A 
postmortem showed anthrax bacilli in his spinal fluid. Aware of the deaths 
in Scotland, CAMR asked the Glasgow health board to send some samples.

A CAMR spokesman, Phil Luton, said: "We got two very weak positives, which 
is not conclusive evidence of anthrax, but we can't rule it out and are 
continuing to test."

The victims' symptoms were indicative of anthrax, he said. Phil Hanna, an 
anthrax specialist at the University of Michigan at Ann Arbor, made the 
same observation in the New Scientist report.

The Scottish victims - 10 from Glasgow, one from Aberdeen - all died in a 
similar way: several hours after injecting they had accumulated symptoms 
including a heavy build-up of fluid, leakage of fluids round the heart and 
lungs, and rapidly rising white blood cell counts as their metabolism 
rallied to fight a major infection.

Dr Gruer said he hoped to get the further test results from CAMR today or 
tomorrow.

Besides the Porton Down tests, he said, Glasgow specialists had been 
culturing blood and tissue samples from the victims to see if anthrax 
spores could be detected through a microscope, but with negative results.

Other theories have included necrotising fasciitis, known as flesh-eating 
disease, or alternative contaminants in heroin, or the citric acid used by 
addicts to dissolve heroin in water to make an injectable solution.

The muscle-injecting addicts have complained that lately they have had to 
use more acid than usual, causing a burning sensation and, doctors 
speculate, severe muscle damage.

Dr Gruer said one possibility was that the muscle damage had combined with 
minor bacterial infections to cause the addicts' deaths.

Anthrax is not passed from person to person, so there is no risk of an 
epidemic outside the heroin-injecting community even if it turns out to be 
the cause.

It is not clear how it may have contaminated heroin, although the bacterium 
is endemic in livestock in prime heroin poppy growing regions such as 
Afghanistan.
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MAP posted-by: Keith Brilhart