Pubdate: Sun,  4 Jun 2000
Source: Independent, The (UK)
Copyright: 2000 Independent Newspapers (UK) Ltd.
Contact:  1 Canada Square, Canary Wharf, London E14 5DL
Website: http://www.independent.co.uk/
Author: Robert Mendick

HEROIN DEATHS EPIDEMIC BAFFLES SCIENTISTS

Scientists last night admitted that an unknown illness that has so far
killed 31 heroin addicts in the UK and Ireland has reached "epidemic
proportions".

Teams of medical specialists, and a squad of detectives are now
working round the clock to solve the mystery of what the illness is
and where it came from. They are increasingly concerned at the speed
at which the death toll is rising and the spread of the deaths to
locations in England in the past few days.

Experts from leading research laboratories worldwide have been called
in, but remain mystified as to the cause of the sudden and agonising
deaths, first reported in Glasgow at the start of April and whose
latest victims were announced last Friday.

Microbiologists suspect that the cause is a form of bacteria they have
never seen before, but they have not isolated it despite weeks of
tests on samples at laboratories including the world's leading disease
control centre in Atlanta, Georgia, and the chemical defence
establishment at Porton Down, Wiltshire.

The Porton Down lab was asked to look for traces of anthrax but found
none. Attention is now centring on an unknown variant of an existing
bacteria, most likely botulism, which is one of the deadliest toxins.

Police, led by a detective superintendent with the Strathclyde force,
have set up a round-the-clock team entering data on "Holmes" (Home
Office Large Major Enquiry System) to see if it can come up with
answers. It is normally used in conventional homicides.

Although a bacterium is the most likely cause, some strain of virus is
not being ruled out. Scientists do not believe the illness can spread
from person to person, as with HIV, but admit they cannot be sure, and
medical staff handling bodies and patients are taking no risks.

Dr Laurence Gruer, public health consultant at the Greater
Glasgow Health Board, told the Independent on Sunday: "In
strict public-health terms it is now an epidemic. It has
reached a level of infection well above the normal. We have
never come across anything like this. We have no way of
knowing how big it is."

Dr Gruer ventured that the heroin had been imported through Liverpool,
then distributed to Dublin and Glasgow. "One theory is it has come
from Liverpool. There are no deaths in Liverpool but that could be
because it came in there and was then moved on."

The 31 deaths are from a total of 63 reported cases. There have been
16 deaths in Scotland (14 in Glasgow and two in north-east Scotland)
eight in Dublin and seven, announced on Friday night by the Public
Health Laboratory Service, in England.

The condition seems to affect heroin addicts who inject into muscle
rather than a vein. Addicts normally inject into a muscle only because
they can no longer find a vein because of heavy drug use. Infection
spreads from an abscess formed at the point of injection but rapidly
moves through the body causing total breakdown of the vital organs,
especially the heart. Death is agonising and usually occurs in hours.
Antibiotics and all known treatments cannot prevent it.

By 19 May, the Greater Glasgow Health Board had grown so alarmed by
the number of deaths that it issued a warning on the European
Infection Warning System. Ireland's public health bodies began
studying deaths among heroin users and public health doctors in
England and Wales are now doing the same.

Professor Brian Duerden, deputy director of the Public Health
Laboratory Service, said: "It is not something that has been reported
before."

Leading epidemiologists were sent last week from the Infectious
Diseases Centre in Atlanta, with Dr Kristy Murray working with a team
in Dublin and Dr Jai Lingappa in Glasgow. A spokesman in Atlanta said:
"This is a rare illness, that's for sure. But we have to get to the
bottom of this as soon as possible."
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