The ongoing anthrax outbreak in Europe seen in injectable heroin users increased by one case, after the British Health Protection Agency (HPA) officials reported a fatality in a Medway drug user who had an anthrax infection, according to an HPA press release Dec. 19.

European health officials say that 13 injectable heroin users have been infected with anthrax since the outbreak began in June.

The distribution of the cases are as follows:

Including the Medway case, the total number affected in the UK is six – four in England (including three fatalities), one in Scotland and one in Wales. In addition, four cases have been reported in Germany, two in Denmark and one in France.

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 infections among people who inject drugs at the HPA, said: “Anthrax can be cured with antibiotics, if treatment is started early. It is therefore important for medical professionals to be alert to the possibility of anthrax infection in heroin users presenting with signs and symptoms – which include severe soft tissue infections or blood poisoning – to prevent any delays in providing treatment.

“It is possible that further cases may be seen in people who inject heroin. People who use drugs may become infected with anthrax when the heroin they use 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.”

Anthrax is primarily a disease of livestock; however, humans can become infected with this lethal pathogen via occupational or incidental exposure and most recently, it has been used as an agent of bioterrorism.

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