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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.”

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